The p53 protein is a pivotal tumor suppressor that is frequently mutated in many human cancers, although precisely how p53 prevents tumors is still unclear. To add to its complexity, several isoforms of human p53 have now been reported. The ⌬133p53 isoform is generated from an alternative transcription initiation site in intron 4 of the p53 gene (Tp53) and lacks the N-terminus. Elevated levels of ⌬133p53 have been observed in a variety of tumors. To explore the functions of ⌬133p53, we created a mouse expressing an N-terminal deletion mutant of p53 (⌬122p53) that corresponds to ⌬133p53. ⌬122p53 mice show decreased survival and a different and more aggressive tumor spectrum compared with p53 null mice, implying that ⌬122p53 is a dominant oncogene. Consistent with this, ⌬122p53 also confers a marked proliferative advantage on cells and reduced apoptosis. In addition to tumor development, ⌬122p53 mice show a profound proinflammatory phenotype having increased serum concentrations of interleukin-6 and other proinflammatory cytokines and lymphocyte aggregates in the lung and liver as well as other pathologies. Based on these observations, we propose that human ⌬133p53 also functions to promote cell proliferation and inflammation, one or both of which contribute to tumor development. (Blood. 2011;117(19): 5166-5177) Introduction p53 is most important for preventing cancers. We know this because mice deleted for the p53 gene (Trp53) are highly tumor prone 1 ; in humans, Li-Fraumeni syndrome, characterized by multiple tumor phenotypes, is the result of germline inherited mutations in the p53 gene (Tp53) 2 ; and most common human cancers contain mutations in Tp53 (www.p53.iarc.fr), generally rendering the protein functionally impaired. Ten isoforms of human p53 have been reported that are generated by the use of alternative translation initiation sites, splicing, or alternative promoters. [3][4][5][6][7][8][9] Two p53 isoforms (⌬40p53 and ⌬133p53) lack the N-terminus of p53, whereas 4 others (⌬40p53, ⌬40p53␥, ⌬133p53, and ⌬133p53␥) also lack part of the C-terminus beyond codon 331. In addition, 3 more isoforms have recently been described (⌬160p53, ⌬160p53, ⌬160p53␥) that use an alternative start codon at position 161 in the transcript for the ⌬133p53 isoform family. 8 The isoforms are generally expressed in a variable and to some extent tissue specific manner, although the ⌬133p53 isoform appears to be ubiquitous. 5 Aberrant expression of the ⌬133p53 isoforms occurs in a variety of tumors, including breast, 5 head and neck, 10 acute myeloid leukemia, 11 melanoma, 12 colon cancer, 13 and ovarian cancer, 14 suggesting that ⌬133p53 contributes to tumor formation. In zebrafish, the homolog of ⌬133p53 (⌬113p53) attenuates p53-dependent apoptosis by activating the homolog (bcl2l) of the antiapoptotic protein Bcl-xl, 15 and knockdown of ⌬113p53 using silencing RNA induced p53-dependent apoptosis. In another study, overexpression of ⌬133p53 extended the life span of normal human fibroblasts by inhibiting replicative senescen...