Alternative titles; symbols
HGNC Approved Gene Symbol: SMAD3
Cytogenetic location: 15q22.33 Genomic coordinates (GRCh38): 15:67,065,602-67,195,169 (from NCBI)
| Location | Phenotype |
Phenotype MIM number |
Inheritance |
Phenotype mapping key |
|---|---|---|---|---|
| 15q22.33 | Loeys-Dietz syndrome 3 | 613795 | Autosomal dominant | 3 |
Drosophila Mad is required for signaling by the TGF-beta (e.g., 190180)-related factor decapentaplegic. Zhang et al. (1996) cloned a human cDNA encoding MADH3, a homolog of Drosophila Mad. The deduced 425-amino acid MADH3 protein (GenBank 2522267) is 92% identical to MADH2 (601366).
By searching an expressed sequence tag database with the protein sequences of Mad and Mad homologs, Riggins et al. (1996) isolated human cDNAs encoding MADH3, which they called JV15-2. The C terminus of MADH3 shows significant homology to that of Drosophila Mad.
Arai et al. (1998) determined the genomic structure of SMAD3, which contains 9 exons.
Riggins et al. (1996) mapped the MADH3 gene to 15q21-q22 by somatic cell hybrid analysis and screening of YAC clones.
Zhang et al. (1996) showed that MADH3 and MADH4 (SMAD4; 600993) synergized to induce strong ligand-independent TGF-beta-like responses. MADH3 containing a C-terminal truncation acted as a dominant-negative inhibitor of the normal TGF-beta response. The activity of MADH3 was regulated by the TGF-beta receptors (e.g., 190181), and MADH3 was phosphorylated and associated with the ligand-bound receptor complex. Zhang et al. (1996) stated that these results define MADH3 as an effector of the TGF-beta response.
Zawel et al. (1998) found that human SMAD3 and SMAD4 proteins could specifically recognize an identical 8-bp palindromic sequence (GTCTAGAC). Tandem repeats of this palindrome conferred striking TGF-beta responsiveness to a minimal promoter. This responsiveness was abrogated by targeted deletion of the cellular SMAD4 gene. These results showed that SMAD proteins are involved in the biologic responses to TGF-beta and related ligands.
You and Kruse (2002) studied corneal myofibroblast differentiation and signal transduction induced by the TGFB family members activin A (147290) and bone morphogenetic protein-7 (BMP7; 112267). They found that activin A induced phosphorylation of SMAD2 (601366), and BMP7 induced SMAD1 (601595), both of which were inhibited by follistatin (136470). Transfection with antisense SMAD2/SMAD3 prevented activin-induced expression and accumulation of alpha-smooth muscle actin. The authors concluded that TGFB proteins have different functions in the cornea. Activin A and TGFB1, but not BMP7, are regulators of keratocyte differentiation and might play a role during myofibroblast transdifferentiation. SMAD2/SMAD3 signal transduction appeared to be important in the regulation of muscle-specific genes.
SMAD3 is a direct mediator of transcriptional activation by the TGF-beta receptor. Its target genes in epithelial cells include cyclin-dependent kinase (CDK; see 116953) inhibitors that generate a cytostatic response. Chen et al. (2002) defined how, in the same context, SMAD3 can mediate transcriptional repression of the growth-promoting gene MYC (190080). A complex containing SMAD3, the transcription factors E2F4 (600659), E2F5 (600967), and DP1 (189902), and the corepressor p107 (116957) preexists in the cytoplasm. In response to TGF-beta, this complex moves into the nucleus and associates with SMAD4, recognizing a composite SMAD-E2F site on MYC for repression. Previously known as the ultimate recipients of CDK regulatory signals, E2F4/E2F5 and p107 act here as transducers of TGF-beta receptor signals upstream of CDK. SMAD proteins therefore mediate transcriptional activation or repression depending on their associated partners.
TGFB (190180) stimulation leads to phosphorylation and activation of SMAD2 and SMAD3, which form complexes with SMAD4 that accumulate in the nucleus and regulate transcription of target genes. Inman et al. (2002) demonstrated that following TGFB stimulation of epithelial cells, receptors remain active for at least 3 to 4 hours, and continuous receptor activity is required to maintain active SMADs in the nucleus and for TGFB-induced transcription. Continuous nucleocytoplasmic shuttling of the SMADs during active TGFB signaling provides the mechanism whereby the intracellular transducers of the signal continuously monitor receptor activity. These data explain how, at all times, the concentration of active SMADs in the nucleus is directly dictated by the levels of activated receptors in the cytoplasm.
