Tumor Protein p63/Nuclear Factor κB Feedback Loop in Regulation of Cell Death*

Background: TP53 members and NF-κB respond to stresses. Results: TAp63α induced the expression of RelA and downstream genes involved in cell cycle arrest or apoptosis. TAp63α and RELA formed protein complexes resulting in their mutual stabilization, and TAp63α induced the RelA transcription. Conclusion: We defined a novel a feedback loop between NF-κB and TP63. Significance: TP53 members and NF-κB contribute to the regulation of cell death. Tumor protein (TP)-p53 family members often play proapoptotic roles, whereas nuclear factor κB (NF-κB) functions as a proapoptotic and antiapoptotic regulator depending on the cellular environment. We previously showed that the NF-κB activation leads to the reduction of the TP63 isoform, ΔNp63α, thereby rendering the cells susceptible to cell death upon DNA damage. However, the functional relationship between TP63 isotypes and NF-κB is poorly understood. Here, we report that the TAp63 regulates NF-κB transcription and protein stability subsequently leading to the cell death phenotype. We found that TAp63α induced the expression of the p65 subunit of NF-κB (RELA) and target genes involved in cell cycle arrest or apoptosis, thereby triggering cell death pathways in MCF10A cells. RELA was shown to concomitantly modulate specific cell survival pathways, making it indispensable for the TAp63α-dependent regulation of cell death. We showed that TAp63α and RELA formed protein complexes resulted in their mutual stabilization and inhibition of the RELA ubiquitination. Finally, we showed that TAp63α directly induced RelA transcription by binding to and activating of its promoter and, in turn, leading to activation of the NF-κB-dependent cell death genes. Overall, our data defined the regulatory feedback loop between TAp63α and NF-κB involved in the activation of cell death process of cancer cells.

Tumor protein (TP)-p53 family members often play proapoptotic roles, whereas nuclear factor B (NF-B) functions as a proapoptotic and antiapoptotic regulator depending on the cellular environment. We previously showed that the NF-〉 activation leads to the reduction of the TP63 isoform, ⌬Np63␣, thereby rendering the cells susceptible to cell death upon DNA damage. However, the functional relationship between TP63 isotypes and NF-B is poorly understood. Here, we report that the TAp63 regulates NF-B transcription and protein stability subsequently leading to the cell death phenotype. We found that TAp63␣ induced the expression of the p65 subunit of NF-B (RELA) and target genes involved in cell cycle arrest or apoptosis, thereby triggering cell death pathways in MCF10A cells. RELA was shown to concomitantly modulate specific cell survival pathways, making it indispensable for the TAp63␣-dependent regulation of cell death. We showed that TAp63␣ and RELA formed protein complexes resulted in their mutual stabilization and inhibition of the RELA ubiquitination. Finally, we showed that TAp63␣ directly induced RelA transcription by binding to and activating of its promoter and, in turn, leading to activation of the NF-B-dependent cell death genes. Overall, our data defined the regulatory feedback loop between TAp63␣ and NF-B involved in the activation of cell death process of cancer cells.
Tp63 encodes several protein isotypes with the long transactivation domain (TD) 2 (TA-) and the short TD (⌬N-) (1,2). ⌬Np63 isotypes often function as a dominant negative inhibitor toward TAp63 isotypes and TP53 exerting the opposing transcriptional functions (1,2). However, a few reports showed that ⌬Np63 isotypes could play the proactive role in regulation of gene transcription, RNA splicing, and signaling leading to modulation of cell survival/cell death, tumorigenesis, and drug resistance (30 -33). Recent findings further showed that the treatment of cancer cells with cisplatin generated phosphorylated (p)-⌬Np63␣ that appears to act similar to TAp63 isotypes or p53 by activating genes implicated in apoptosis and autophagy (34 -36).
We and others previously showed that the NF-〉 activation is a potential mechanism by which levels of ⌬Np63␣ are reduced, thereby rendering the cells susceptible to cell death in the face of cellular stress (37)(38)(39). Although the NF-B was found to regulate TAp63 promoter activity (40), the functional relationship between TAp63 isotypes and NF-B is poorly understood. We showed that TAp63 and NF-B form protein complexes and TAp63 regulates the NF-B transcription and protein stability leading to a cell death phenotype.
