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Updated: February 12, 2006

Section 15.5 — Assays for Apoptosis

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Apoptosis (programmed cell death) is the genetically controlled ablation of cells during normal development.ref Inappropriately regulated apoptosis is implicated in disease states such as Alzheimer's disease, stroke and cancer.ref Apoptosis is distinct from necrosis in both the biochemical and the morphological changes that occur.ref In contrast to necrotic cells, apoptotic cells are characterized morphologically by compaction of the nuclear chromatin, shrinkage of the cytoplasm and production of membrane-bound apoptotic bodies. Biochemically, apoptosis is distinguished by fragmentation of the genome and cleavage or degradation of several cellular proteins.

As with cell viability, no single parameter fully defines cell death in all systems; therefore, it is often advantageous to use several different approaches when studying apoptosis. Several methods have been developed to distinguish live cells from early and late apoptotic cells and from necrotic cells; these are described below and in a number of review articles and seminal publications.ref Anti-cancer drug candidates failing to induce apoptosis are likely to have decreased clinical efficacy,ref making apoptosis assays important tools for high-throughput drug screening. Apoptotic cells are typically eliminated by phagocytosis; thus, apoptotic cells that have been selectively labeled with a fluorescent dye can potentially be used as tracers for phagocytosis,ref a cell process that is discussed in Section 16.1.

Apoptosis Assays Using Nucleic Acid Stains

DNA Stains for Detecting Apoptotic Cells

The characteristic breakdown of the nucleus during apoptosis comprises collapse and fragmentation of the chromatin, degradation of the nuclear envelope and nuclear blebbing, resulting in the formation of micronuclei. Therefore, nucleic acid stains can be useful tools for identifying even low numbers of apoptotic cells in cell populations. Several nucleic acid stains, all of which are listed in Section 8.1, have been used to detect apoptotic cells by fluorescence imaging or flow cytometry.ref

  • Our YO-PRO-1 (Y3603) nucleic acid stain is the basis of an important assay for apoptotic cells that is compatible with both fluorescence microscopy and flow cytometry.ref Selective uptake of YO-PRO-1 by apoptotic cells of a dexamethasone-treated population of thymocytes, an irradiated peripheral blood mononuclear cell population and a growth factor–depleted tumor B cell line was confirmed by cell sorting.ref Unlike Hoechst 33342 staining, YO-PRO-1 staining had no effect on the ability of stained T cells to proliferate. Moreover, the visible-light absorption of the YO-PRO-1 stain (spectra) eliminates the need for UV excitation capabilities in flow cytometry. YO-PRO-1 is the key reagent in our Vybrant Apoptosis Assay Kits #4 and #7 (V13243, V23201, see below), which provide the reagents and tested protocols for combination flow cytometric apoptosis and necrosis assays.
  • Some of our cell-permeant, green-fluorescent SYTO dyes, including the SYTO 13 and SYTO 16 nucleic acid stains (S7575, S7578), are proving useful for distinguishing apoptotic neuronal cells ref and apoptotic thymocytes.ref Our SYTO Fluorescent Nucleic Acid Stain Sampler Kits (S7554, S7572, S11340, S11350, S11360; Section 8.1) provide fluorescent SYTO dyes covering the entire visible spectrum (Table 8.3) that may be screened for their utility in monitoring apoptosis. In addition, apoptotic cells in a follicular lymphoma cell line could be discriminated earlier with our SYTO 17 red-fluorescent nucleic acid stain (S7579) than with either fluorescein-labeled annexin V or propidium iodide.ref
  • Hoechst 33342 (H1399, H3570; FluoroPure Grade, H21492) is readily taken up by cells during the initial stages of apoptosis, whereas cell-impermeant dyes such as propidium iodide (P1304MP, P3566, P21493; Section 8.1) and ethidium bromide ref (E1305, E3565; Section 8.1) are excluded. Later stages of apoptosis are accompanied by an increase in membrane permeability, which allows propidium iodide to enter cells. Thus, a combination of Hoechst 33342 and propidium iodide has been extensively used for simultaneous flow cytometric and fluorescence imaging analysis of the stages of apoptosis and cell-cycle distribution.ref Our Vybrant Apoptosis Assay Kit #5 (V13244, see below) is based on these reagents, and our Vybrant Apoptosis Assay Kit #7 (V23201, see below) adds the YO-PRO-1 nucleic acid to selectively determine the apoptotic cell population in a three-color experiment.
  • The rate of Hoechst 33342 uptake in partially apoptotic cell populations is correlated with low intracellular pH, as measured with our carboxy SNARF-1 pH indicator ref (C1271, C1272; Section 20.2).
  • Hoechst 33342, which selectively stains nuclei of apoptotic cells blue fluorescent, has also been used in combination with calcein AM (C1430, C3099, C3100MP; Section 15.2), which stains all cells that have intact membranes — even apoptotic cells — green fluorescent.ref Presumably the dead-cell population could be selectively detected using propidium iodide to make this a three-color assay.
  • 7-Aminoactinomycin D (7-AAD, A1310) has been used alone or in combination with Hoechst 33342 to separate populations of live cells, early apoptotic cells and late apoptotic cells by flow cytometry.ref The staining pattern of 7-AAD is retained following cell fixation, and its unusually large Stokes shift is advantageous when simultaneously staining with cell-surface labels. 7-AAD staining has also been used to detect apoptotic cells by their characteristic morphology using fluorescence microscopy.ref 7-AAD has also been used in combination with the green-fluorescent SYTO 16 nucleic acid stain (S7578) to detect early stages of apoptosis that could not be detected by 7-AAD alone.ref
  • The cell-permeant nucleic acid stain LDS 751 (L7595) has been used to discriminate intact nucleated cells from nonnucleated cells and cells with damaged nuclei,ref as well as to differentiate apoptotic cells from nonapoptotic cells.ref
  • Acridine orange (A1301, A3568) exhibits metachromatic fluorescence that is sensitive to DNA conformation, making it a useful probe for detecting apoptotic cells.ref When analyzed by flow cytometry, apoptotic cells stained by acridine orange show reduced green fluorescence and enhanced red fluorescence in comparison to normal cells.ref
  • DAPI (D1306, D21490; Section 8.1) and sulforhodamine 101 (S359, Section 14.3) can be used together in fixed apoptotic cells to reveal concomitant breakdown of proteins and DNA.ref
  • The excited-state lifetime of ethidium homodimer-2 (E3599, Section 8.1) has been shown to be different in populations of aldehyde-fixed apoptotic and nonapoptotic cells.ref
  • Ethidium monoazide (E1374, Section 15.2) passes through the partially compromised membrane of apoptotic cells; photolysis results in covalent labeling of intracellular nucleic acids that persists through fixation and permeabilization.ref

