Three oxidized analogs of cholesterol have been characterized for their ability to cause apoptotic cell death in CEM-C7-14 human leukemic cells. In addition to testing 15-ketocholestenol (K15), 15-ketocholestenol hydroxyethyl ether (CK15), and 7-ketocholesterol hydroxyethyl ether (CK7), an oxysterol of known apoptotic response, 25-hydroxycholesterol (25OHC), served as a standard for comparison. Growth studies based on dye exclusion by viable cells while using a sublethal concentration of oxysterols ranked their potency for cell kill as 25OHC > K15 > CK15 > CK7. Both the TUNEL assay (terminal deoxynucleotidyl transferase-mediated dUTP-X nick end labeling), which quantifies the amount of DNA nicks caused by a toxic agent, and the MTT assay, which measures cell metabolism and thus reflects cell viability, substantiated the same rank order. An ELISA assay for evaluating release of DNA fragments into the cytosol after treatment gave a similar potency order. The oncogene c-myc mRNA was suppressed by all three oxysterols, with 25OHC and K15 being the most potent suppressors. Hoechst and Annexin V staining documented that these oxysterols kill cells by an apoptotic pathway as evidenced by condensation of nuclear chromatin and plasma membrane inversion, respectively. From these in vitro studies, we believe that 25OHC, K15, and possibly CK15 have the potential to be chemotherapeutic agents.Paper no. L8259 in Lipids 35, 305-315 (March 2000).Both glucocorticoids and oxysterols can cause apoptosis of certain cells. For this action, glucocorticoids require a specific cytosolic protein, the glucocorticoid receptor (GR). No oxysterol receptor has been unequivocally identified, although two cellular proteins do specifically bind oxysterols: the oxysterol binding protein (OBP) and LXR, a member of the nuclear receptor family of proteins. As yet it is not certain that either protein is required for oxysterols' apoptotic actions. In our test system, the human leukemic cell line CEM, analysis of the events following addition of either class of steroid shows similarities at several points. These include a delay of about 1 d before the activation of caspases and nucleases, which occurs around the time of overt apoptosis. During this initial phase of cell death when the steroidal effects can be reversed, both types of steroids cause profound suppression of the oncogene product, cMyc (1,2). Because of their apoptotic action, glucocorticoids are used widely as antileukemic drugs. The similarity of effects of oxysterols suggests that they also might have therapeutic usefulness, alone, or in conjunction with glucocorticoids. Oxysterols are able to elicit changes in cholesterol synthesis, cell growth, and membrane composition, and can cause immunosuppression (3-8). These activities have led to many studies of oxysterols, usually as toxins in the environment and foods (9,10), or as implicated in atherosclerosis (11-14). The relatively greater sensitivity of certain malignant, as opposed to normal, cells offers an opportunity to use...