Plasmid Constructs-TAp63␣ was amplified from its cDNA and subcloned into the BamHI and NotI sites of the pFLAG-CMV-5.1 (E7901; Sigma) expression vector in front of the FLAG tag. Expression cassettes pCMV4-RelA, pCMV-HA-Ub, pBbc3-luc, and pCDKN1A-luc were purchased from Addgene (as deposited by Dr. Warner Greene, Gladstone Institute of Virology and Immunology, University of California at San Francisco, Dr. Dirk. P. Bohmann, University of Rochester, NY, and Dr. Bert Vogelstein, Johns Hopkins University School of Medicine, Baltimore, MD). The control (empty) TA-luc (LR0000) and RelA-luc (LR0051 and LR0052) reporter vectors were purchased from Panomics/Affymetrix. All clones were verified by sequencing.
Immunoprecipitation Analysis-Cells transfected with various constructs for 48 h were lysed using a lysis buffer (50 mM Tris-HCl, pH 7.4, 150 mM NaCl, 1 mM EDTA, 1% Triton X-100) with protease and phosphatase inhibitors (Sigma). Lysates were precleared with protein A-Sepharose beads and then incubated for 2 h at 4°C with primary antibody or affinity matrix. Immune complexes were precipitated with protein A-Sepharose beads for 4h at 4°C, and the nonspecific bound proteins were washed with the Nonidet P-40 lysis buffer at 4°C. Beads in Laemmli buffer were resolved by SDS-PAGE and immunoblotted with anti-FLAG or anti-HA antibodies.
Semiquantitative (q)RT-PCR-Total RNA was isolated from 1 ϫ 10 6 cells using an RNeasy kit (Qiagen). First-strand cDNA was synthesized from 1 g of total RNA using qScript TM cDNA SuperMix kit (Quanta Biosciences). Each semi-qRT-PCR was performed for 25 or 30 cycles of 1 min at 94°C, 1 min at 55°C, and 1 min at 72°C. Quantitation of the PCR product was performed after electrophoresis on 1% agarose gels and ethidium bromide staining. PCR primers are listed in supplemental Table  S1.
Cellular Viability Assay (MTT Assay)-Cellular viability was monitored by the 3-(4,5-dimethyl thiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay kit (MTT; ATCC). Briefly, 10 4 cells/ well in 96-well plates were cultured in 5% FBS for 24h. 10 l of MTT labeling reagent (5 g/ml) was added to the culture medium without FBS, and the mix was then incubated in the dark for 4 h at 37°C. Cells were lysed by the addition of 100 l of an SDS-based detergent reagent, incubated for 2 h at 37°C, and measurements (A 570 nm to A 650 nm ) were obtained on a Spectra Max 250 96-well plate reader (Molecular Devices). Each assay was carried out in triplicate and repeated at least three times. Diagrams indicated the extent of cell viability expressed as a percentage of control.
NF-B Luciferase Assay-MCF10A and H1299 cells were transfected with the pCMV-TAp63␣-FLAG or control vector using FuGENE HD in the presence or absence of the pRelA-MetLuc2 reporter vector or pMetLuc2 control vector, and after 24 -48 h, the RelA promoter-driven luciferase activity was determined by a Ready-To-Glow pNF-B MetLuc luciferase reporter system (Clontech). Each transfection was performed in duplicate at least three times.
Measurement of RELA Half-life-100 g/ml of cycloheximide (Sigma) was added to MCF10A cells 24 h after transfection with the indicated combination of plasmids. Protein levels were monitored at the indicated time points. To confirm equal loading, the membrane was reprobed with the ␤-actin antibody.
Promoter Luciferase Activity Assays-MCF10A cells were transiently transfected with the Bbc3-luc and pCDKN1A-luc reporter plasmids along with 500 ng of the pCMV-TAp63␣ expression plasmid (where indicated) in the presence or absence of the 1.0 g pCMV4-RelA expression plasmid and the empty pGL3-Basic vector. For the NF-B luciferase assay, MCF10A cells were transiently transfected with the RelA luciferase reporter plasmids along with the 500 ng of pCMV-TAp63␣ expression plasmid in the presence or absence of the 1.0 g of pCMV4-RelA expression plasmid and the TA-luc empty vector. Transfection efficiency was determined by the Renilla luciferase gene-containing pRL-CMV plasmid (Promega). 48 h after transfection, cells were lysed in a lysis buffer (5ϫ PLBR; Promega) with gentle shaking at room temperature for 20 min, and then total lysates were spun down at 13,000 rpm for 2 min to pellet the cell debris. The supernatants were transferred to a fresh tube, and the Dual luciferase activity in 2 l (2 g) of the cell lysates was measured according to the manufacturer's protocol (Promega). Firefly luciferase activity was monitored by a luminometer programmed as described elsewhere (38,39). After stopping the firefly luciferase activity, the Renilla luciferase activity was then measured. Each experiment was repeated at three times with duplicate transfections.