DNA fragmentation can also be detected in vitro using electrophoresis. DNA extracted from apoptotic cells, separated by gel electrophoresis and stained with ethidium bromide reveals a characteristic ladder pattern of low molecular weight DNA fragments.ref Ethidium bromide has been used for a dot-blot assay to detect apoptotic DNA fragments.ref Our ultrasensitive SYBR Green I nucleic acid stain (S7567, Section 8.4) and SYBR DX DNA blot stain (S7550, Section 8.5) allow the detection of even fewer apoptotic cells in these applications (photo). Electrophoresis of apoptotic cells in an agarose gel matrix results in the formation of distinctive "comets" of DNA leaking from apoptotic cells (but not normal cells; see the paragraph, Comet (Single-Cell Gel Electrophoresis) Assay to Detect Damaged DNA, below) (photo).

Vybrant Apoptosis Assay Kit #4

Our Vybrant Apoptosis Assay Kit #4 (V13243) detects apoptosis based on changes that occur in the permeability of cell membranes. This kit contains ready-to-use solutions of both the YO-PRO-1 and propidium iodide nucleic acid stains. Our Patented YO-PRO-1 nucleic acid stain selectively passes through the plasma membranes of apoptotic cells and labels them with moderate green fluorescence.ref Necrotic cells are stained with the red-fluorescent propidium iodide, a DNA-selective dye that is membrane impermeant but that easily passes through the compromised plasma membranes of necrotic cells. Live cells are not appreciably stained by either YO-PRO-1 or propidium iodide. The dyes included in the Vybrant Apoptosis Assay Kit #4 are effectively excited by the 488 nm spectral line of the argon-ion laser and are useful for both flow cytometry (Figure 15.85) and fluorescence microscopy (photo). We have optimized our Vybrant Apoptosis Assay Kits using Jurkat cells, a human T-cell leukemia clone, treated with camptothecin to induce apoptosis. Some modifications may be required for use with other cell types. The kit components, number of assays and assay principles are summarized in Table 15.4.

