The
mammalian BAF complex is disrupted frequently in human disease, and mutations in the subunits of the BAF complex have been responsible for causing roughly 20% of all human tumors. Because the BAF complex is modular, phenotypes in disease can indicate which subunit is altered. Through destabilizing the cBAF complex and the accessibility of enhancers, ARID1A, for instance, is mutated in nearly half of all ovarian clear-cell and endometrioid carcinomas and is associated with loss-of-function defects that occur early in the progression of malignant transformation of endometriosis. The majority of ARID1A mutations are truncating, leading to the protein being lost; however, without ARID1A, cBAF shifts to using ARID1B, which has far less abundance at enhancers, all the while decreasing the accessibility of the chromatin. Beyond defects that target enhancers, the loss of structural subunits removes the platform that recruits BRG1/BRM onto the chromatin, diminishing remodeling at genes involved in
checkpoint and differentiation. Particularly, SMARCB1 is biallelically inactivated in nearly all malignant rhabdoid tumors, which demonstrates one of the first genetic links between loss of the BAF complex and severe pediatric cancers. SMARCA4 loss of function can disable the very ATPase involved in remodeling in BAF and cause
small cell carcinoma of the ovary, hypercalcemic type, while recurring as mutations in non-small cell lung cancers, where the restriction of nucleosome mobility can silence the existing tumor suppressor genes. Carcinogenic potential is not restricted to the cBAF complex, however, since over 40% of clear-cell renal carcinomas are characterized by PBRM1 deletions/truncations. The loss of bromodomain in PBRM1 reduces the ability to recognize acetylated histones, causing a change in gene expression. Although they are less frequent, ARID2 mutations, also disrupting PBAF-derived chromatin regulation, play a part in
hepatocellular carcinoma development like that of hepatitis C through defectively recruiting chromatin remodelers to the tumor suppressors that restrain uncontrolled proliferation. Germline disruption of the BAF complex's chromatin-remodeling specific complexes is a central cause of Mendelian neurodevelopmental disease. Other subunits of the BAF complex, including ARID1A, SMARCB1, SMARCE1, and SMARCA4, can also cause Coffin–Siris–like phenotypes when mutated, underscoring the specific roles of this remodeling machinery in human neural development. By contrast,
Nicolaides–Baraitser syndrome is caused primarily by de novo missense variants in SMARCA2, which produce severe intellectual disability, distal-limb anomalies, and sparse hair.
Role of ARID1A as tumor suppressor ARID1A, as part of cBAF, possesses an essential tumor-suppressing activity that is frequently mutated in various human cancers, including in 46–57% of ovarian
clear cell carcinomas and 30% of endometrioid carcinomas as well as in prostate, breast, pancreatic and more cancers. One of ARID1A's several pivotal functions is its ability to direct cBAF to the enhancers, promoting oncogenesis through faulty genomic regulation. Although ARID1A loss on its own has been shown as insufficient for tumorigenesis, it can induce ovarian
adenocarcinomas when paired with PIK3CA activation, after having released IL-6 and activated
NF-κB. This cooperation between PI3K and ARID1A is prominent because PIK3CA supplies proliferation of cells and the loss of ARID1A changes the interactions between enhancers and inflammation within the cells, creating a feed-forward loop between IL-6, STAT3 and NFkB. Through reactivating tumor suppressors like PIK3IP1, which can represent a potential therapeutic strategy due to its ability to limit PI3K–AKT signalling, EZH2 inhibition is able to target specifically cancer cells that are ARID1A-mutant tumors. Thus, the cell can pass through most immune checkpoints because the loss of ARID1A leads to closing antigen-related enhancers. In prostate tumours, ARID1A deletion combines with loss of PTEN to increase the amount of tumor growth as well as PMN-MDSCs infiltration through continued NF-κB activation. Inflammatory IKKβ signalling
phosphorylates ARID1A, degrading the protein as well as silencing of A20 enhancer activity, which further boosts suppression from immune NF-κB, creating a feedback loop of NF-κB. Without SMARCB1, the chromatin is repressed by Polycomb repressive complexes because SMARCB1 can mark specific genes for silencing and can even compact the chromatin further. In contrast to most cases of cancer, invasive childhood neurological malignancies can arise through even the smallest change, sometimes with SMARCB1 as the sole driver event. In fact, studies in mice have demonstrated that SMARCB1 functions as a tumor suppressor with two major pathways for destruction: if deleted heterozygously, there could be sporadic MRT development, whereas conditional homozygous loss leads to fast-spreading
lymphomas, demonstrating that SMARCB1 by itself can be enough for tumorigenesis. Rhabdoid tumorigenesis, however, can only happen in particular parts of development. For instance, the loss of SMARCB1 affects embryonic progenitors, like neural stem cells or primordial germ cells, more than already differentiated cells, indicating the role of age in tissue tropism of RTs. The activity of enhancers requires SMARCB1, and, as evidence, its loss can stifle the ability of genes to allow cells to differentiate. This creates a therapeutic vulnerability to EZH2 inhibition, a strategy that is supported by clinical evaluation with agents such as tazemetostat. Although rare cases can include the loss of SMARCA4 rather than SMARCB1, the resulting defects in chromatin remodeling are very similar, indicating potentially shared therapeutic targets.
