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Propofol is a commonly used intravenous anesthetic agent,which has been found to affect cell survival and proliferation especially in early life.Our previous studies show that propofol-induced neurodegeneration and neurogenesis are closely associated with cell autophagy.In the present study we explored the roles of autophagy-related gene 5 (ATG5) in propofol-induced autophagy in mouse embryonic fibroblasts (MEF) in vitro.We showed that ATG5 was functionally related to propofol-induced cell survival and damage:propofol significantly enhanced cell survival and proliferation at a clinically relevant dose (10 μM),but caused cell death at an extremely high concentration (200 μM) in ATG5-/-MEF,but not in WT cells.The dual effects found in ATG5-/-MEF could be blocked by intracellular Ca2+ channel antagonists.We also found that propofol evoked a moderate (promote cell growth) and extremely high (cause apoptosis) cytosolic Ca2+ elevation at the concentrations of 10 μM and 200 μM,respectively,only in ATG5-/-MEF.In addition,ATG5-/-MEF themselves released more Ca2+ in cytosolic space and endoplasmic reticulum compared with WT ceils,suggesting that autophagy deficiency made intracellular calcium signaling more vulnerable to exteal stimuli (propofol).Altogether,our results reveal that ATG5 plays a crucial role in propofol regulation of cell survival and proliferation by affecting intracellular Ca2+ homeostasis.