Vybrant Apoptosis Assay Kit #5

The Vybrant Apoptosis Assay Kit #5 (V13244) provides a rapid and convenient assay for apoptosis based upon fluorescence detection of the compacted state of the chromatin in apoptotic cells. This kit contains ready-to-use solutions of the blue-fluorescent Hoechst 33342 dye (excitation/emission maxima ~350/461 nm when bound to DNA), which stains the condensed chromatin of apoptotic cells more brightly than the chromatin of nonapoptotic cells, and the red-fluorescent propidium iodide (excitation/emission maxima ~535/617 nm when bound to DNA), which is permeant only to dead cells with compromised membranes. The staining pattern resulting from the simultaneous use of these dyes makes it possible to distinguish normal, apoptotic and dead cell populations by flow cytometry or fluorescence microscopy.ref The 351 nm spectral line of an argon-ion laser or other suitable UV source is required for excitation of the Hoechst 33342 dye, whereas propidium iodide can be excited with the 488 nm spectral line of an argon-ion laser. We have optimized this assay using Jurkat cells, a human T-cell leukemia clone, treated with camptothecin to induce apoptosis. Some modifications may be required for use with other cell types. The kit components, number of assays and assay principles are summarized in Table 15.4.

Vybrant Apoptosis Assay Kit #7

The Vybrant Apoptosis Assay Kit #7 (V23201) combines the detection principles used in our Vybrant Apoptosis Assay Kits #4 and #5 (see above). Three nucleic acid stains — Hoechst 33342, YO-PRO-1 and propidium iodide — are utilized to identify by flow cytometry the blue-fluorescent live-cell population, the green-fluorescent apoptotic population and the red-fluorescent dead-cell population. The stains are provided as separate solutions to facilitate optimization of the assay for the cell line under study and the equipment available. However, once optimized, the assay can be completed using simultaneous staining with a mixture of the three nucleic acid stains and either UV excitation of all three dyes or with a combination of UV excitation for the Hoechst 33342 dye and excitation by the 488 nm spectral line of the argon-ion laser. Differences in the intensity of the dye staining may make it difficult to simultaneously photograph the live, apoptotic and dead cells by microscopy. The kit components, number of assays and assay principles are summarized in Table 15.4.

Vybrant Apoptosis Assay Kit #12

The Vybrant Apoptosis Assay Kit #12 (V35121) provides a rapid and convenient assay for apoptosis based upon fluorescence detection of the compacted state of the chromatin in apoptotic cells. This kit contains ready-to-use solutions of the violet-fluorescent Vybrant DyeCycle Violet stain (excitation/emission maxima ~370/440 nm when bound to DNA), which stains the condensed chromatin of apoptotic cells more brightly than the chromatin of nonapoptotic cells, and the red-fluorescent 7-aminoactinomycin (7-AAD) (excitation/emission maxima ~546/650 nm when bound to DNA), which is permeant only to dead cells with compromised membranes. The staining pattern resulting from the simultaneous use of these dyes makes it possible to distinguish normal, apoptotic and dead cell populations by flow cytometry. The 405 nm spectral line of the violet laser is used for excitation of the Vybrant DyeCycle Violet stain, whereas 7-AAD may be excited by the 488 nm spectral line of an argon-ion laser. We have optimized this assay using Jurkat cells, a human T-cell leukemia clone, treated with camptothecin to induce apoptosis. Some modifications may be required for use with other cell types. The kit components, number of assays and assay principles are summarized in Table 15.4.

Vybrant Apoptosis Assay Kit #13

Like the Vybrant Apoptosis Assay Kit #4, the Vybrant Apoptosis Assay Kit #13 (V35123) detects apoptosis based on changes that occur in the permeability of cell membranes (Table 15.4). This kit contains ready-to-use solutions of both PO-PRO-1 and 7-aminoactinomycin (7-AAD) nucleic acid stains. Our Patented PO-PRO-1 nucleic acid stain selectively passes through the plasma membranes of apoptotic cells and labels them with violet fluorescence. Furthermore, annexin V labeling of apoptosis yields poor results with trypsinized cells, whereas PO-PRO-1 dye provides te same efficiency for detecting apoptosis with trypsinized cells as it does with suspension cells. Necrotic cells are stained with the red-fluorescent 7-AAD, a DNA-selective dye that is membrane impermeant but that easily passes through the compromised plasma membranes of necrotic cells. Live cells are not appreciably stained by either PO-PRO-1 or 7-AAD. The dyes included in the Vybrant Apoptosis Assay Kit #13 are effectively excited by a flow cytometer that uses both the 405 nm spectral line of the violet laser and the 488 nm spectral line of the argon-ion laser for excitation. We have optimized our Vybrant Apoptosis Assay Kits using Jurkat cells, a human T-cell leukemia clone, treated with camptothecin to induce apoptosis. Some modifications may be required for use with other cell types. The kit components, number of assays and assay principles are summarized in Table 15.4.

