The stress response and cell survival are necessary for normal pancreatic β-cell function, glucose homeostasis, and prevention of diabetes. The homeodomain transcription factor and human diabetes gene pancreas/duodenum homeobox protein 1 (Pdx1) regulates β-cell survival and endoplasmic reticulum stress susceptibility, in part through direct regulation of activating transcription factor 4 (Atf4). Here we show that Atf5, a close but less-studied relative of Atf4, is also a target of Pdx1 and is critical for β-cell survival under stress conditions. Pdx1 deficiency led to decreased Atf5 transcript, and primary islet ChIP-sequencing localized PDX1 to the Atf5 promoter, implicating Atf5 as a PDX1 target. Atf5 expression was stress inducible and enriched in β cells. Importantly, Atf5 deficiency decreased survival under stress conditions. Loss-of-function and chromatin occupancy experiments positioned Atf5 downstream of and parallel to Atf4 in the regulation of eIF4E-binding protein 1 (4ebp1), a mammalian target of rapamycin (mTOR) pathway component that inhibits protein translation. Accordingly, Atf5 deficiency attenuated stress suppression of global translation, likely enhancing the susceptibility of β cells to stress-induced apoptosis. Thus, we identify ATF5 as a member of the transcriptional network governing pancreatic β-cell survival during stress.educed pancreatic β-cell number and function characterize all forms of diabetes. Insulin-secreting β cells are notoriously susceptible to stress, including endoplasmic reticulum (ER), cytokine, and oxidative stress (1-4). Thus, understanding apoptotic cell-fate decisions during stress could provide new targets that could be exploited for the prevention or amelioration of diabetes.In secretory cells such as the β cell, the unfolded protein response (UPR) and regulation of translation, particularly in response to stress, are key factors in maintaining cellular homeostasis, as clearly demonstrated in mouse models with deficiencies of critical regulators such as protein kinase R-like ER kinase (PERK) and EIF2α (5-7). In humans, PERK mutation causes Wolcott-Rallison syndrome, a rare autosomal recessive disorder characterized by permanent neonatal diabetes (8, 9). Downstream of PERK, the basic leucine zipper (bZIP) transcription factor activating transcription factor 4 (ATF4) regulates the expression of 4ebp1, a member of the eukaryotic translation initiation factor 4E (eIF4E)-binding protein family (4EBPs). 4EBP1 is the most abundant mammalian isoform in the pancreas (10) and functions as an inhibitor of translation initiation by binding the capbinding protein eIF4E, thereby preventing formation of the eIF4F translational initiation complex (11,12). Expression of 4EBP1 is induced by stress, and 4ebp1 deficiency results in deregulated translational control and increased susceptibility to ER stressmediated apoptosis in β cells (13).We previously demonstrated that the homeodomain transcription factor and human diabetes gene pancreas/duodenum homeobox protein 1 (Pdx1) regulates p...