WWOX maintains epidermal identity and suppresses EMT to prevent aggressive cutaneous squamous cell carcinoma

T Tirza Bidany-Mizrahi (The Concern Foundation Laboratories, The Lautenberg Center for Immunology and Cancer Research, Department of Immunology and Cancer Research, Faculty of Medicine, The Hebrew University of Jerusalem) K Kian Maroun (The Concern Foundation Laboratories, The Lautenberg Center for Immunology and Cancer Research, Department of Immunology and Cancer Research, Faculty of Medicine, The Hebrew University of Jerusalem) M Mara Mancini (Department of Experimental Medicine, University of Rome “Tor Vergata”) O Osama Hidmi (The Concern Foundation Laboratories, The Lautenberg Center for Immunology and Cancer Research, Department of Immunology and Cancer Research, Faculty of Medicine, The Hebrew University of Jerusalem) I Ihab Ansari (Department of Developmental Biology and Cancer Research, Institute for Medical Research Israel-Canada, Hebrew University Medical School) J Jonathan Monin (The Concern Foundation Laboratories, The Lautenberg Center for Immunology and Cancer Research, Department of Immunology and Cancer Research, Faculty of Medicine, The Hebrew University of Jerusalem) T Tal Keidar Haran (Department of Pathology, Hadassah University Hospital) A Alexander Maly (Department of Pathology, Hadassah University Hospital) G Gerry Melino (Department of Experimental Medicine, TOR, University of Rome “Tor Vergata”) E Eleonora Candi (Department of Experimental Medicine, University of Rome “Tor Vergata”) R Rami I. Aqeilan (The Concern Foundation Laboratories, The Lautenberg Center for Immunology and Cancer Research, Department of Immunology and Cancer Research, Faculty of Medicine, The Hebrew University of Jerusalem)

Abstract

Cutaneous squamous cell carcinoma (cSCC), the second most common skin cancer, remains a major health burden worldwide. The WW domain–containing oxidoreductase (WWOX) is frequently altered in cancer; however, its role in epidermal biology and skin carcinogenesis remains undefined. Here, we uncover an essential function for WWOX in safeguarding epithelial identity and restraining cSCC progression. Using conditional knockout mice, we demonstrate that WWOX loss accelerates p53-driven cSCC, resulting in early, highly penetrant, and poorly differentiated tumors. Transcriptomic profiling revealed that WWOX deficiency drives epithelial-to-mesenchymal transition (EMT) and transcriptional plasticity, hallmarks of aggressive disease. Mechanistically, proximity ligation assays together with biochemical and cellular analyses support a close association between WWOX and p63 and imply that WWOX contributes to p63 stabilization; loss of WWOX reduces p63 protein levels and diminishes its binding to epithelial target genes, thereby disrupting epidermal transcriptional programs. Human tissue microarrays confirmed a concordant reduction of WWOX and p63 in advanced cSCC, correlating with poor differentiation. Functional assays in human keratinocytes and cSCC cells further showed that WWOX depletion enhances EMT plasticity, invasiveness, and metastatic colonization. Together, these findings identify WWOX as a critical regulator of epidermal integrity and reveal a previously unrecognized WWOX–p63 axis that constrains EMT and tumor progression in cSCC.

Article Details

Volume / Issue Vol. 123, Issue 16
Published April 21, 2026
ISSN 0027-8424
Publisher National Academy of Sciences

Authors (11)

T

Tirza Bidany-Mizrahi

The Concern Foundation Laboratories, The Lautenberg Center for Immunology and Cancer Research, Department of Immunology and Cancer Research, Faculty of Medicine, The Hebrew University of Jerusalem

K

Kian Maroun

The Concern Foundation Laboratories, The Lautenberg Center for Immunology and Cancer Research, Department of Immunology and Cancer Research, Faculty of Medicine, The Hebrew University of Jerusalem

M

Mara Mancini

Department of Experimental Medicine, University of Rome “Tor Vergata”

O

Osama Hidmi

The Concern Foundation Laboratories, The Lautenberg Center for Immunology and Cancer Research, Department of Immunology and Cancer Research, Faculty of Medicine, The Hebrew University of Jerusalem

I

Ihab Ansari

Department of Developmental Biology and Cancer Research, Institute for Medical Research Israel-Canada, Hebrew University Medical School

J

Jonathan Monin

The Concern Foundation Laboratories, The Lautenberg Center for Immunology and Cancer Research, Department of Immunology and Cancer Research, Faculty of Medicine, The Hebrew University of Jerusalem

T

Tal Keidar Haran

Department of Pathology, Hadassah University Hospital

A

Alexander Maly

Department of Pathology, Hadassah University Hospital

G

Gerry Melino

Department of Experimental Medicine, TOR, University of Rome “Tor Vergata”

E

Eleonora Candi

Department of Experimental Medicine, University of Rome “Tor Vergata”

R

Rami I. Aqeilan

The Concern Foundation Laboratories, The Lautenberg Center for Immunology and Cancer Research, Department of Immunology and Cancer Research, Faculty of Medicine, The Hebrew University of Jerusalem