Mutations in the SMN1 (survival motor neuron 1) gene cause spinal muscular atrophy (SMA). We now show that SMN protein, the SMN1 gene product, interacts directly with the tumor suppressor protein, p53. Pathogenic missense mutations in SMN reduce both self-association and p53 binding by SMN, and the extent of the reductions correlate with disease severity. The inactive, truncated form of SMN produced by the SMN2 gene in SMA patients fails to bind p53 efficiently. SMN and p53 colocalize in nuclear Cajal bodies, but p53 redistributes to the nucleolus in fibroblasts from SMA patients. These results suggest a functional interaction between SMN and p53, and the potential for apoptosis when this interaction is impaired may explain motor neuron death in SMA.Spinal muscular atrophy is a neurodegenerative disorder characterized by loss of the ␣-motor neurons of the spinal cord, resulting in progressive atrophy of the voluntary muscles of the limb and trunk (1). There are three forms of the childhood disease, types I, II, and III, with type I being the most severe. All three forms are due to mutations of the telomeric copy of the SMN1 (survival motor neuron 1) gene (2). The centromeric copy of the SMN gene (SMN2) differs from SMN1 by only 11 nucleotides (2, 3). One of these is a C/T transition located in exon 7 and results in different pre-mRNA splicing patterns; SMN1 produces mainly full-length product, whereas the majority of SMN2-derived transcripts lack exon 7, SMN⌬7 (2-4).SMN is a ubiquitously expressed protein localized within the cytoplasm and the nucleus (2). Nuclear SMN localizes within Cajal bodies (5). Cajal bodies are defined by the presence of p80 coilin (6). Although the precise nature of the motor neuronspecific defect in SMA 1 is not known, the SMN protein has been implicated in several pathways, including nucleo-cytoplasmic transportation, UsnRNP assembly, transcription, and apoptosis (7). SMN can serve as an anti-apoptotic factor in neuronal cells, whereas SMN⌬7 and C-terminal missense mutations promote apoptosis (8). The means by which SMN achieves pro-and anti-apoptotic activities are not known. SMN self-association is a prerequisite for essentially all SMN functions (9 -13). The SMN protein self-associates independently through regions encoded by exons 2b and 6, and the ability to homodimerize correlates with disease severity (14, 15). The primary product of SMN2, SMN⌬7, lacks exon 7, and the resultant protein has a reduced ability to self-associate, accounting for the inability of SMN2 to compensate for the loss of SMN1 (15). The tumor suppressor protein p53 is multifunctional factor involved in cell cycle control (16), DNA repair (17, 18), transcription activation (19,20), and apoptosis (21). p53 can induce apoptosis through several pathways, including mechanisms that are dependent or independent of p53-mediated transcriptional activity (21,22). Under normal physiological conditions, p53 protein levels are maintained at relatively low levels through a negative feedback loop mediated by HDM2 (23-25). ...