In murine embryonic fibroblasts, N-acetyl-L-cysteine (NAC), a GSH generating agent, enhances hypoxic apoptosis by blocking the NFB survival pathway (Qanungo, S., Wang, M., and Nieminen, A. L. (2004) J. Biol. Chem. 279, 50455-50464). Here, we examined sulfhydryl modifications of the p65 subunit of NFB that are responsible for NFB inactivation. In MIA PaCa-2 pancreatic cancer cells, hypoxia increased p65-NFB DNA binding and NFB transactivation by 2.6-and 2.8-fold, respectively. NAC blocked these events without having an effect on p65-NFB protein levels and p65-NFB nuclear translocation during hypoxia. Pharmacological inhibition of the NFB pathway also induced hypoxic apoptosis, indicating that the NFB signaling pathway is a major protective mechanism against hypoxic apoptosis. In cell lysates after hypoxia and treatment with N-ethylmaleimide (thiol alkylating agent), dithiothreitol (disulfide reducing agent) was not able to increase binding of p65-NFB to DNA, suggesting that most sulfhydryls in p65-NFB protein were in reduced and activated forms after hypoxia, thereby being blocked by N-ethylmaleimide. In contrast, with hypoxic cells that were also treated with NAC, dithiothreitol increased p65-NFB DNA binding. Glutaredoxin (GRx), which specifically catalyzes reduction of protein-SSG mixed disulfides, reversed inhibition of p65-NFB DNA binding in extracts from cells treated with hypoxia plus NAC and restored NFB activity. This finding indicated that p65-NFB-SSG was formed in situ under hypoxia plus NAC conditions. In cells, knock-down of endogenous GRx1, which also promotes protein glutathionylation under hypoxic radical generating conditions, prevented NAC-induced NFB inactivation and hypoxic apoptosis. The results indicate that GRx-dependent S-glutathionylation of p65-NFB is most likely responsible for NAC-mediated NFB inactivation and enhanced hypoxic apoptosis.Tumor hypoxia is strongly associated with tumor propagation, malignant progression, and resistance to chemo-and radiation therapy (1). NFB 2 is a redox-regulated transcription factor that is activated during hypoxia (2, 3). NFB belongs to the Rel family, which includes five mammalian Rel/NFB proteins: RelA (p65), c-Rel, RelB, NFB1 (p50/p105), and NFB2 (p52/ p100) (4). The inactive form of NFB is localized in the cytoplasm as p65:p50 (the most abundant form) or p50:cRel heterodimers through interaction with IB repressor proteins (IB␣, IB, IB␥, and IB⑀) (5). Once activated, NFB translocates to the nucleus, where it binds to DNA and activates various target genes including Bcl-xL, Bcl-2, a hematopoieticspecific Bcl-2 homologue A1, caspase-8-FADD-like interleukin-1-converting enzyme inhibitory protein, tumor necrosis factor receptor-associated factors 1 and 2, cellular inhibitors of apoptosis, and X chromosome-linked inhibitor of apoptosis (XIAP/hILP) (6, 7).NFB family proteins have a conserved domain of ϳ300 amino acids in the amino-terminal region known as the Rel homology region. The Rel homology region consists of a DNA binding domain, a dimerization d...