Bok is a member of the Bcl-2 protein family that governs the intrinsic apoptosis pathway, although the role that Bok plays in this pathway is unclear. We have shown previously in cultured cell lines that Bok interacts strongly with inositol 1,4,5-trisphosphate receptors (IP 3 Rs), suggesting that it may contribute to the structural integrity or stability of IP 3 R tetramers. Here we report that Bok is similarly IP 3 R-assocated in mouse tissues, that essentially all cellular Bok is IP 3 R bound, that it is the helical nature of the Bok BH4 domain, rather than specific amino acids, that mediates binding to IP 3 Rs, that Bok is dramatically stabilized by binding to IP 3 Rs, that unbound Bok is ubiquitinated and degraded by the proteasome, and that binding to IP 3 Rs limits the pro-apoptotic effect of overexpressed Bok. Agents that stimulate IP 3 R activity, apoptosis, phosphorylation, and endoplasmic reticulum stress did not trigger the dissociation of mature Bok from IP 3 Rs or Bok degradation, indicating that the role of proteasome-mediated Bok degradation is to destroy newly synthesized Bok that is not IP 3 R associated. The existence of this unexpected proteolytic mechanism that is geared toward restricting Bok to that which is bound to IP 3 Rs, implies that unbound Bok is deleterious to cell viability and helps explain the current uncertainty regarding the cellular role of Bok.Bok is a member of the Bcl-2 protein family that controls the intrinsic apoptosis pathway (1-3). Bok contains four Bcl-2 homology domains (BH1-4) 2 and shares greatest sequence homology with the pro-apoptotic proteins Bak and Bax (1-4). However, unlike Bak and Bax, which have clearly defined roles in mediating mitochondrial outer membrane permeabilization (5, 6), the cellular role of Bok is unclear. Key observations that pertain to our current understanding of the function of Bok are (i) that the atypical C-terminal transmembrane (TM) domain of Bok localizes it to membranes of the endoplasmic reticulum (ER) and Golgi (7), (ii) that Bok over-expression leads to apoptosis (7-10) if Bak or Bax are present (7), indicating that Bok lies upstream of Bak and Bax, (iii) that Bok Ϫ/Ϫ mice are phenotypically normal (4, 11, 12), while Bax Ϫ/Ϫ Bak Ϫ/Ϫ mice exhibit multiple severe defects (1), indicating that Bok cannot substitute for Bak and Bax, and (iv) that ER stress-induced apoptosis (13) can be suppressed in Bok Ϫ/Ϫ mouse cells in vitro and in vivo (12), although this result has not been seen by all groups (7). Overall, these data suggest that Bok plays a very different role from Bax and Bak, and that it may participate in the pathway between ER stress and apoptosis.Another intriguing facet of Bok cell biology is that it binds very strongly to inositol 1,4,5-trisphosphate (IP 3 ) receptors (IP 3 Rs) (14), proteins that form tetrameric, IP 3 -, and Ca 2ϩ -gated Ca 2ϩ channels in ER membranes and play a key role in vertebrate cell signaling (15,16). Of the three mammalian IP 3 R types, Bok binding is strongest to IP 3 R1 and IP 3 R2 (14) and the...