Physiological and pharmacological modulation of BAX

Trends Pharmacol Sci. 2022 Mar;43(3):206-220. doi: 10.1016/j.tips.2021.11.001. Epub 2021 Nov 27.

Abstract

Bcl-2-associated X protein (BAX) is a critical executioner of mitochondrial regulated cell death through its lethal activity of permeabilizing the mitochondrial outer membrane (MOM). While the physiological function of BAX ensures tissue homeostasis, dysregulation of BAX leads to aberrant cell death. Despite BAX being a promising therapeutic target for human diseases, historically the development of drugs has focused on antiapoptotic BCL-2 proteins, due to challenges in elucidating the mechanism of BAX activation and identifying druggable surfaces of BAX. Here, we discuss recent studies that have provided structure-function insights and identified regulatory surfaces that control BAX activation. Moreover, we emphasize the development of small molecule orthosteric, allosteric, and oligomerization modulators that provide novel opportunities for biological investigation and progress towards drugging BAX.

Keywords: BAX; BAX activators; BAX inhibitors; BCL-2 family; apoptosis; mitochondria.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Apoptosis / physiology
  • Humans
  • Mitochondria / metabolism
  • Mitochondrial Membranes* / metabolism
  • Proto-Oncogene Proteins c-bcl-2* / metabolism
  • bcl-2-Associated X Protein / metabolism

Substances

  • Proto-Oncogene Proteins c-bcl-2
  • bcl-2-Associated X Protein