Macrophages play a pivotal role in the pathogenesis of a variety of diseases. These studies were performed to characterize the mechanisms by which Toll-like receptor 4 (TLR4)-mediated NF-B activation promotes resistance to cell death in macrophages. When NF-B activation was inhibited by a super-repressor, IB␣, the TLR4 ligand lipopolysaccharide induced the activation of caspase 8, the loss of mitochondrial transmembrane potential (⌬⌿ m ), and apoptotic cell death in macrophages. The inhibition of caspase 8 activation suppressed DNA fragmentation but failed to protect macrophages against the loss of ⌬⌿ m and resulted in necrotic cell death. In contrast, the reduction of receptor-interacting protein 1 suppressed the loss of ⌬⌿ m and inhibited apoptotic cell death. Further, when caspase 8 activation was suppressed, the knock down of receptor-interacting protein inhibited the loss of ⌬⌿ m and necrotic cell death. These observations demonstrate that following TLR4 ligation by lipopolysaccharide, NF-B is a critical determinant of macrophage life or death, whereas caspase 8 determines the pathway employed.Macrophages play a pivotal role in infection, atherosclerosis, and chronic inflammation such as observed in rheumatoid arthritis. The ligation of Toll-like receptors (TLRs) 3 activates intracellular signal transduction pathways, including NF-B (1). Expressed on macrophages and monocytes, TLR4 is critical for the recognition of lipopolysaccharide (LPS) from Gram-negative bacteria. Recent studies have demonstrated that endogenous TLR4 ligands are highly expressed at sites of chronic inflammation, characterized by the accumulation of macrophages, such as the joints of patients with rheumatoid arthritis (2-8). Resistance to apoptosis may contribute to the persistence of chronic inflammation (9). Therefore, microbial and endogenous TLR4 ligands may promote resistance to apoptosis through the activation of NF-B.Apoptosis may be initiated by two different pathways, the death receptor-mediated pathway and the mitochondria-dependent pathway.Death receptors, such as Fas and TNFR1, possess intracellular death domains that may initiate apoptosis through the recruitment of Fasassociated death domain protein (FADD) and the activation of caspase 8. Activated caspase 8 may directly activate caspase 3, which results in apoptotic cell death (reviewed in Ref. 9). In the mitochondria-dependent pathway, apoptotic signals induce the loss of mitochondrial integrity and the release of pro-apoptotic molecules, including cytochrome c. Once in the cytosol, cytochrome c binds to apoptotic protease activating factor-1, resulting in activation of caspases 9 and 3, thus triggering apoptosis (10). These two pathways may be linked by the pro-apoptotic Bcl-2 family member Bid, which may be cleaved by caspase 8, resulting in truncated Bid (tBid), which may trigger the mitochondrial pathway.Although TLR4 ligation induces NF-B activation, which may promote cell survival through the induction of anti-apoptotic genes, recent evidence has demonstrated that ...