Statistical Analysis-Data represent mean Ϯ S.D. from independent experiments, and statistical analysis was performed using a Student's t test at a significance level of p Ͻ 0.05 to Ͻ 0.001.

TAp63␣ Regulates NF-B/RelA Expression and Cell Death-
TP63 plays a critical role in various cellular processes, including cell proliferation, differentiation, apoptosis, and senescence. We and others recently showed that NF-〉 regulates ⌬Np63␣ and TAp63␣ functions in cellular response to external stimuli (38,39,40). Because both TAp63␣ and NF-B have been implicated in regulation of cell proliferation/differentiation, cell death/survival, we focused our studies on whether TAp63␣ plays a role in regulating NF-B expression.
We initially examined how the TAp63␣ forced expression affects the RELA endogenous expression in MCF10A cells and H1299 cells (Fig. 1). We found that the RELA protein levels markedly increased by the ectopic TAp63␣ (0 -1.5 g) in a dose-dependent manner (Fig. 1, A and C). We further showed that TAp63␣ induced levels of CDKN1A and BBC3 proteins (Fig. 1, A and C), and subsequently increased cell death, as observed by the CASP3 and PARP cleavage (Fig. 1, A and C), and MTT assay (Fig. 1, B and D). Because MCF10A expresses detectable levels of the endogenous TAp63␣, we next transfected MCF10A cells with the scrambled siRNA or TAp63␣ siRNA and found that the RELA protein levels markedly decreased upon the TAp63␣ silencing (Fig. 1E), whereas no changes were found under control (scrambled) conditions. Similarly, the TAp63␣ knockdown exclusively decreased the CDKN1A and BBC3 protein levels (Fig. 1E) and dramatically inhibited the cell death, as observed by a reduced CASP3 and PARP cleavage and MTT assay (Fig. 1F). These findings suggested that TAp63␣ could regulate RELA expression.
We next examined whether overexpression or down-regulation of RELA regulated CDKN1A, BBC3 protein levels, as well as cell survival. We showed that with the increased NF-B expression (0 -1.5 g) up-regulated the TAp63␣, CDKN1A, and BBC3 protein levels, increased the CASP3-and PARPcleaved product levels ( Fig. 2A), and markedly reduced the cell viability (Fig. 2B). At the same time, siRNA-mediated RELA knockdown decreased the TAp63␣, CDKN1A, and BBC3 protein levels (Fig. 2C). To eliminate the off-target effect of RelA-shRNA, the shRNA-resistant pEGFP-p65 Res construct (42) was added to the cells (Fig. 2D). Expression of p65 Res in the RelA knocked-down MCF10A cells exhibited a "rescue" effect on TAp63␣, CDKN1A, and BBC3 protein levels (Fig. 2D). However, shRNA-mediated knockdown of RELA dramatically reduced the cell death, as observed by the decreased CASP3 and PARP cleavage (Fig. 2C), or by cell viability assay (Fig. 2D), whereas co-transfection with the pEGFP-p65 Res plasmid increased cell death (Fig. 2E). These data strongly suggest the specific effect of RelA down-regulation on TAp63␣ expression and cell death.
To examine further the role for TAp63␣/RelA axis in the cell death regulation, we transfected MCF10A cells with 20 nM TAp63␣ siRNA followed by increasing concentration of the ectopic RelA expression cassette (0 -1.5 g). In addition, we transfected MCF10A cells with 1 g of RelA shRNA and then with the TAp63␣ expression cassette (0 -1.5 g). We found that the RELA up-regulation following the TAp63␣ down-regulation increased the CDKN1A, BBC3 protein levels, PARP cleavage, and induced cell death (Fig. 3, A and B). However, the TAp63␣ up-regulation following the RELA down-regulation failed to affect the CDKN1A, BBC3 protein levels, PARP cleavage, and cell death induction (Fig. 3, C and D). This observation suggests that TAp63␣ regulates cell viability of MCF10A cells through a RELA overexpression.