Based upon molecular allelotyping and comparative genomic hybridization studies, chromosome 15q is the likely location of a tumor suppressor gene important in the pathogeneses of sporadic enteropancreatic endocrine tumors and parathyroid adenomas. To determine whether SMAD3 plays a primary role in the development of these tumors, Shattuck et al. (2002) investigated 20 enteropancreatic tumors and 67 parathyroid adenomas for LOH at DNA markers surrounding SMAD3. Twenty percent of enteropancreatic tumors and 24% of parathyroid adenomas showed loss. All 9 coding exons and intron-exon boundaries of the SMAD3 gene were then sequenced in genomic DNA from all 20 enteropancreatic and 25 parathyroid tumors, including every case with LOH. No acquired clonal mutations, insertions, or microdeletions in SMAD3 were detected in any tumors. Because inactivating somatic mutation is the hallmark of an authentic tumor suppressor, SMAD3 is unlikely to function as a classic tumor suppressor gene in the pathogenesis of sporadic parathyroid or enteropancreatic endocrine tumors.
Matsuura et al. (2004) showed that SMAD3 is a major physiologic substrate of the G1 cyclin-dependent kinases CDK4 (123829) and CDK2 (116953). Except for the retinoblastoma protein family, SMAD3 was the only CDK4 substrate demonstrated to that time. Matsuura et al. (2004) mapped CDK4 and CDK2 phosphorylation sites to thr8, thr178, and ser212 in SMAD3. Mutation of the CDK phosphorylation sites increased Smad3 transcriptional activity, leading to higher expression of the CDK inhibitor p15 (600431). Mutation of the CDK phosphorylation sites of Smad3 also increased its ability to downregulate the expression of c-myc. Using Smad3 knockout mouse embryonic fibroblasts and other epithelial cell lines, Matsuura et al. (2004) further showed that Smad3 inhibits cell cycle progression from G1 to S phase and that mutation of the CDK phosphorylation sites in Smad3 increases this ability. They concluded that CDK phosphorylation of SMAD3 inhibits its transcriptional activity and antiproliferative function.
To determine the role of SMAD3 in the pathogenesis of lymphoid neoplasia, Wolfraim et al. (2004) measured SMAD3 mRNA and protein in leukemia cells obtained at diagnosis from 19 children with acute leukemia: 10 with T-cell acute lymphoblastic leukemia (ALL), 7 with pre-B-cell ALL, and 2 with acute nonlymphoblastic leukemia (ANLL). SMAD3 protein was absent in T-cell ALL but present in pre-B-cell ALL and ANLL. No mutations in the SMAD3 gene were identified in T-cell ALL, and SMAD3 mRNA was present in T-cell ALL and normal T cells at similar levels. Wolfraim et al. (2004) concluded that loss of SMAD3 protein is a specific feature of pediatric T-cell lymphoblastic leukemia.
In experiments using mouse muscle, Carlson et al. (2008) found that, in addition to the loss of Notch (190198) activation, old muscle produces excessive TGF-beta (but not myostatin, 601788), which induces unusually high levels of Smad3 in resident satellite cells and interferes with the regenerative capacity. Importantly, endogenous Notch and Smad3 antagonize each other in the control of satellite cell proliferation, such that activation of Notch blocks the TGF-beta-dependent upregulation of the cyclin-dependent kinase (CDK) inhibitors p15, p16 (600160), p21 (116899), and p27 (600778), whereas inhibition of Notch induces them. Furthermore, in muscle stem cells, Notch activity determined the binding of Smad3 to the promoters of these negative regulators of cell cycle progression. Attenuation of TGF-beta/Smad3 in old, injured muscle restored regeneration to satellite cells in vivo. Thus, a balance between endogenous Smad3 and active Notch controls the regenerative competence of muscle stem cells, and deregulation of this balance in the old muscle microniche interferes with regeneration.
Davis et al. (2008) demonstrated that induction of a contractile phenotype in human vascular smooth muscle cells by TGF-beta (190180) and BMPs (see 112264) is mediated by miR21 (611020). miR21 downregulates PDCD4 (608610), which in turn acts as a negative regulator of smooth muscle contractile genes. Surprisingly, TGF-beta and BMP signaling promoted a rapid increase in expression of mature miR21 through a posttranscriptional step, promoting the processing of primary transcripts of miR21 (pri-miR21) into precursor miR21 (pre-miR21) by the Drosha complex (see 608828). TGF-beta and BMP-specific SMAD signal transducers SMAD1 (601595), SMAD2 (601366), SMAD3, and SMAD5 (603110) are recruited to pri-miR21 in a complex with the RNA helicase p68 (DDX5; 180630), a component of the Drosha microprocessor complex. The shared cofactor SMAD4 (600993) is not required for this process. Thus, Davis et al. (2008) concluded that regulation of microRNA biogenesis by ligand-specific SMAD proteins is critical for control of the vascular smooth muscle cell phenotype and potentially for SMAD4-independent responses mediated by the TGF-beta and BMP signaling pathways.