SMARCA4 and cancer SMARCA4, otherwise called BRG1, is one of the most integral tumor suppressors in the BAF complex, and its loss can lead to mechanistically different but functionally similar types of aggressive malignancies. In hypercalcemic ovarian small cell carcinoma, biallelic mutations of SMARCA4 gene, which leads to the loss of BRG1, are extremely widespread, as shown in ovary small cell carcinoma, where 94% of the cases have SMARCA4 mutation. In fact, identification of the genetic status of SMARCA4 is one of the criteria/the main criterion for confirming the disease. Moreover, blocking a second, compensatory pathway that the cells rely on after the first copy of the gene is lost stands out as a therapeutic possibility. In non-small cell lung cancer, SMARCA4 mutations are present in about 5–10% of tumors, especially in those with undifferentiated or rhabdoid phenotype. At a more cellular level, BRG1 loss disrupts chromatin accessibility that cells obtain from SWI/SNF, reducing DNA repair through p53 and BRCA1, as well as activating previously inactivated oncogenic MYC programs. Activation of MYC programs accelerates the cell cycle, increasing transcriptional demand, which promotes growth but also elevates
replication stress. These changes collectively destabilize the genome and lead to dedifferentiation through loss of H3K27 acetylation. These mutations may lead to therapeutic susceptibilities, where SMARCA4-deficient cells face replication stress as well as chromatin compaction, making them highly sensitive to ATR inhibitors. The said replication stress can cause DNA breaks and chromosome instability that drive tumor initiation.
Therapeutic strategies Mutations of the SWI/SNF complex have provided the initial push for finding therapeutic measures to target cancers where ARID1A is mutated. Common ARID1A loss-of-function cancers allow for specific properties that are being examined to understand more about the role of mutations in subunits of SWI/SNF in the proliferation of cancer cells.
Epigenetic therapy is one of the advancements made in this matter, where it was found that cancer cells lacking ARID1A can die when EZH2 is inhibited. In particular, ARID1A-mutant ovarian clear cell carcinomas show dramatic regression when there is the inhibition of EZH2. As such, inhibition of the ATR kinase acts specifically to induce DNA damage, premature
mitosis, and
cell death of ARID1A-loss models, which has prompted clinical studies. ARID1A loss decreases homologous recombination repair, which repairs harmful DNA breaks, so the cells are acutely susceptible to inhibition of PARP, a protein found in the cell nucleus that can detect said DNA damage. Besides impacting the cell cycle alongside DNA repair tracks, ARID1A inactivation produces metabolic instabilities as well. ARID1A-mutant tumors can become addicted to glutamine as a side-product of glycolysis down-regulation in their cells as well as enhanced glutaminase dependence. Therefore, inhibition of GLS1, the enzyme that converts glutamine to glutamate, causes metabolic collapse. Other BAF complex subunits are also being used for research into cancer therapy. In fact, loss of SMARCB1, as seen in cancerous rhabdoid tumors and epithelioid
sarcoma, causes early dependence on EZH2 activity. Similarly, inhibition of EZH2 by the EZH2 inhibitor tazemetostat has shown clinical activity as an approved treatment of SMARCB1-deficient sarcomas. Random mutations of the PBAF sub-complex also offer hints at immune therapy since mutations of the PBRM1 gene in renal cell carcinomas are related to improved response to PD-1 blockade, which uses inhibitors that target PD-1 protein in T cells, allowing the immune system to attack the said cancer cells. == History ==