Non-melanoma skin cancers are the most common malignancies in the general population of the United States and are highly prevalent in the veteran population. While not usually fatal, these skin cancers can be a major source of morbidity, impair quality of life, and utilize significant health care resources. Cumulative DNA damage in epidermal keratinocytes, particularly from solar ultraviolet radiation, is an important factor in the development of non-melanoma skin cancers. In addition, certain therapies for other skin diseases utilize DNA damaging agents that increase the risk of skin cancer. Bulky, distorting DNA lesions are removed by the process of nucleotide excision repair, but little is known about the regulation of DNA repair in keratinocytes. Clinical observations and recent in vitro studies, including those from the PI's laboratory, indicate that human keratinocytes possess unique mechanisms for regulating nucleotide excision repair. Loss of the tumor suppressor, p53, in non-keratinocyte cell types typically results in a loss of repair of the most abundant UVR- induced photoproduct. However, work during the current award period has documented that keratinocytes require loss of both p53 and another member of the family-p63-before repair is compromised. Furthermore, recent work in the PI's laboratory suggests that a dual deficiency in p53 and p63 is associated with impaired nucleotide excision repair in squamous cell carcinomas that could be exploited to preferentially kill these cancers. The current proposal seeks to understand the mechanisms by which p53 and p63 regulate DNA repair in human keratinocytes during normal physiology, and to determine their role in the genesis and behavior of non-melanoma skin cancers. We hypothesize that p53 and p63 coordinately regulate repair of the major UVR-induced DNA photoproducts in both undifferentiated and terminally differentiating keratinocytes, and that dysregulation of this process occurs in squamous cell carcinomas and provides a mechanism for mutagenesis and tumor progression that may be therapeutically exploitable. The hypotheses will be tested by the following Specific Aims: 1) To determine the mechanisms by which p53 and p63 regulate repair protein levels in keratinocytes;2) To determine the role of p63 in nucleotide excision repair during keratinocyte differentiation;3) To assess the response of nucleotide excision repair to p63 over-expression in keratinocytes; and 4) To model, characterize and correct p63-mediated repair dysregulation in squamous cell carcinomas. At its conclusion, this project will elucidate the molecular basis of the unique photoprotective mechanisms of epidermal skin cells, allow us to understand how these mechanisms are dysfunctional during skin carcinogenesis, and suggest new strategies for preventing and treating skin cancers.
This project is significant for the health of veterans for the following reasons: 1) Sun-induced skin cancer is a considerable burden on veterans and VA. Skin cancers are the most prevalent malignancy in the United States, significantly affectquality of life are among the most costly of all cancers to treat. These cancers will continue to be a significant issue for VA in the future. 2) The DNA repair system studied also repairs other relevant DNA damage particular to military personnel and veterans, such as DNA lesions from heavy metals and from organic compounds from burning materials. 3) DNA damage and the response of the p53 family arise in other organ systems and injuries and are important in wound healing and other tissues' responses to ischemic or other physical trauma that are significant issues currently deployed troopswho will be the veterans of the future. 4) A mechanistic understanding of skin cancer may lead to more specific medical treatments for skin cancer that avoid the morbidity, travel and cost of surgery.