Chuderland et al. (2008) identified an SPS motif in ERK2 (MAPK1; 176948) and SMAD3 and a similar TPT motif in MEK1 (MAP2K1; 176872) that directed protein nuclear accumulation when phosphorylated.
Using coimmunoprecipitation and in vitro binding assays, Liu et al. (2017) found that human BRD7 (618489) interacted with SMAD3 and SMAD4 in HEK293T cells. The MH1 and MH2 domains of the SMADs were sufficient for BRD7 binding, and the N-terminal region preceding the bromodomain in BRD7 was required for SMAD binding. Overexpression of BRD7 significantly increased TGF-beta-induced transcriptional activation of p21, whereas knockdown of BRD7 reduced it. Chromatin immunoprecipitation assays demonstrated that, via its bromodomain, BRD7 increased SMAD3/SMAD4 binding to the p21 promoter in the presence of TGF-beta. BRD7 also enhanced TGF-beta-induced transcriptional activity of SMAD4 by interacting and cooperating with p300 (EP300; 602700). BRD7 knockdown attenuated the TGF-beta-induced antiproliferation phenotype in tumor cells, whereas expression of BRD7 had a suppressive effect on tumor formation and enhanced TGF-beta-mediated epithelial-mesenchymal transition responses.
Bertero et al. (2018) described the interactome of SMAD2/3 in human pluripotent stem cells. This analysis revealed that SMAD2/3 is involved in multiple molecular processes in addition to its role in transcription. In particular, Bertero et al. (2018) identified a functional interaction with the METTL3 (612472)-METTL14 (616504)-WTAP (605442) complex, which mediates the conversion of adenosine to N6-methyladenosine (m6A) on RNA. Bertero et al. (2018) showed that SMAD2/3 promotes binding of the m6A methyltransferase complex to a subset of transcripts involved in early cell fate decisions. This mechanism destabilizes specific SMAD2/3 transcriptional targets, including the pluripotency factor gene NANOG (607937), priming them for rapid downregulation upon differentiation to enable timely exit from pluripotency. Bertero et al. (2018) concluded that their findings revealed the mechanism by which extracellular signaling can induce rapid cellular responses through regulation of the epitranscriptome. These aspects of TGF-beta signaling could have far-reaching implications in many other cell types and in diseases such as cancer.
Loeys-Dietz Syndrome 3
In a 4-generation Dutch family with arterial aneurysms and dissections and early-onset osteoarthritis mapping to chromosome 15q22.2-q24.2, van de Laar et al. (2011) analyzed the candidate gene SMAD3 and identified heterozygosity for a missense mutation (R287W; 603109.0001) that segregated with disease. The authors designated the disorder aneurysms-osteoarthritis syndrome (AOS), but it is here incorporated into the Loeys-Dietz phenotypic series as Loeys-Dietz syndrome-3 (LDS3; 613795). Analysis of SMAD3 in 99 patients with thoracic aortic aneurysms and dissections and Marfan-like features, who were known to be negative for mutation in the FBN1 (134797), TGFBR1 (190181), and TGFBR2 (190182) genes, revealed 2 additional probands with heterozygous SMAD3 mutations (603109.0002; 603109.0003). All 3 mutations were located in the MH2 domain, which mediates oligomerization of SMAD3 with SMAD4 (600993) and SMAD-dependent transcriptional activation.
Regalado et al. (2011) reported 4 new mutations in SMAD3. One mutation (603109.0004) was a frameshift mutation in exon 5 segregating in a family with LDS3 phenotype. The other 3 were missense mutations in invariant codons.
Van de Laar et al. (2012) identified 5 novel SMAD3 mutations in 5 additional families with aneurysms-osteoarthritis syndrome (see, e.g., 603109.0008-603109.0010).
Associations Pending Confirmation
For discussion of a possible association between variation in the SMAD3 gene and dizygotic twinning, see 276400.
Exclusion Studies
Using cDNA, Roth et al. (2000) conducted mutation analysis of the SMAD2, SMAD3, and SMAD4 genes in 14 Finnish kindreds with hereditary nonpolyposis colon cancer (see 120435). They found no mutations.
