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AIA1 (Apoptosis Inducing Agent 1) is a small molecule direct activator of the pro-apoptotic BCL-2 family proteins BAX and BAK. Identified through a high-throughput screen of nearly 100,000 compounds, AIA1 promotes mitochondrial outer membrane permeabilization (MOMP) and the subsequent release of cytochrome c by directly interacting with BAX and BAK. This mechanism triggers apoptotic cell death independently of p53 status, making it a potential therapeutic strategy for p53-mutant cancers that are resistant to traditional DNA-damaging therapies. Preclinical studies have demonstrated that AIA1 can suppress tumor growth and prolong survival in xenograft models of ovarian cancer and acute myeloid leukemia (AML). Furthermore, AIA1 has been shown to sensitize cancer cells to chemotherapy and BH3 mimetics, such as BCL-2 and BCL-XL inhibitors, by increasing the apoptotic priming of the cells.
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