Annexin V is a Ca2 dependent phospholipid-binding protein that specifically binds to phosphatidylserine (PS) Normally PS resides on the inner surface of the cell membrane s phospholipid bilayer During early stages of apoptosis it translocates from the inner leaflet to the outer surface thus exposing itself to the extracellular environment Biotin labeled Annexin V can be detected through binding with fluorescently labeled streptavidin (such as fluorescein-conjugated streptavidin or PE-conjugated streptavidin) The occurrence of apoptosis can then be identified using flow cytometry or fluorescence microscopy within only 10 to 20 minutes PI (propidium iodide) binds specifically to double-stranded DNA producing a red fluorescence signal PI cannot penetrate the intact cell membrane but late apoptotic and dead cells staining their nuclei Simultaneous staining with Annexin V-Biotin and PI permits differentiation among cells at various stages of apoptosis and dead cells