Title: Elucidating the abilities of MDM2, MDMX and p21 to regulate ferroptosis
Description: In this thesis, I have explored the role of three genes related to p53, namely p21, MDM2 and MDMX, in regulating ferroptosis, a form of non-apoptotic cell death. Ferroptosis, an iron-dependent mechanism that leads to cell death due to lipid peroxidation, has a large potential to be used as a cancer therapy. My results indicate that p21, the effector of p53-mediated cell cycle arrest, can suppress ferroptosis possibly through its interaction with CDKs. Further, that MDM2 and MDMX, the negative regulators of p53, can act as pro-ferroptosis agents and that this role is independent of p53. Using various approaches to alter their activity, I found that MDM2 and MDMX, likely working in part as a complex, normally facilitate ferroptotic death. They were found to alter the cellular lipid profile to prevent the cells from mounting an adequate defense against lipid peroxidation. For example, inhibition of MDM2 or MDMX lead to increased levels of FSP1 protein and a consequent increase in the levels of coenzyme Q₁₀, an endogenous lipophilic antioxidant.

Moreover, I found that PPARα activity is essential for MDM2 and MDMX to promote ferroptosis. My findings also suggest that MDM2-MDMX inhibition might be useful for preventing degenerative diseases involving ferroptosis. Further, that MDM2/MDMX amplification may predict sensitivity of some cancers to ferroptosis inducers. Therefore, I believe that this thesis project has successfully identified several new regulators of ferroptosis and this knowledge can aid better design of therapies centered around ferroptosis.