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The SMARCA4 gene (SWI/SNF Related, Matrix Associated, Actin Dependent Regulator of Chromatin, Subfamily A, Member 4) is located on human chromosome 19q13.2 and contains 38 exons. This gene encodes the BRG1 protein, which is composed of 1,870 amino acids and functions as the ATPase catalytic subunit of the SWI/SNF chromatin remodeling complex.
BRG1 Protein Structure and Mechanisms
The BRG1 protein belongs to the SF2 superfamily of DNA-dependent ATPases. Its conserved enzymatic center hydrolyzes ATP to provide energy for remodeling nucleosome–DNA interactions, thereby regulating chromatin accessibility. Structurally, BRG1 contains several key domains:
This multi-domain organization makes BRG1 the molecular engine of SWI/SNF chromatin remodeling activity.
Figure 1. Schematic diagram of the molecular and DNA association of BRG1 with targets related to cardiac hypertrophy. (Ma ZY, et al., 2023)
Within the nucleus, BRG1 catalyzes chromatin remodeling through three main mechanisms:
These actions directly influence the recruitment of transcriptional activators, repressors, and RNA polymerase II to promoters and enhancers, enabling precise transcriptional control. Importantly, BRG1 functions in a developmentally and tissue-specific manner. For example, during neurodevelopment, BRG1-containing npBAF complexes maintain neural progenitor proliferation, while differentiation into neurons requires replacement by nBAF complexes, a process tightly regulated by non-coding RNAs such as Evf2.
BRG1 plays essential roles in embryonic development, lineage differentiation, and metabolic regulation. In mouse models, complete gene deletion leads to embryonic lethality, highlighting its indispensable developmental function. In the nervous system, BRG1 balances self-renewal and differentiation of neural progenitors to ensure cortical development. In brown adipose tissue, BRG1 regulates thermogenic gene expression such as UCP1, contributing to energy metabolism and thermoregulation. It also modulates epithelial–mesenchymal transition (EMT) by cooperating with transcriptional repressors like ZEB1, thereby influencing tissue repair and regeneration.
Loss-of-function mutations in SMARCA4 disrupt chromatin remodeling and lead to profound transcriptional dysregulation. In 2021, the WHO classified SMARCA4-deficient undifferentiated tumors as a distinct thoracic tumor entity. These tumors frequently occur in male smokers and are characterized by the complete absence of BRG1 protein expression, often in conjunction with mutations in TP53, KRAS, or STK11. Genomic studies report mutation frequencies of 5–10% in lung cancer overall, with particularly high rates in large cell carcinoma (LCC).
Clinically, SMARCA4-deficient tumors are highly aggressive, with rapid progression and poor response to standard chemotherapy, targeted therapy, and immunotherapy. Unlike other lung cancers, they often lack expression of markers such as TTF1 and p40, and they rarely harbor common actionable driver mutations (e.g., EGFR, ALK, ROS1).
Beyond thoracic malignancies, SMARCA4 deficiency is strongly linked to ovarian hypercalcemic small cell carcinoma (SCCOHT), a rare but aggressive tumor type in young women. In the majority of SCCOHT cases, BRG1 protein expression is absent, which makes SMARCA4 immunohistochemistry an important diagnostic tool to distinguish SCCOHT from morphologically similar ovarian tumors.
In pathology practice, SMARCA4 immunohistochemistry is now widely applied for diagnosing poorly differentiated or marker-negative tumors. Two categories of mutations have been described:
In cases with uncertain IHC results, next-generation sequencing (NGS) provides critical confirmation.
SMARCA4 deficiency is recognized as an independent marker of poor prognosis in lung cancer and other malignancies. The aggressive biology is thought to stem from the combination of high tumor mutation burden and an immunosuppressive microenvironment, limiting responses to immune checkpoint blockade.
Since BRG1 is a tumor suppressor rather than an oncogenic driver, conventional targeted approaches are not feasible. Research is focusing on synthetic lethality strategies:
Although BRG1-deficient tumors usually show low PD-L1 expression, their high mutation burden suggests that some patients may still benefit from immune checkpoint blockade, particularly when combined with treatments that enhance immunogenicity, such as radiotherapy. Clinical trials are ongoing to explore optimal therapeutic strategies based on SMARCA4 status.
The study of SMARCA4/BRG1 continues to provide insights into chromatin biology and tumorigenesis. In diagnostics, protein-level detection remains a key tool for classification of aggressive tumor subtypes. In therapeutics, synthetic lethality and epigenetic targeting represent promising approaches for tumors lacking SMARCA4 function. Ultimately, a deeper structural and mechanistic understanding of BRG1 may open avenues for rational drug development and precision oncology.
Reference
Nambirajan A, Singh V, Bhardwaj N, et al. SMARCA4/BRG1-Deficient Non-Small Cell Lung Carcinomas: A Case Series and Review of the Literature. Arch Pathol Lab Med. 2021 Jan 1;145(1):90-98.
Ma ZY, Li J, Dong XH, et al. The role of BRG1 in epigenetic regulation of cardiovascular diseases. Eur J Pharmacol. 2023 Oct 15;957:176039.
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