Defective mitochondrial function has been observed in type 2 diabetes and is proposed to be a major contributing factor in the pathogenesis and progression of the disease (1, 2). Although the mechanism leading to mitochondrial dysfunction in diabetes remains under intensive investigation, a critical role for nonesterified fatty acids (NEFA) 2 and/or fatty acid metabolites is emphasized by an increasing body of evidence (3-5). NEFA may influence mitochondrial function by alterations in gene expression (6), metabolism (7), and/or mitochondrial Ca 2ϩ homeostasis (8, 9). Ionic Ca 2ϩ in the mitochondria regulates substrate oxidation by activation of mitochondrial dehydrogenases (9). Deficiency of pyruvate dehydrogenase (PDH) activity in pancreatic islet -cells (10), cardiomyocytes (11), and skeletal muscles (7, 12, 13) has been demonstrated in diabetes. The degree to which PDH is dephosphorylated (i.e. the balance between phosphorylation and dephosphorylation) determines the level of enzyme activity. The concentration of mitochondrial Ca 2ϩ ([Ca 2ϩ ] m ) is an important activator of PDH phosphatase, which dephosphorylates and activates PDH. Additionally, [Ca 2ϩ ] m has been shown to activate at least three other mitochondrial dehydrogenases (i.e. glycerol 3-phosphate dehydrogenase, NAD-linked isocitrate dehydrogenase, and 2-oxoglutarate dehydrogenase), all of which play important roles in substrate oxidation (9). NEFA, which are chronically elevated in type 2 diabetes, inhibit PDH by mechanisms thought to involve FA oxidation and elevation of acetyl-CoA. We have previously reported that polyunsaturated fatty acids (PUFA) induce Ca 2ϩ efflux from mitochondria (8), an action that could deplete [Ca 2ϩ ] m and thus contribute to NEFA-responsive reduction of PDH activity and mitochondrial dysfunction. The PUFA-induced mitochondrial Ca 2ϩ efflux (PIMCE) cannot be blocked with cyclosporine A and bongkrekic acid, two inhibitors of the mitochondrial permeability transition pore. However, the pathway(s) underlying PIMCE has not previously been defined.In the current work, we have used proteomic analysis to demonstrate a parallel reduction in PIMCE and the level of heat shock protein 901 (hsp901) in NT2 cells treated with retinoic acid (RA). Further studies with pharmacological inhibitors and RNA interference (RNAi) indicate that hsp901 plays an essential role in PIMCE in NT2 cells.