Wisam Zaatra, George Philippos, Petr Smirnov, Shira Milo, Jan Otoničar, Michelle Chan, Michal Harel, Frauke Devens, Tchelet Goldberg, Alexandra Eliassaf, Karen Grimes, Michal Irony-Tur Sinai, Gianluca Sigismondo, Kathrin Laue, Uri Ben-David, Tamar Geiger, Jan O Korbel, Jeroen Krijgsveld, Ori Shalev, Batsheva Kerem, Aurélie Ernst
p53 plays a central role in the DNA damage response, inducing repair, cell-cycle arrest or apoptosis. Its loss is associated with replication stress and genomic instability. While several underlying mechanisms were suggested, the primary triggers of catastrophic genomic events like chromothripsis, a known driver of tumorigenesis linked with p53 loss, are still unclear. Using p53-depleted epithelial cells and fibroblasts, as well as patient-derived fibroblasts with germline p53 variants that spontaneously undergo chromothripsis, we found that p53 loss causes hypertranscription and increased nucleotide consumption. The resulting nucleotide shortage induces replication stress, causing telomere dysfunction, micronuclei formation, and chromothripsis. These effects were rescued by nucleoside supplementation or normalization of transcription levels, demonstrating a causal link between transcriptional activity, nucleotide availability, and genome stability. Emerging chromothriptic clones displayed restored DNA replication, telomere stabilization, and extrachromosomal DNA, suggesting key features that support clonal selection. We identify nucleotide pool homeostasis as a critical p53 function that suppresses replication stress, prevents chromothripsis, and protects against early tumorigenesis.