TAp63␣ Binds to RELA and Depresses Its Ubiquitin-mediated Degradation-To explore the molecular mechanism underlying the TAp63␣/NF-B functional relationship, we transfected MCF10A cells with the TAp63␣-FLAG expression cassette. We precipitated total lysates with an anti-FLAG anti-body and probed TAp63␣ protein complexes with an antibody to RELA and vice versa. We showed that TAp63␣ and RELA, indeed, formed protein complexes in MCF10A cells (Fig. 4A).
We previously reported that IKK␤ promotes a proteasomal degradation of ⌬Np63␣ through a NF-B-dependent pathway. Here, we further examined whether the physical interaction of TAp63␣ and RELA leads to a degradation of any of them. We transfected MCF10A cells with the scrambled siRNA and TAp63␣ siRNA and subsequently treated cells with the proteasome inhibitor, MG-132 or control medium. We found that the TAp63␣ down-regulation resulted in a decrease of the endogenous RELA, whereas the MG-132 treatment significantly restored the RELA levels (Fig. 4B), suggesting a proteasome-de-   pendent mechanism for the RELA reduction induced by TAp63␣ knockdown.
To assess directly the role for TAp63␣ in regulation of RELA protein stability, we analyzed the effect of the TAp63␣ forced expression on the RELA half-life in MCF10A cells. Cells were co-transfected with the RELA and TAp63␣ expression cassettes or with scrambled and TAp63␣ siRNAs for 24 h. Cells were further exposed to cycloheximide for an additional 24 h. Immunoblot analysis of RELA at serial time intervals showed that the overexpression of the exogenous TAp63␣ increased the RELA half-life, whereas the down-regulation of the endogenous TAp63␣ dramatically modulated the RELA half-life (Fig.  4, C-E), supporting the notion that TAp63␣ positively regulates the RELA half-life in MCF10A cells.
Because TAp63␣ interacts with RELA and decreases its protein degradation, we further examined the role for ubiquitinproteasome pathway in this process (43). We transfected MCF10A cells with the RelA and HA-Ub expression cassettes along with the increasing concentrations of the TAp63␣ or its siRNA for 36 h, and then cells were treated with MG-132 for an additional 10 h. Total lysates were precipitated with anti-HAmatrix, and then HA-Ub protein complexes were probed with the RELA antibody. We showed that the TAp63␣ down-regulation elevated the ubiquitination of RELA protein, whereas TAp63␣ overexpression modulated RELA ubiquitination in a dose-dependent manner (Fig. 4F, lane 2 to lanes 3-5, or lanes  6 -7), suggesting that TAp63␣ effectively suppressed the RELA ubiquitination. TAp63␣ Can Activate RelA Transcription-To exert its transcriptional activity, NF-B is activated by phosphorylation and then translocates into the nucleus (29,44). We showed that TAp63␣ overexpression led to an increasing Ser-536 phosphorylaton of RELA and subsequent translocation of activated RELA from cytoplasm to nucleus (Fig. 5A). Using semi-qRT-PCR we then found that TAp63␣ induction (0 -1.5 g) caused a significant increase in the RelA mRNA levels, and subsequently a dramatic increase in the levels of mRNAs (e.g. c-Myc, Bcl-xL and Bad) known to be up-regulated by RELA (Fig. 5B).
We next performed the ChIP analysis of the endogenous RelA promoter (supplemental Fig. S1) in MCF10A cells transfected with an empty vector and TAp63␣ expression cassette or scrambled siRNA and TAp63␣ siRNAs. Using the anti-TP63 antibody, we found that TAp63␣ displayed a strong binding enrichment to the specific region (Ϫ1900 to Ϫ1551 bp, where TP63-responsive element is present) (32,33) of the RelA promoter, whereas no binding with the nonspecific region (Ϫ600 to Ϫ351 bp, where TP63-responsive element is absent) of the RelA promoter (Fig. 5C). However, the siRNA-mediated  5 g). A, immunoblotting of the nuclear and cytosolic fractions with indicated antibodies. B, semi-qRT-PCR analysis for mRNA levels of indicated genes. C, ChIP assay performed with MCF10A cells, 72 h after transfection with the TAp63␣ expression construct or an empty vector, as well as with the TAp63␣ siRNA or scrambled siRNA. Total lysates aliquots of the same samples (for specific and nonspecific regions) were tested for both TAp63␣ and ␤-actin levels using immunoblotting, as indicated. TAp63␣-bound RelA promoter DNA was precipitated with the 4A4 antibody followed by the PCR for the specific (Ϫ1900 to Ϫ1551bp; supplemental Fig. S1) and nonspecific regions (Ϫ600 to Ϫ351bp; supplemental Fig. S1), designated as ChIP. PCR with the purified DNA (Input) for both regions is shown. D, MCF10A (left) and H1299 (right) cells were transfected with the basic TA-luc and RelA-luc constructs along with the Renilla luciferase plasmid, with or without the TAp63␣ and/or RelA expression cassette for 24 h. The firefly luciferase activity was normalized for the Renilla luciferase activity. Immunoblotting for TAp63␣ and ␤-actin was performed. Data are presented as relative -fold change units (RFU) from the basic TA-luc activity designated as 1. *, p Յ 0.001(n ϭ 5) compared with basic TA-luc activity or RelA-luc activity alone.
