| p22phox, also known as CYBA, is a critical membrane-spanning subunit of the NADPH oxidase (NOX) complex. It forms a stable heterodimer with the catalytic NOX2 (gp91phox) subunit in phagocytes and associates with NOX1, NOX3, and NOX4 in non-phagocytic cells to facilitate the production of superoxide, a process essential for innate immunity and redox signaling. p22phox features a compact four-helix bundle transmembrane domain composed of helices M1 to M4, which laterally interacts with the transmembrane domain of NOX2 across three conserved interfaces involving NOX2’s M3, M4, and M5 and p22phox’s M1 and M4. Its extracellular loops form a glycan shield, while the cytoplasmic C-terminus, containing the Thr147 phosphorylation site, extends into the cytosol to provide docking sites for cytosolic factors. The segment spanning residues 128 to 136 inserts into a crevice in NOX2, stabilizing the overall assembly. p22phox stabilizes the latent NOX complex and facilitates its activation: upon phagocytic stimulation, cytosolic subunits such as p47phox, p67phox, p40phox, and the small GTPase Rac translocate to the membrane, initiating conformational changes that allow docking of NOX2’s dehydrogenase domain. This enables the oxidation of NADPH, electron transfer through flavin and heme cofactors, and reduction of molecular oxygen to superoxide, driving microbicidal reactive oxygen species (ROS) bursts and regulating vascular smooth muscle growth, inflammation, and tumorigenesis. p22phox is indispensable for phagosome maturation, pathogen killing, and also plays non-immune roles such as maintaining endothelial function. Phosphorylation at Thr147 enhances complex assembly. Mutations in p22phox cause chronic granulomatous disease due to impaired ROS production and recurrent infections, whereas overexpression is linked to ROS-driven pathologies such as cancer, where it stabilizes HIF-2α via tuberin phosphorylation, atherosclerosis, neurodegeneration (as seen in SOD1-linked ALS and amyloid-beta-exacerbated neuronal death in Alzheimer’s disease), hyperglycemia, and NF-κB-mediated smooth muscle proliferation. |