Detection of a novel, primate-specific ‘kill switch’ tumor suppression mechanism that may fundamentally control cancer risk in humans: an unexpected twist in the basic biology of TP53

• Published in: Endocrine-related cancer Vol. 25; no. 11; pp. R497 - R517
• Main Author: Nyce, Jonathan W
• Format: Journal Article
• Language: English
• Published: England Bioscientifica Ltd 01.11.2018; Society for Endocrinology & BioScientifica Ltd
• Subjects: Age; Cancer; Cell death; Dehydroepiandrosterone; Glucose; Glucose-6-phosphatase; Glucosephosphate dehydrogenase; Hexokinase; Humans; Mutation; Neoplasms - genetics; Neoplasms - pathology; p53 Protein; Reactive oxygen species; Regulatory sequences; Review; Somatic cells; Steroid sulfatase; Tumor suppression; Tumor Suppressor Protein p53 - genetics; Tumorigenesis; endocrine system; tumor suppression; glucose-6-phosphate dehydrogenase; DHEAS; endocrine-related cancer; animal models of cancer; PTEN; TP53; aging and cancer; p53-knockout mouse; p53
• ISSN: 1351-0088; 1479-6821
• DOI: 10.1530/ERC-18-0241

The activation of TP53 is well known to exert tumor suppressive effects. We have detected a primate-specific adrenal androgen-mediated tumor suppression system in which circulating DHEAS is converted to DHEA specifically in cells in which TP53 has been inactivated. DHEA is an uncompetitive inhibitor of glucose-6-phosphate dehydrogenase (G6PD), an enzyme indispensable for maintaining reactive oxygen species within limits survivable by the cell. Uncompetitive inhibition is otherwise unknown in natural systems because it becomes irreversible in the presence of high concentrations of substrate and inhibitor. In addition to primate-specific circulating DHEAS, a unique, primate-specific sequence motif that disables an activating regulatory site in the glucose-6-phosphatase (G6PC) promoter was also required to enable function of this previously unrecognized tumor suppression system. In human somatic cells, loss of TP53 thus triggers activation of DHEAS transport proteins and steroid sulfatase, which converts circulating DHEAS into intracellular DHEA, and hexokinase which increases glucose-6-phosphate substrate concentration. The triggering of these enzymes in the TP53-affected cell combines with the primate-specific G6PC promoter sequence motif that enables G6P substrate accumulation, driving uncompetitive inhibition of G6PD to irreversibility and ROS-mediated cell death. By this catastrophic ‘kill switch’ mechanism, TP53 mutations are effectively prevented from initiating tumorigenesis in the somatic cells of humans, the primate with the highest peak levels of circulating DHEAS. TP53 mutations in human tumors therefore represent fossils of kill switch failure resulting from an age-related decline in circulating DHEAS, a potentially reversible artifact of hominid evolution.