Summary In mammalian cells, there are two isoforms of DNA topoisomerase 11, designated a (170-kDa form) and ,B (180-kDa form). Previous studies using cell lines have shown that the topoisomerase Ila and [ isoforms are differentially regulated during the cell cycle and in response to changes in growth state. Moreover, both isoforms can act as targets for a range of anti-tumour drugs. Here, we have analysed the normal tissue distribution in humans of topoisomerase Ila and f using isoform-specific antibodies. In addition, we have studied expression of these isoforms in 69 primary tumour biopsies, representative either of tumours that are responsive to topoisomerase 11-targeting drugs (breast, lung, lymphoma and seminoma) or of those that show de novo drug resistance (colon). Topoisomerase lla was expressed exclusively in the proliferating compartments of all normal tissues, and was detectable in both the cell nucleus and cytoplasm. In biologically aggressive or rapidly proliferating tumours (e.g. high-grade lymphomas and seminomas), there was a high level of topoisomerase Ila, although expression was still detectable in colon tumours, indicating that expression of this isoform is not sufficient to explain the intrinsic drug resistance of colon tumours. Topoisomerase Ill was expressed ubiquitously in vivo and was localized in both the nucleoli and the nucleoplasm. This isoform was present in quiescent cell populations, but was expressed at a generally higher level in all tumours and proliferating cells than in normal quiescent tissues. We conclude that topoisomerase Ila is a strict proliferation marker in normal and neoplastic cells in vivo, but that topoisomerase ll[ has a much more general cell and tissue distribution than has topoisomerase Ila. The apparent up-regulation of topoisomerase II,B in neoplastic cells has implications for the response of patients to anti-tumour therapies that include topoisomerase Il-targeting drugs.Keywords: topoisomerase Ila; topoisomerase P; immunochemistry Topoisomerase II is a homodimeric nuclear protein with many different roles in DNA metabolism, including relief of torsional stress and mitotic chromosome condensation and segregation (reviewed in Wang, 1985(reviewed in Wang, , 1991Watt and Hickson, 1994). Topoisomerase II is also one of the most important determinants of cellular sensitivity to a range of clinically important anti-tumour drugs. For example, topoisomerase II is the primary cellular target for several intercalating agents, including doxorubicin, mitoxantrone and epirubicin, as well as for the non-intercalating epipodophyllotoxins, etoposide and teniposide (reviewed in Osheroff et al, 1991;Pommier, 1993;Beck et al, 1993). Topoisomerase II is a so-called type II enzyme, defined as acting via the creation of double-stranded breaks in DNA, through which an intact DNA duplex is passed, before the break is resealed. As part of this breakage and religation process, a transient reaction intermediate is generated, termed the cleavage complex, consisting of a topoisomerase...