NQO1: A target for the treatment of cancer and neurological diseases, and a model to understand loss of function disease mechanisms

Biochim Biophys Acta Proteins Proteom. Jul-Aug 2019;1867(7-8):663-676. doi: 10.1016/j.bbapap.2019.05.002. Epub 2019 May 12.


NAD(P)H quinone oxidoreductase 1 (NQO1) is a multi-functional protein that catalyses the reduction of quinones (and other molecules), thus playing roles in xenobiotic detoxification and redox balance, and also has roles in stabilising apoptosis regulators such as p53. The structure and enzymology of NQO1 is well-characterised, showing a substituted enzyme mechanism in which NAD(P)H binds first and reduces an FAD cofactor in the active site, assisted by a charge relay system involving Tyr-155 and His-161. Protein dynamics play important role in physio-pathological aspects of this protein. NQO1 is a good target to treat cancer due to its overexpression in cancer cells. A polymorphic form of NQO1 (p.P187S) is associated with increased cancer risk and certain neurological disorders (such as multiple sclerosis and Alzheimer´s disease), possibly due to its roles in the antioxidant defence. p.P187S has greatly reduced FAD affinity and stability, due to destabilization of the flavin binding site and the C-terminal domain, which leading to reduced activity and enhanced degradation. Suppressor mutations partially restore the activity of p.P187S by local stabilization of these regions, and showing long-range allosteric communication within the protein. Consequently, the correction of NQO1 misfolding by pharmacological chaperones is a viable strategy, which may be useful to treat cancer and some neurological conditions, targeting structural spots linked to specific disease-mechanisms. Thus, NQO1 emerges as a good model to investigate loss of function mechanisms in genetic diseases as well as to improve strategies to discriminate between neutral and pathogenic variants in genome-wide sequencing studies.

Keywords: Alzheimer’s disease; Antioxidant enzyme; Multiple sclerosis; Pharmacological chaperone; Protein misfolding; Quinone oxidoreductase.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Alzheimer Disease / drug therapy*
  • Alzheimer Disease / enzymology
  • Alzheimer Disease / genetics
  • Animals
  • Flavin-Adenine Dinucleotide / genetics
  • Flavin-Adenine Dinucleotide / metabolism
  • Genome-Wide Association Study
  • Humans
  • Molecular Chaperones / therapeutic use*
  • Multiple Sclerosis / drug therapy*
  • Multiple Sclerosis / enzymology
  • Multiple Sclerosis / genetics
  • NAD(P)H Dehydrogenase (Quinone) / genetics
  • NAD(P)H Dehydrogenase (Quinone) / metabolism*
  • Neoplasms / drug therapy*
  • Neoplasms / enzymology
  • Neoplasms / genetics
  • Neoplasms / pathology
  • Polymorphism, Genetic
  • Protein Domains
  • Protein Folding / drug effects
  • Tumor Suppressor Protein p53 / genetics
  • Tumor Suppressor Protein p53 / metabolism


  • Molecular Chaperones
  • TP53 protein, human
  • Tumor Suppressor Protein p53
  • Flavin-Adenine Dinucleotide
  • NAD(P)H Dehydrogenase (Quinone)
  • NQO1 protein, human