High linear energy transfer (LET) ionizing radiation (IR) kills more cells as compared with low LET IR at the same doses. High LET IR is induced by high-charge (HZE) particles (a component in space radiation), high energy ions or by a special clinical radiotherapy machine. Low LET IR includes X or Îł ray (a major component of IR from standard clinical radiotherapy machines), etc. The more cell death induced by high LET IR than by low LET IR at the same dose reflects a relative biological effectiveness (RBE). RBE on all kinds of quantitative effects induced by IR in X-ray exposed cells is 1. The RBE of cell killing induced by high LET IR is ~2-4 in cultured cells (killing ~2-4 times the number of cells at the same dose) depending on cell type. The induction of DNA double strand breaks (DSBs) either by high LET IR or by low-LET IR is a severe threat to genomic integrity that determines radiosensitivity (short term effect) and carcinogenesis (long term effect). It is believed that the higher RBE on cell killing by high LET IR is because of ineffective rejoining of DNA DSBs. [1][2][3][4] Two major DNA DSB repair pathways exist in eukaryotic cells, homologous recombination repair (HRR) and non-homologous end joining (NHEJ). Recently our group and others showed that high LET IR killing more cells than low LET IR is mainly due to the inhibition of Ku-dependent NHEJ. 5,6 After induction of DSBs, proliferating cells actively slow down cell cycle progression via checkpoint activation to provide time for repair. Previously, we and others showed that IR-induced checkpoint response mainly promotes HRR and has little effect on NHEJ. 7-10 These results provide important information that because the NHEJ pathway is inhibited in high LET irradiated cells, HRR might play a more protective role in such cells than that in low LET irradiated cells; because checkpoint facilitates mainly the HRR pathway, checkpoint response might be a more efficient factor for modifying cell sensitivity to high LET IR than to low LET IR. To test this hypothesis, we examined and analyzed the RBE on sensitivity in ATM or ATR, the two most important checkpoint genes, deficient or kinase dead cell lines following either high LET or low LET IR. The results support our hypothesis: both the cell lines either deficient in ATM or with kinase dead ATR, show higher RBE than their wild type counterpart cells (Fig. 1A and B). The RBE difference at 2 Gy is 3 times between AT cells and their wild type counterpart and is 5 times between ATR cells and their wild type counterpart (Fig. 1C). These results indicate that checkpoint response plays a more protective role in HZE particleirradiated cells than in X ray-irradiated cells, suggesting that checkpoint response is a more efficient target for modifying cell sensitivity to high LET IR than that to low LET IR.