Comet (Single-Cell Gel Electrophoresis) Assay to Detect Damaged DNA

The Comet assay, or single-cell gel electrophoresis assay, is used for rapid detection and quantitation of DNA damage from single cells.ref The Comet assay is based on the alkaline lysis of labile DNA at sites of damage. Cells are immobilized in a thin agarose matrix on slides and gently lysed. When subjected to electrophoresis, the unwound, relaxed DNA migrates out of the cells. After staining with a nucleic acid stain, cells that have accumulated DNA damage appear as fluorescent comets, with tails of DNA fragmentation or unwinding (photo). In contrast, cells with normal, undamaged DNA appear as round dots, because their intact DNA does not migrate out of the cell. The ease and sensitivity of the Comet assay has provided a fast and convenient way to measure damage to human sperm DNA,ref evaluate DNA replicative integrity,ref monitor the sensitivity of tumor cells to radiation damage ref and assess the sensitivity of molluscan cells to toxins in the environment.ref The Comet assay can also be used in combination with FISH (Section 8.5) to identify specific sequences with damaged DNA.ref

Comet assays have traditionally been performed using ethidium bromide to stain the DNA.ref However, our YOYO-1 dye was found to increase the sensitivity of the assay eightfold, as compared with ethidium bromide.ref Use of the SYBR Gold and SYBR Green I stains ref improves the sensitivity of this assay (photo).

Detecting DNA Strand Breaks with ChromaTide Nucleotides

DNA fragmentation that occurs during apoptosis produces DNA strand breaks. TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling) assays are widely used for detecting DNA nicks in apoptotic cells. Once the cells are fixed, DNA strand breaks can be detected in situ using mammalian terminal deoxynucleotidyl transferase (TdT), which covalently adds labeled nucleotides to the 3'-hydroxyl ends of these DNA fragments in a template-independent fashion.ref Break sites have traditionally been labeled with biotinylated dUTP, followed by subsequent detection with an avidin or streptavidin conjugate ref (Section 7.6, Table 7.23). However, a more direct approach for detecting DNA strand breaks in apoptotic cells is possible via the use of our ChromaTide BODIPY FL-14-dUTP (C7614) as a TdT substrate ref (photo).

The single-step BODIPY FL dye–based assay has several advantages over indirect detection of biotinylated or haptenylated nucleotides, including fewer protocol steps and increased cell yields. BODIPY FL dye–labeled nucleotides have also proven superior to fluorescein-labeled nucleotides for detection of DNA strand breaks in apoptotic cells because they provide stronger signals, a narrower emission spectrum and less photobleaching ref (photo). Moreover, it has been reported that ChromaTide BODIPY FL-14-dUTP incorporated into the granules of the condensed chromatin structure of late-apoptotic cells — cells characterized by extensive nuclear fragmentation — exhibits yellow fluorescence, whereas uncondensed areas of the nuclei or early-apoptotic cells exhibit green fluorescence. This spectral shift, which is characteristic of the BODIPY fluorophores, is most likely a consequence of stacking of the BODIPY FL fluorophores (Figure 13.6) and could be very useful for identifying the stages of apoptosis on a single-cell basis. Our ChromaTide Texas Red-12-dUTP (C7631) has been used similarly for a TdT-mediated apoptosis assay.ref Presumably a number of the ChromaTide dUTP nucleotides listed in Table 8.7 could be used for the direct or indirect TUNEL assay; we have not yet tried the ChromaTide dCTP nucleotides in this assay. Furthermore, our anti-dye antibodies (Section 7.4) can amplify the signal of many of the dyes used to prepare the ChromaTide nucleotides.

