DNA damage induced by reactive oxygen species and several chemotherapeutic agents promotes both p53 and poly (ADP-ribose) polymerase (PARP) activation. p53 activation is well known to regulate apoptotic cell death, whereas robust activation of PARP-1 has been shown to promote a necrotic cell death associated with energetic collapse. Here we identify a novel role for p53 in modulating PARP enzymatic activity to regulate necrotic cell death. In mouse embryonic fibroblasts, human colorectal and human breast cancer cell lines, loss of p53 function promotes resistance to necrotic, PARP-mediated cell death. We therefore demonstrate that p53 can regulate both necrotic and apoptotic cell death, mutations or deletions in this tumorsuppressor protein may be selected by cancer cells to provide not only their resistance to apoptosis but also to necrosis, and explain resistance to chemotherapy and radiation even when it kills via non-apoptotic mechanisms. Cell Death and Differentiation (2013) 20, 1465-1474 doi:10.1038/cdd.2013 published online 24 May 2013 Mutations in the p53 protein (encoded by TP53 in humans) are detected in approximately half of human cancers.1-3 This tumor-suppressor protein regulates apoptosis, cell cycle and metabolism. Numerous signaling pathways converge in p53 after cellular insults, including DNA damage, oncogene activation or hypoxia. For instance, after DNA injury, p53 is activated promoting cell cycle arrest, transactivation of repairing enzymes and, if the damage cannot be repaired, apoptosis.4 Under these conditions, p53 is posttranscriptionally modified, assisting in the expression of several proteins including p21, GADD45/PCNA or pro-apoptotic genes like BAX, PUMA, NOXA, BID and APAF-1.5 Moreover, a directly pro-apoptotic cytosolic function has been described, directly binding to anti-apoptotic proteins (BCL-2 and BCL-XL) and directly activating BAX and BAK to induce mitochondrial outer membrane permeabilization (MOMP) and apoptosis in a transcriptional-independent manner. 6 Because of its broad effects in the cell, loss of p53 activity confers growth advantage and ensures survival in cancer cells by inhibiting the apoptotic response necessary for tumor suppression. [7][8][9] Following DNA damage, poly(ADP-ribose)polymerase-1 (PARP-1), the founding member of the PARP superfamily of proteins, is activated by DNA nicks and rapidly uses nicotinamide adenine dinucleotide (NAD) to polymerize adenosine diphosphate (ADP)-ribose and covalently modify target proteins to orchestrate DNA repair. These include chromatin structure regulators and DNA modulators like histones, HMG proteins, topoisomerases I and II, DNA helicases, single-strand break repair and base-excision repair enzymes, and different transcription factors.10,11 Briefly, PARP activation promotes chromatin relaxation and the recruitment of base-excision repair proteins, including XRCC1, DNA ligase III and DNA polimerase b, that will ensure the DNA repair. For instance, several studies using either PARP inhibitors or PARP knockout (KO) ...