TAp63␣ knockdown caused a significant decrease in its binding to the RelA promoter (Fig. 5C). Altogether, these data supported the notion that TAp63␣ directly regulates RelA transcription.
To examine further the effect of TAp63␣ on the RelA transcription, we transfected MCF10A cells and H1299 cells with the RelA luciferase reporter plasmid along with the TAp63␣ or RelA expression constructs. Using the luciferase reporter assay, we found that TAp63␣ dramatically increased the RelA promoter-driven luciferase activity in both MCF10A and H1299 cells (Fig. 5D). To confirm the activation of RelA after TAp63␣ up-regulation, we transfected MCF10A cells and H1299 cells with 1 g of the TAp63␣ expression cassette along with the pRelA-MetLuc2 reporter construct or pMetLuc2 control con-struct (Fig. 6, A and B). Resulting cells were subjected to luciferase reporter assay (45). We thus found that the TAp63␣ overexpression significantly increased the RelA promoter-enhancer activity in both H1299 and MCF10A cells (Fig. 6, A and B).
Next, we showed that both TAp63␣ and RELA concomitantly induced that expression of cell cycle arrest and pro-apoptotic genes, such as pCdkn1a and Bbc3 (46,47). MCF10A cells were transfected with the pCdkn1a-luc or BBC3-luc constructs along with or without the TAp63␣ and/or RelA expression constructs for 24 h. We then showed that both TAp63␣ and RELA greatly increased Cdkn1a and Bbc3 promoter-driven luciferase activities (Fig. 6, C and D). In addition, co-transfection with the TAp63␣ and RelA expression cassettes further increased the Cdkn1a and Bbc3 promoter activities (Fig. 6, C and D), support-FIGURE 6. TAp63␣ increased levels of RelA-dependent genes. MCF10A cells were transfected with the TAp63␣ expression plasmid (0 -1.5 g). A and B, Ready-To-Glow TM Secreted Luciferase assay for the NF-B/RelA response element-driven Metridia luciferase activity. 12 h after transfection of H1299 (A) and MCF10A (B) cells with the indicated constructs, the medium was replaced, and then after 16 h, samples of the medium were analyzed for secreted Metridia luciferase activity. The -fold induction was calculated following the substrate addition. C and D, luciferase reporter assay for the Cdkn1a (C) and Bbc3 (D) promoters. MCF10A cells were transfected with the basic TA-luc, pCdkn1a-luc, or Bbc3-luc constructs along with the Renilla luciferase plasmid and the TAp63␣ or RelA or basic vector for 24 h. Immunoblotting for each sample was performed for ⌻〈p63␣, RelA, and ␤-actin. Firefly luciferase activity was normalized for the Renilla luciferase activity. Data presented as relative-fold change units (RFU) from the basic TA-luc activity are designated as 1. *, p Յ 0.001(n ϭ 5) compared with basic TA-luc activity, or pCdkn1a-luc (C) or Bbc3-luc (D) activities alone. DECEMBER 16, 2011 • VOLUME 286 • NUMBER 50 ing the notion that TAp63␣ activates the RelA transcription leading to subsequent nuclear translocation of activated RELA and, in turn, to cooperative regulation of the NF-B-dependent downstream target genes playing a critical role in cell cycle arrest or cell death.

DISCUSSION
TP53 family members (TP53, TP63, and TP73) shared their modular structure and function as key regulators of cell cycle arrest and apoptosis and as critical determinants of the tumor progression and chemotherapeutic response (1, 3, 9 -11, 48 -50) TP53 family proteins exert their function through activation or repression of the downstream target genes (1-3, 32, 51). The molecular mechanism underlying the choice between activation and repression of the target genes is very complex and not limited to the inhibitory effect of the protein isotypes lacking the long TD (also known as ⌬N-isotypes).