Zhu et al. (1998) reported the targeted disruption of the mouse Smad3 gene. Smad3 mutant mice were viable and fertile. Between 4 and 6 months of age, the Smad3 mutant mice became moribund with colorectal adenocarcinomas. The neoplasms penetrated through the intestinal wall and metastasized to lymph nodes. Since TGF-beta transduces its signal to the interior of the cell via Smad2, Smad3, and Smad4, these results directly implicate TGF-beta signaling in the pathogenesis of colorectal cancer and provide a compelling animal model for the study of human colorectal cancer.
Yang et al. (1999) found that Smad3-null (ex8/ex8) mice died between 1 and 8 months due to a primary defect in immune function. The mice exhibited inflammatory lesions in a number of organs, including the nasal mucosa, stomach, pancreas, colon, and small intestine, as well as enlarged lymph nodes, an involuted thymus, and the formation of bacterial abscesses adjacent to mucosal surfaces. Immunostaining revealed a significant increase in T-cell activation, suggesting that Smad3 has a role in TGFB-mediated regulation of T-cell activation.
Renal tubulointerstitial fibrosis is a chronic inflammatory condition in which renal fibrosis is associated with epithelial-mesenchymal transition of the renal tubules and synthesis of extracellular matrix in response to multiple entities, including ureteral obstruction. TGFB plays a pivotal role in the disease process. Sato et al. (2003) found that Smad3-null mice with ureteral obstruction were protected against tubulointerstitial fibrosis, presumably by blocking the downstream effects of TGFB. Levels of TGFB mRNA and mature protein were decreased in the mutant animals compared to experimental controls, indicating that the Smad3 pathway is also essential for autoinduction of TGFB.
Wolfraim et al. (2004) used mice in which 1 or both alleles of Smad3 were inactivated to evaluate the role of Smad3 in the response of normal T cells to TGF-beta and in the susceptibility to spontaneous leukemogenesis in mice in which both alleles of the tumor suppressor p27(Kip1) (CDKN1B; 600778) were deleted. The loss of 1 allele for Smad3 impaired the inhibitory effect of TGF-beta on the proliferation of normal T cells and worked in tandem with the homozygous inactivation of p27(Kip1) to promote T-cell leukemogenesis. Wolfraim et al. (2004) concluded that a reduction in Smad3 expression and the loss of p27(Kip1) work synergistically to promote T-cell leukemogenesis in mice.
Ashcroft et al. (1999) generated Smad3-null mice and observed accelerated cutaneous wound healing, with complete reepithelialization by day 2 compared to day 5 in wildtype mice, and significantly reduced local infiltration of monocytes. Smad3 -/- keratinocytes showed altered patterns of growth and migration, and Smad3 -/- monocytes exhibited a selectively blunted chemotactic response to TGF-beta (190180).
Arany et al. (2006) created excisional ear wounds in Smad3 -/- mice and observed wound enlargement compared to wildtype controls. Levels of elastin and glycosaminoglycans were increased, collagen fibers were more compactly organized, and integrins, TGFB1, and matrix metalloproteinases were altered both basally and after wounding in Smad3-knockout mice. Mechanical testing revealed an increased modulus of elasticity, suggesting an imbalance of tissue forces. Arany et al. (2006) proposed that the altered mechanical elastic properties lead to a persistent retractile force that is opposed by decreased wound contractile forces.
Kanamaru et al. (2005) found that bone marrow-derived mast cells (BMMCs) from Smad3-null mice had an augmented capacity to produce proinflammatory cytokines upon stimulation with lipopolysaccharide. Mast cell-deficient mice reconstituted with Smad3-null BMMCs survived significantly longer in an acute peritonitis model than mast cell-deficient mice reconstituted with wildtype BMMCs. Kanamaru et al. (2005) proposed that SMAD3 in mast cells inhibits mast cell-mediated immune responses against gram-negative bacteria.
Gupta et al. (2006) retracted their paper describing the identification of a microRNA in the latency-associated transcript (Lat) of herpes simplex virus (HSV)-1 (miR-Lat) that targets TGFB and SMAD3 via sequences in their 3-prime UTRs that show partial homology to miR-Lat.
The article in which Dong et al. (2002) suggested that alterations in the SMAD pathway, including marked SMAD7 (602932) deficiency and SMAD3 upregulation, may be responsible for the TGFB1 (191080) hyperresponsiveness observed in scleroderma (181750) was retracted because some of the elements in figure 3 may have been fabricated.
