Activated p53 in the anti-apoptotic milieu of tuberous sclerosis gene mutation induced diseases leads to cell death if thioredoxin reductase is inhibited

Apoptosis. 2021 Jun;26(5-6):253-260. doi: 10.1007/s10495-021-01670-4. Epub 2021 Apr 16.


Tuberous sclerosis, angiomyolipoma and lymphangioleiomyomatosis are a group of diseases characterized by mutation in tuberous sclerosis genes (TSC 1-2). TSC mutation leads to continuous activation of the mTOR pathway that requires adaptation to increased ATP requirement. With limited treatment options, there is an increasing demand to identify novel therapeutic targets and to understand the correlations between mTOR pathway activation and the lack of cell death in the presence of TSC mutation. In the current study, we demonstrate deregulation of p53 controlled and mitochondria associated cell death processes. The study also reveals that treatment of TSC mutant cells with the drug candidate Proxison combined with reduced concentration of rapamycin can increase production of reactive oxygen species (ROS), can modify miRNA expression pattern associated with p53 regulation and can reduce cell viability.

Keywords: Apoptosis; MTOR; P53; ROS; TSC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Apoptosis / drug effects
  • Apoptosis / genetics*
  • Cell Death / drug effects
  • Cell Death / genetics
  • Cells, Cultured
  • Flavonoids / pharmacology
  • Humans
  • MicroRNAs / genetics
  • Mitochondria / metabolism
  • Mutation
  • Reactive Oxygen Species / metabolism
  • Signal Transduction / drug effects
  • Sirolimus / pharmacology
  • TOR Serine-Threonine Kinases / metabolism
  • Thioredoxin-Disulfide Reductase / antagonists & inhibitors*
  • Thioredoxin-Disulfide Reductase / metabolism
  • Tuberous Sclerosis Complex 1 Protein / genetics*
  • Tuberous Sclerosis Complex 1 Protein / metabolism
  • Tuberous Sclerosis Complex 2 Protein / genetics*
  • Tuberous Sclerosis Complex 2 Protein / metabolism
  • Tumor Suppressor Protein p53 / genetics
  • Tumor Suppressor Protein p53 / metabolism*


  • Flavonoids
  • MicroRNAs
  • Reactive Oxygen Species
  • TP53 protein, human
  • TSC1 protein, human
  • TSC2 protein, human
  • Tuberous Sclerosis Complex 1 Protein
  • Tuberous Sclerosis Complex 2 Protein
  • Tumor Suppressor Protein p53
  • Thioredoxin-Disulfide Reductase
  • MTOR protein, human
  • TOR Serine-Threonine Kinases
  • Sirolimus