We used Saccharomyces cerevisiae as a model system in which to examine the mechanism of action of the anti-Pneumocystis drug pentamidine. Pentamidine at low concentrations inhibited S. cerevisiae growth on nonfermentable carbon sources (50%o inhibitory concentration [IC50] of 1.25 ,ug/ml in glycerol). Pentamidine inhibited growth on fermentable energy sources only at much higher concentrations (IC50 of 250 ,ug/ml in glucose). Inhibition at low pentamidine concentrations in glycerol was due to cytostatic activity rather than cytotoxic or mutagenic activity. Pentamidine also rapidly inhibited respiration by intact yeast cells, although inhibitory concentrations were much higher than those inhibitory to growth (IC50 of 100 ,ug/ml for respiration).Pentamidine also induced petite mutations, although only at concentrations much higher than those required for growth inhibition. These results suggest that a function essential for respiratory growth is inhibited by pentamidine and that pentamidine affects mitochondrial processes. We propose the hypothesis that the primary cellular target of pentamidine in S. cerevisiae is the mitochondrion.Pentamidine is widely used for the prophylaxis and treatment of Pneumocystis carinii pneumonia in AIDS patients (32). Pentamidine is also used to treat African trypanosomiasis and leishmaniasis (33). Unfortunately, pentamidine is not always effective, and it frequently causes undesirable side effects (21). Although pentamidine has been used in clinical settings for 40 years, uncertainty remains about its mechanism of action. In addition, widespread use of pentamidine as a prophylactic provokes concern over the evolution of pentamidine resistance in P. carinii (32,35). Resistance to pentamidine, both natural and acquired, occurs in trypanosomes (11,17).Although one can investigate the effects of pentamidine on P. carinii by using immunocompromised animals (20) or an in vitro microculture test system (6), detailed studies are hindered by the inability to culture P. carinii in vitro. Therefore, we have identified a model organism, Saccharomyces cerevisiae, that is sensitive to pentamidine under appropriate conditions and that can be readily manipulated by sophisticated biological techniques.In phylogenetic terms, S. cerevisiae is an appropriate model for P. carinii. Considerable molecular and morphologic evidence indicates that P. carinii is a fungus (29). Molecular similarities of P. carinii to the fungi include not only the rRNA genes (14, 30) but also many other genes, such as the dihydrofolate reductase (13) and thymidylate synthase (15) genes. An authoritative analysis of the rRNA phylogeny, including appropriate outgroups, indicates that P. carinii diverged from (or within) the Ascomycetes lineage very early in fungal evolution, such that P. carinii is as closely related to S. cerevisiae as it is to any other known fungus (5).Pentamidine has been implicated in the inhibition of a bewildering variety of cellular processes in various systems (10,12,18,23,25,26). Much recent work has f...