In situ DNA modifications by labeled nucleotides have been used to detect DNA fragmentation in what may be apoptotic cells in autopsy brains of Huntington's and Alzheimer's disease patients.ref DNA fragmentation is also associated with amyotrophic lateral sclerosis.ref Analogous to TdT's ability to label double-strand breaks, the E. coli repair enzyme DNA polymerase I can be used to detect single-strand nicks,ref which appear as a relatively early step in some apoptotic processes.ref Because our ChromaTide BODIPY FL-14-dUTP (C7614) and ChromaTide fluorescein-12-dUTP ref (C7604) are incorporated into DNA by E. coli DNA polymerase I, it is likely that they may also be effective for in situ labeling with the nick translation method.

APO-BrdU TUNEL Assay Kit

Because DNA fragmentation is one of the most reliable methods for detecting apoptosis,ref we have collaborated with Phoenix Flow Systems to offer the APO-BrdU TUNEL Assay Kit (A23210), which provides all the materials necessary to label and detect the DNA strand breaks of apoptotic cells.ref When DNA strands are cleaved or nicked by nucleases, a large number of 3'-hydroxyl ends are exposed. In the APO-BrdU assay, these ends are labeled with BrdUTP and terminal deoxynucleotidyl transferase (TdT) using the TUNEL technique described above. Once incorporated into the DNA, BrdU is detected using an Alexa Fluor 488 dye–labeled anti-BrdU monoclonal antibody (photo). This kit also provides propidium iodide for determining total cellular DNA content, as well as fixed control cells for assessing assay performance.

The APO-BrdU TUNEL Assay Kit includes complete protocols for use in flow cytometry applications, though it may also be adapted for use with fluorescence microscopy. Each kit contains:

  • Terminal deoxynucleotidyl transferase (TdT), for catalyzing the addition of BrdUTP at the break sites
  • 5-Bromo-2'-deoxyuridine 5'-triphosphate (BrdUTP)
  • Alexa Fluor 488 dye–labeled anti-BrdU mouse monoclonal antibody PRB-1, for detecting BrdU labels
  • Propidium iodide/RNase staining buffer, for quantitating total cellular DNA
  • Reaction, wash and rinse buffers
  • Positive control cells (a fixed human lymphoma cell line)
  • Negative control cells (a fixed human lymphoma cell line)
  • Detailed protocols (APO-BrdU TUNEL Assay Kit)

Sufficient reagents are provided for approximately 60 assays of 1 mL samples, each containing 1–2 × 106 cells/mL.

Apoptosis Assays Using Annexin V Conjugates

Annexin V Conjugates

Molecular Probes is collaborating with Nexins Research BV — the original developer of fluorescent phosphatidylserine-binding proteins — to provide what we feel are the best and brightest annexin V conjugates available. The human vascular anticoagulant annexin V is a 35–36 kilodalton, Ca2+-dependent phospholipid-binding protein that has a high affinity for phosphatidylserine ref (PS). In normal viable cells, PS is located on the cytoplasmic surface of the cell membrane. However, in apoptotic cells, PS is translocated from the inner to the outer leaflet of the plasma membrane, exposing PS to the external cellular environment where it can be detected by annexin V conjugates.ref In leukocyte apoptosis, PS on the outer surface of the cell marks the cell for recognition and phagocytosis by macrophages.ref

Highly fluorescent annexin V conjugates provide quick and reliable detection methods for studying the externalization of phosphatidylserine,ref an indicator of intermediate stages of apoptosis. Nuclear fragmentation, mitochondrial membrane potential flux and caspase-3 activation apparently precede phosphatidylserine "flipping" during apoptosis, whereas permeability to propidium iodide and cytoskeletal collapse occur later. The difference in fluorescence intensity between apoptotic and nonapoptotic cells stained by our fluorescent annexin V conjugates, as measured by flow cytometry, is typically about 100-fold (Figure 15.90). Annexin V conjugates (Annexin V Conjugates for Apoptosis Detection) are very useful for flow cytometry, confocal or epifluorescence microscopy and, like antibody staining, can be used in combination with other dyes, including nucleic acid stains, to accurately assess mixed populations of apoptotic and nonapoptotic cells.ref Our annexin V conjugates are available as stand-alone reagents, each suitable for 50–100 flow cytometry assays or many more imaging assays, or in several variations of our Vybrant Apoptosis Assay Kits (Table 15.4). Our annexin V conjugates include:

  • Alexa Fluor 488 annexin V ref (A13201, photo), a green-fluorescent conjugate (excitation/emission maxima ~495/519 nm) that has spectral characteristics similar to fluorescein conjugates, but exhibits fluorescence that is brighter, much more photostable and less pH dependent (Figure 1.9, photo, photo, Figure 1.53). Alexa Fluor 488 annexin V is used in both our Vybrant Apoptosis Assays Kits #1 and #2 (V13240, V13241; see below), which contain all of the reagents and an easy-to-follow protocol for flow cytometric detection and quantitation of apoptotic cells.
  • Fluorescein (FITC) annexin V (A13199), a green-fluorescent conjugate that has been extensively used by a number of laboratories to detect apoptotic cells populations.ref Fluorescein annexin V is frequently used in combination with propidium iodide to detect necrotic cells, as in our Vybrant Apoptosis Assay Kit #3 (V13242, see below).
  • Oregon Green 488 annexin V (A13200), a green-fluorescent conjugate that is spectrally similar to the fluorescein annexin V conjugate but is brighter and more photostable (Figure 1.46).
  • R-phycoerythrin annexin V (A35111), a highly fluorescent phycobiliprotein conjugate with absorption maxima at 496 nm, 546 nm and 565 nm and an emission maximum at 578 nm.
  • Alexa Fluor 568 annexin V (A13202), a red-orange–fluorescent annexin V conjugate (excitation/emission maxima ~578/603 nm) with exceptionally bright and photostable fluorescence. We have determined that this conjugate can be used for simultaneous staining with green-fluorescent probes, such as our green-fluorescent Alexa Fluor 488 anti–CD 4 conjugate (A21335, Section 7.5), for multiparameter experiments.
  • Alexa Fluor 594 annexin V ref (A13203), a red-fluorescent annexin V conjugate with spectra similar to those of Texas Red conjugates (excitation/emission maxima ~590/617 nm) that can be used with green-fluorescent probes for multiparameter experiments. The Alexa Fluor 594 conjugate is readily excited by the 568 nm spectral line used in many confocal laser-scanning microscopes and has fluorescence that is well separated from the emission of green-fluorescent probes.
  • Alexa Fluor 647 annexin V (A23204), which permits use of long-wavelength excitation sources for detection of apoptotic cells by either flow cytometry or microscopy.
  • Allophycocyanin annexin V (A35110), a highly fluorescent phycobiliprotein conjugate with absorption/emission maxima of 650/660 nm.
  • Alexa Fluor 350 annexin V (A23202) can be excited in the ultraviolet and has bright blue fluorescence. Alternatively, the reagents in our Vybrant Apoptosis Assay Kit #6 (V23200) can be used in this spectral region.
  • Pacific Blue annexin V (A35122) can be excited with the 405 nm spectral line of the violet laser, making it ideal for instruments equipped with a violet laser and for multicolor experiments that include green- or red-fluorescent dyes.
  • Biotin-X annexin V ref (A13204), which can be detected by any of our fluorescent avidin or streptavidin conjugates (Section 7.6, Table 7.23), gives the researcher the ultimate in color selection for multiparameter experiments. Biotin-X annexin V also permits detection of apoptotic cells by electron microscopy ref and should permit separation of apoptotic cells with our Captivate ferrofluid streptavidin conjugate (C21476, Section 7.6), optionally in combination with the Captivate microscope-mounted magnetic yoke assembly (C24700, Section 23.3, Figure).

Vybrant Apoptosis Assay Kit #1

With the Vybrant Apoptosis Assay Kit #1 (V13240), apoptotic cells are detected based on the externalization of phosphatidylserine. This kit contains recombinant annexin V conjugated to the Alexa Fluor 488 dye, our brightest and most photostable green fluorophore, to provide maximum sensitivity. In addition, the kit includes a ready-to-use solution of the SYTOX Green nucleic acid stain. The SYTOX Green dye is impermeant to live cells and apoptotic cells but stains necrotic cells with intense green fluorescence by binding to cellular nucleic acids. After staining a cell population with Alexa Fluor 488 annexin V and SYTOX Green dye in the provided binding buffer, apoptotic cells show green fluorescence, dead cells show a higher level of green fluorescence and live cells show little or no fluorescence (Figure 15.92). These populations can easily be distinguished using a flow cytometer with the 488 nm spectral line of an argon-ion laser for excitation. Both Alexa Fluor 488 annexin and the SYTOX Green dye emit a green fluorescence that can be detected in the green channel, freeing the other channels for the detection of additional probes in multicolor labeling experiments. We have optimized the Vybrant Apoptosis Assay Kits using Jurkat cells, a human T-cell leukemia clone, treated with camptothecin to induce apoptosis. Some modifications may be re