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Published on: March 15, 2024
Leveraging BRG1 Driven Ferroptosis Resistance to Overcome Treatment Resistance
Abstract:
Resistance to Bruton's tyrosine kinase inhibitors (BTKi) remains a major therapeutic challenge in B-cell malignancies, limiting treatment durability. Here, we identify ferroptosis suppression as a central mechanism of BTKi resistance in mantle cell lymphoma (MCL). Aberrant BRG1 activity protects cells from BTKi-induced ferroptosis by restricting reactive oxygen species (ROS) and labile iron. Mechanistically, BRG1 promotes resistance through both BTK-dependent survival signaling and a BTK-independent transcriptional program. The latter is mediated by BRG1-driven induction of MEF2B, which upregulates NDUFA4L2 to inhibit mitochondrial respiration, thereby blocking mitochondria-dependent ferroptosis. Pharmacologic inhibition of BRG1 disrupts these programs, restoring ferroptotic sensitivity and synergizing with BTKi across resistant MCL models. Together, these findings establish BRG1 as a central regulator of therapy resistance and provide a rationale for co-targeting BRG1 and BTK as a therapeutic strategy for B-cell malignancies.
Insights
Bruton
Area of Science:
- Oncology
- Molecular Biology
- Cancer Research
Background:
- Bruton's tyrosine kinase inhibitors (BTKi) are crucial for treating B-cell malignancies.
- Therapeutic resistance to BTKi limits treatment effectiveness and durability.
- Understanding resistance mechanisms is vital for improving patient outcomes.
Purpose of the Study:
- To investigate the mechanisms underlying BTKi resistance in mantle cell lymphoma (MCL).
- To identify novel therapeutic targets for overcoming BTKi resistance.
Main Methods:
- Investigated ferroptosis suppression as a resistance mechanism.
- Analyzed the role of BRG1 (BRG1-associated factor 1) in regulating ferroptosis.
- Examined BTK-dependent and independent signaling pathways.
- Utilized pharmacologic inhibition of BRG1 in MCL models.
Main Results:
- Ferroptosis suppression is a key mechanism of BTKi resistance in MCL.
- Aberrant BRG1 activity protects MCL cells from ferroptosis by limiting reactive oxygen species (ROS) and labile iron.
- BRG1 promotes resistance via BTK-dependent survival and a BTK-independent transcriptional program involving MEF2B and NDUFA4L2.
- BRG1 inhibition restores ferroptosis sensitivity and synergizes with BTKi.
Conclusions:
- BRG1 is a central regulator of BTKi resistance in B-cell malignancies.
- Co-targeting BRG1 and BTK presents a promising therapeutic strategy for resistant MCL.
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