Resistance to leishmanial infections depends on intracellular parasite killing by activated host macrophages through the L-arginine-nitric oxide (NO) metabolic pathway. Here we investigate the cell death process induced by NO for the intracellular protozoan Leishmania amazonensis. Exposure of amastigotes to moderate concentrations of NO-donating compounds (acidified sodium nitrite NaNO 2 or nitrosylated albumin) or to endogenous NO produced by lipopolysaccharide or gamma interferon treatment of infected macrophages resulted in a dramatic time-dependent cell death. The combined use of several standard DNA status analysis techniques (including electrophoresis ladder banding patterns, YOPRO-1 staining in flow cytofluorometry, and in situ recognition of DNA strand breaks by TUNEL [terminal deoxynucleotidyltransferase-mediated dUTPbiotin nick end labeling] assay) revealed a rapid and extensive fragmentation of nuclear DNA in both axenic and intracellular NO-treated amastigotes of L. amazonensis. Despite some similarities to apoptosis, the nuclease activation responsible for characteristic DNA degradation was not under the control of caspase activity as indicated by the lack of involvement of cell-permeable inhibitors of caspases and cysteine proteases. In contrast, exposure of NO-treated amastigotes with specific proteasome inhibitors, such as lactacystin or calpain inhibitor I, markedly reduced the induction of the NO-mediated apoptosis-like process. These data strongly suggest that NO-induced oligonucleosomal DNA fragmentation in Leishmania amastigotes is, at least in part, regulated by noncaspase proteases of the proteasome. The determination of biochemical pathways leading up to cell death might ultimately allow the identification of new therapeutic targets.Leishmania spp. are obligate intracellular protozoan parasites of macrophages that are responsible for a wide range of human diseases, including self-healing skin lesions, diffuse cutaneous and mucosal lesions, or fatal visceral infections. In the Leishmania life cycle, two principal parasite forms exist: (i) the amastigote form that develops inside mononuclear phagocytes of a vertebrate host and (ii) the motile promastigote form that develops in the vector gut. The various possible outcomes of leishmanial infection have been associated with expansion of specific T helper lymphocyte populations (52). Immune control of leishmaniasis involves a dominant Th1 response, leading to macrophage activation and elimination of intracellular parasites through the induction of nitric oxide synthase (NOS II) and NO synthesis from L-arginine. This prototypical model has been largely evidenced in murine leishmaniasis (17,22,33). Human activated macrophages can also induce antileishmanial activity via the L-arginine NO pathway (44,58,60). Studies on human cutaneous leishmaniasis reveal that Leishmania killing is associated with NO production (40). Moreover, the capacity of canine macrophages to eliminate intracellular amastigotes through a NO-dependent mechanism has been docum...