Simultaneous measurement of cell cycle and apoptotic cell death

Understanding the dynamics of cell death in conjunction with those of cell cycle can be illuminating in the investigation of various cellular behaviors. Robust assays for measuring such parameters are invaluable. Many assays of apoptosis and/or cell cycle use flow cytometry. This chapter describes two different assays to measure apoptosis and cell cycle simultaneously using flow cytometry. The first involves the use of terminal transferase (the "TUNEL" assay) together with propidium iodide for identification of cell cycle. The second uses fluorescently labeled annexin V, together with propidium iodide as an indicator of cell membrane integrity; and additionally Hoechst 33342 for determination of cell cycle. Each assay has positive and negative attributes. The terminal transferase assay is performed using fixed cells and is therefore useful in the analysis of samples collected over time. The annexin V assay is performed using unfixed cells, and thus provides information regarding membrane integrity. Other practical aspects of both assays are discussed.