Anthracyclines disaggregate and restore mutant p63 function: a potential therapeutic approach for AEC syndrome

Abstract Ankyloblepharon-Ectodermal Defects-Cleft Lip/Palate (AEC) syndrome is a rare genetic disorder caused by mutations in the TP63 gene, which encodes a transcription factor essential for epidermal gene expression. A key feature of AEC syndrome is chronic skin erosion, for which no effective tre...

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Main Authors: Fabiana Boncimino, Ludovica D’Auria, Kristina Todorova, Sabina Y. van der Zanden, Jacques Neefjes, Anna Mandinova, Caterina Missero, Stefano Sol
Format: Article
Language:English
Published: Nature Publishing Group 2025-01-01
Series:Cell Death Discovery
Online Access:https://doi.org/10.1038/s41420-025-02307-0
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author Fabiana Boncimino
Ludovica D’Auria
Kristina Todorova
Sabina Y. van der Zanden
Jacques Neefjes
Anna Mandinova
Caterina Missero
Stefano Sol
author_facet Fabiana Boncimino
Ludovica D’Auria
Kristina Todorova
Sabina Y. van der Zanden
Jacques Neefjes
Anna Mandinova
Caterina Missero
Stefano Sol
author_sort Fabiana Boncimino
collection DOAJ
description Abstract Ankyloblepharon-Ectodermal Defects-Cleft Lip/Palate (AEC) syndrome is a rare genetic disorder caused by mutations in the TP63 gene, which encodes a transcription factor essential for epidermal gene expression. A key feature of AEC syndrome is chronic skin erosion, for which no effective treatment currently exists. Our previous studies demonstrated that mutations associated with AEC syndrome lead to p63 protein misfolding and aggregation, exerting a dominant-negative effect. By performing a high-throughput screening of epigenetic and FDA-approved compounds in a co-transfection model of wild-type and mutant p63, we found that two compounds, Doxorubicin and Epirubicin, alleviate protein aggregation and restore p63 transactivation function. Moreover, treatment with these compounds reduced protein aggregation and restored the expression of keratinocyte-specific p63 target genes in primary keratinocytes derived from a conditional ΔNp63αL514F knock-in AEC mouse model, which mimics the ectodermal defects and skin erosions characteristic of AEC syndrome. A chemical analog of Doxorubicin, diMe-Doxorubicin, which exhibits lower tissue and organ toxicity, was also found to be effective in promoting the disaggregation of mutant p63 and rescuing its transcriptional activity. Our findings identify compounds that can partially resolve mutant p63 aggregation, increase its monomeric isoform, and reactivate its transcriptional function. These results suggest potential therapeutic efficacy for treating skin erosions in AEC syndrome.
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spelling doaj-art-e966ad0324984f8a9a1c74b3ed2274a22025-01-26T12:15:25ZengNature Publishing GroupCell Death Discovery2058-77162025-01-011111910.1038/s41420-025-02307-0Anthracyclines disaggregate and restore mutant p63 function: a potential therapeutic approach for AEC syndromeFabiana Boncimino0Ludovica D’Auria1Kristina Todorova2Sabina Y. van der Zanden3Jacques Neefjes4Anna Mandinova5Caterina Missero6Stefano Sol7Cutaneous Biology Research Center, Massachusetts General Hospital and Harvard Medical SchoolCEINGE Biotecnologie Avanzate Franco SalvatoreCutaneous Biology Research Center, Massachusetts General Hospital and Harvard Medical SchoolDepartment of Cell and Chemical Biology, ONCODE Institute, Leiden University Medical CenterDepartment of Cell and Chemical Biology, ONCODE Institute, Leiden University Medical CenterCutaneous Biology Research Center, Massachusetts General Hospital and Harvard Medical SchoolCEINGE Biotecnologie Avanzate Franco SalvatoreCutaneous Biology Research Center, Massachusetts General Hospital and Harvard Medical SchoolAbstract Ankyloblepharon-Ectodermal Defects-Cleft Lip/Palate (AEC) syndrome is a rare genetic disorder caused by mutations in the TP63 gene, which encodes a transcription factor essential for epidermal gene expression. A key feature of AEC syndrome is chronic skin erosion, for which no effective treatment currently exists. Our previous studies demonstrated that mutations associated with AEC syndrome lead to p63 protein misfolding and aggregation, exerting a dominant-negative effect. By performing a high-throughput screening of epigenetic and FDA-approved compounds in a co-transfection model of wild-type and mutant p63, we found that two compounds, Doxorubicin and Epirubicin, alleviate protein aggregation and restore p63 transactivation function. Moreover, treatment with these compounds reduced protein aggregation and restored the expression of keratinocyte-specific p63 target genes in primary keratinocytes derived from a conditional ΔNp63αL514F knock-in AEC mouse model, which mimics the ectodermal defects and skin erosions characteristic of AEC syndrome. A chemical analog of Doxorubicin, diMe-Doxorubicin, which exhibits lower tissue and organ toxicity, was also found to be effective in promoting the disaggregation of mutant p63 and rescuing its transcriptional activity. Our findings identify compounds that can partially resolve mutant p63 aggregation, increase its monomeric isoform, and reactivate its transcriptional function. These results suggest potential therapeutic efficacy for treating skin erosions in AEC syndrome.https://doi.org/10.1038/s41420-025-02307-0
spellingShingle Fabiana Boncimino
Ludovica D’Auria
Kristina Todorova
Sabina Y. van der Zanden
Jacques Neefjes
Anna Mandinova
Caterina Missero
Stefano Sol
Anthracyclines disaggregate and restore mutant p63 function: a potential therapeutic approach for AEC syndrome
Cell Death Discovery
title Anthracyclines disaggregate and restore mutant p63 function: a potential therapeutic approach for AEC syndrome
title_full Anthracyclines disaggregate and restore mutant p63 function: a potential therapeutic approach for AEC syndrome
title_fullStr Anthracyclines disaggregate and restore mutant p63 function: a potential therapeutic approach for AEC syndrome
title_full_unstemmed Anthracyclines disaggregate and restore mutant p63 function: a potential therapeutic approach for AEC syndrome
title_short Anthracyclines disaggregate and restore mutant p63 function: a potential therapeutic approach for AEC syndrome
title_sort anthracyclines disaggregate and restore mutant p63 function a potential therapeutic approach for aec syndrome
url https://doi.org/10.1038/s41420-025-02307-0
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