In 20 affected members of a 4-generation Dutch family with arterial aneurysms and dissections and early-onset osteoarthritis (LDS3; 613795), van de Laar et al. (2011) identified heterozygosity for an 859C-T transition in exon 6 of the SMAD3 gene, resulting in an arg287-to-trp (R287W) substitution at a highly conserved residue within the MH2 domain. The mutation was not found in 7 unaffected family members or in 544 Dutch control chromosomes. Immunohistochemical analysis of aortic wall tissue from 2 patients showed increased expression of key proteins in the TGF-beta (see TGFB1, 190180) pathway.
In 3 Dutch sibs with arterial aneurysms and dissections and early-onset osteoarthritis (LDS3; 613795), van de Laar et al. (2011) identified heterozygosity for a 2-bp deletion (741delAT) in exon 6 of the SMAD3 gene, resulting in a frameshift and a premature termination sequence at codon 309 in exon 7 that removes nearly the complete MH2 domain (Thr247ProfsTer61). The deletion, which was presumably present in their affected deceased father, was not found in their unaffected mother or in 544 Dutch control chromosomes. Analysis of patient cDNA showed very weak mutant signal compared to wildtype, and treatment of patient fibroblast cultures with cycloheximide markedly increased the mutant signal, indicating that most of the abnormal RNA was subjected to nonsense messenger RNA decay and that a truncated SMAD3 protein was barely formed.
In a Dutch male patient with arterial aneurysm and early-onset osteoarthritis (LDS3; 613795), van de Laar et al. (2011) identified heterozygosity for a 783C-T transition in exon 6 of the SMAD3 gene, resulting in a thr261-to-ile (T261I) substitution at a highly conserved residue in the MH2 domain. The mutation was not found in 544 Dutch control chromosomes.
In a 3-generation pedigree segregating autosomal dominant thoracic aortic aneurysms and dissections with intracranial and other arterial aneurysms (LDS3; 613795), Regalado et al. (2011) identified a deletion of an A at nucleotide 652 in exon 5 of the SMAD3 gene, resulting in frameshift leading to premature termination following asparagine-218 (N218fs). This mutation was present in all individuals with vascular disease in the family and segregated with a lod score of 2.52. The pedigree had originally been reported by Regalado et al. (2011). The mutation was absent from 2,300 control exomes.
In 2 unrelated families of European descent with autosomal dominant thoracic aortic and other aneurysms (LDS3; 613795), Regalado et al. (2011) identified a G-to-A transition at nucleotide 836 in exon 6 of the SMAD3 gene, resulting in an arg-to-lys substitution at codon 279 (R279K). Arg279 is completely conserved from human to Drosophila, and the R279K mutation was predicted to disrupt protein function. The mutation was not identified in 2,300 control exomes. There was decreased penetrance in younger family members.
In a small family with 3 sibs affected with thoracic aortic aneurysm and dissection (LDS3; 613795), Regalado et al. (2011) identified a G-to-A transition at nucleotide 715 in exon 6 of the SMAD3 gene, resulting in a glutamine-to-lysine substitution at codon 239 (E239K). Exon 6 encodes the MH2 protein-protein binding domain. Glu239 is completely conserved from human to Drosophila, and the E239K mutation was predicted to disrupt protein function. The mutation was not identified in 2,300 control exomes.
In a family segregating autosomal dominant thoracic aortic aneurysm with dissection as well as other features of Loeys-Dietz syndrome (LDS3; 613795) including bifid uvula and scoliosis, and early-onset osteoarthritis, Regalado et al. (2011) identified a heterozygous alanine-to-valine substitution at codon 112 (A112V). The mutation segregated with disease with reduced penetrance in this family and was not identified in 2,300 control exomes. Guo (2012) stated that the correct nucleotide change for the A112V mutation is 335C-T in exon 2 rather than 235C-T as cited in Regalado et al. (2011).
In a patient with aneurysms-osteoarthritis syndrome (LCS3; 613795), van de Laar et al. (2012) identified a 1-bp deletion at nucleotide 313 of the SMAD3 gene (313delG), resulting in a frameshift (Ala105ProfsTer11).
In a patient with aneurysms-osteoarthritis syndrome (LCS3; 613795), van de Laar et al. (2012) identified a 788C-T transition in the SMAD3 gene, resulting in a pro263-to-leu (P263L) substitution.
In affected members of a family segregating aneurysms-osteoarthritis syndrome (LCS3; 613795), van de Laar et al. (2012) identified a 1-bp duplication at nucleotide 1080 in the SMAD3 gene (1080dupT), resulting in a glu361-to-ter (E361X) substitution.
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