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Transcription factor 21 (TCF21) is a basic helix-loop-helix (bHLH) transcription factor encoded by the TCF21 gene on chromosome 6. It is highly expressed in several embryonic mesodermal tissues and is essential for the development of the heart, lung, kidney, and spleen. TCF21 regulates cell-fate specification, differentiation, and mesenchymal properties through control of the epithelial-to-mesenchymal transition. It functions as a tumor suppressor, with promoter methylation often observed in cancers such as non–small cell lung cancer, and has been implicated in cardiovascular disease risk due to genetic variants. Loss of TCF21 leads to developmental defects and perinatal lethality in animal models. Despite its biological importance and disease association, there are currently no approved drugs targeting TCF21 directly. TCF21 methylation status serves as a biomarker in oncology research and clinical diagnosis
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