TA-isotypes often displayed the "transactivation ability," whereas the ⌬N-isotypes may counter the function of p53 or TAp63 or TAp73 isotypes by various mechanisms, including competitive interaction with the same or similar cis-elements in target gene promoters (1-3, 9 -11, 32, 51). However, ⌬Np63 isotypes were shown to regulate the transcription of certain genes using their unique but short TD, as well as other mechanisms of molecular collaborating with other transcriptional factors (10,37,38). ⌬Np63 induces proliferation and growth of tumor cells in vitro and in vivo and leads to an increased nuclear accumulation and signaling of ␤-catenin (30).
Conversely, siRNA knockdown of ⌬Np63␣ from malignant cells overexpressing this oncogenic protein results in cell death, accompanied by the PARP1 cleavage (47,48). Inhibition of endogenous ⌬Np63␣ by lentivirus siRNA in squamous cell carcinoma cells was shown to induce the expression of proapoptotic genes, Bbc3 and Pmaip1 (phorbol-12-myristate-13-acetate-induced protein 1, Noxa), whereas induction of these genes following siRNA knockdown of ⌬Np63␣ requires transactivation by p73 isotypes, suggesting that the elevation of endogenous ⌬Np63␣ in squamous cell carcinoma cells promotes survival through direct repression of p73-dependent transcription of proapoptotic genes (48,49).
As such, ⌬Np63␣ can promote tumorigenesis through direct protein-protein interactions in key proliferative pathways, direct regulation of target genes, or inhibition of the transactivation activity of other TP53 family members (30,32). Whereas p53 is stabilized and up-regulated in response to DNA damage induced by radiation or chemotherapeutic agents, ⌬Np63 was shown to be down-regulated through the ATM-dependent phosphorylation mechanism (1, 3, 34 -36, 38).
We defined a novel molecular mechanism underlying a reciprocal regulation (feedback loop) of the transcription factors NF-B and TP63 in cells undergoing death pathway. We found that the TAp63␣ ectopic expression induced the expression of RelA, and downstream genes involved in cell cycle arrest or apoptosis and, in turn activated apoptotic pathways in MCF10A cells, whereas TAp63␣ siRNA inhibited these processes. We further found that the overexpression or down-regulation of RELA concomitantly modulated similar target genes and pathways leading to modulation of cell viability.
We then found that RELA is indispensable for the TAp63␣dependent regulation of cell death by forming TAp63␣-RELA protein complexes resulting in mutual stabilization, as well as in decrease of RELA ubiquitination. On the contrary, the ⌬Np63␣-RELA functional relationship leads to a down-regulation of both ⌬Np63␣ or RELA in squamous cell carcinoma cells (38,39), whereas the forced ⌬Np63␣ expression in MCF10A cells failed to affect the RELA and BBC3 protein levels. PARP cleavage Reduced CDKN1A level (supplemental Fig. S2). Finally, we determined that TAp63␣ directly induced the RelA transcription by binding to and activating of its promoter and, in turn leading to activation of the NF-B-dependent target genes and contributing to regulation of cell survival. Our data support the notion that TAp63␣ and NF-B exert a functional cooperation leading to regulation of the NF-B-dependent downstream target genes playing a decisive role in cell cycle arrest/cell death (52)(53)(54). They also form a regulatory feedback loop that leads to a tune up-regulation of TAp63 or ⌬Np63 expression by NF-B and control of NF-B expression by TAp63 or ⌬Np63 under specific stress conditions and, in turn activate or repress death pathways in cancer cells upon ligand binding to transmembrane death receptors on the target cell (extrinsic caspase cascade pathway), or upon DNA damage/ stress (intrinsic mitochondrial pathway associated with the release of cytochrome c, apoptosis-inducing factor, and Smac/ Diablo proteins) (for review, see Refs. [55][56][57]. Many components of these pathways are downstream transcriptional targets of TP53 and NF-B (e.g. Apaf1, Bax, Bbc3, Bcl2, Bim, Casp1, Casp8, Casp11, Dapk1, Fas/CD95, FasL, Fadd, Gadd45B, Parp1, p53aip1, Pmaip1, Tnfr1, Tnfrsf6, Trail, and Xiap), as described elsewhere (58 -65), suggesting the interplay between both apoptotic pathways.