We examined the mechanisms of apoptosis in a human salivary gland (HSG) cell line induced by tumor necrosis factor (TNF) alpha and interferon (IFN) gamma. DNA fragmentation and the activation of caspase-3 were determined in HSG cells cultured with TNF-alpha or IFN-gamma. Mitochondrial dysfunction also appeared to be involved in the process because a disruption of mitochondrial transmembrane potential with the activation of caspase-9 was demonstrated in TNF-alpha- and IFN-gamma-stimulated HSG cells. Activation of caspase-8 was thought to be essential in TNF-alpha--induced apoptosis of HSG cells; however, the activation of caspase-8 was not involved in IFN-gamma-induced apoptosis of HSG cells. In contrast, Bcl-2 appeared to be an indispensable regulatory molecule in IFN-gamma-induced, but not in TNF-alpha-induced, apoptosis of HSG cells because its expression was inhibited in IFN-gamma-stimulated, but not in TNF-alpha-stimulated, cells. The inhibitory effect of IFN-gamma in Bcl-2 expression was enhanced by coadministration of TNF-alpha and, interestingly, apoptosis of HSG cells, as assessed by DNA fragmentation and the activation of caspase-9 and caspase-3, and disruption of mitochondrial transmembrane potential was also synergistically augmented by TNF-alpha and IFN-gamma. Our results suggest that cytokines expressed in the salivary glands of patients with Sjögren syndrome play an important role in regulating apoptosis of acinar-ductal epithelial cells through distinct and synergistic mechanisms, thereby modulating salivary gland function in patients with Sjögren syndrome.