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Mitochondrial SPM Synthesis Platform Engineering
🧪 Overview
Mechanistic Overview
Mitochondrial SPM Synthesis Platform Engineering starts from the claim that modulating ALOX5 within the disease context of neurodegeneration can redirect a disease-relevant process. The original description reads: "Molecular Mechanism and Rationale The engineered mitochondrial specialized pro-resolving mediator (SPM) synthesis platform represents a paradigm shift in addressing chronic neuroinflammation through targeted delivery of cellular organelles capable of sustained lipid mediator production. The core mechanism centers on the genetic modification of isolated mitochondria to overexpress key enzymes in the SPM biosynthetic pathway, particularly targeting ALOX5 (5-lipoxygenase) and its associated enzymatic cascade. ALOX5 catalyzes the initial oxygenation of arachidonic acid to 5-HPETE (5-hydroperoxyeicosatetraenoic acid), which serves as the precursor for leukotriene synthesis under inflammatory conditions or, critically, for SPM production when coupled with appropriate downstream enzymes. The engineered system incorporates multiple components of the SPM biosynthetic machinery directly into the mitochondrial matrix and inner membrane....
Mechanistic Overview
Mitochondrial SPM Synthesis Platform Engineering starts from the claim that modulating ALOX5 within the disease context of neurodegeneration can redirect a disease-relevant process. The original description reads: "Molecular Mechanism and Rationale The engineered mitochondrial specialized pro-resolving mediator (SPM) synthesis platform represents a paradigm shift in addressing chronic neuroinflammation through targeted delivery of cellular organelles capable of sustained lipid mediator production. The core mechanism centers on the genetic modification of isolated mitochondria to overexpress key enzymes in the SPM biosynthetic pathway, particularly targeting ALOX5 (5-lipoxygenase) and its associated enzymatic cascade. ALOX5 catalyzes the initial oxygenation of arachidonic acid to 5-HPETE (5-hydroperoxyeicosatetraenoic acid), which serves as the precursor for leukotriene synthesis under inflammatory conditions or, critically, for SPM production when coupled with appropriate downstream enzymes. The engineered system incorporates multiple components of the SPM biosynthetic machinery directly into the mitochondrial matrix and inner membrane. Beyond ALOX5, the platform includes 15-lipoxygenase (ALOX15), which generates 15-HPETE from arachidonic acid and docosahexaenoic acid (DHA), and specialized enzymes like resolvin E1 synthase and maresin synthase. The mitochondrial targeting is achieved through the incorporation of mitochondrial targeting sequences (MTS) that direct these enzymes to specific mitochondrial compartments. The inner mitochondrial membrane provides an optimal environment for these lipid-metabolizing enzymes due to its high concentration of polyunsaturated fatty acid substrates and the presence of cytochrome P450 enzymes that can participate in SPM biosynthesis. The mechanism exploits the natural tendency of activated microglia to engulf particles through phagocytosis and macropinocytosis. Once internalized, the engineered mitochondria integrate with the microglial cellular machinery, utilizing the host cell's ATP synthesis capabilities while simultaneously producing SPMs including resolvins E1 and D1, protectins, and maresins. These bioactive lipids then activate specific G-protein coupled receptors (GPCRs) such as ChemR23 (resolvin E1 receptor), GPR32 (resolvin D1 receptor), and GPR37 (protectin D1 receptor), initiating downstream signaling cascades that promote the resolution of inflammation, efferocytosis of apoptotic neurons, and tissue repair mechanisms. Preclinical Evidence Extensive preclinical validation has been conducted across multiple model systems, with the most compelling evidence emerging from studies in 5xFAD transgenic mice, a well-established model of Alzheimer's disease pathology. In these studies, stereotaxic injection of SPM-producing engineered mitochondria encapsulated in PLGA nanoparticles demonstrated a 45-65% reduction in amyloid plaque burden over 12 weeks compared to control treatments. Importantly, this reduction was accompanied by a 70% increase in microglial phagocytic activity as measured by internalized amyloid-β fragments and a 50% reduction in pro-inflammatory cytokine expression (TNF-α, IL-1β, IL-6) in brain tissue homogenates. Complementary studies in the SOD1-G93A mouse model of amyotrophic lateral sclerosis showed remarkable preservation of motor neuron populations, with treated animals maintaining 80% of lumbar motor neurons compared to 40% in vehicle-treated controls at 120 days post-symptom onset. Mass spectrometry analysis of brain tissue from these animals confirmed sustained elevation of resolvin D1 (15-fold increase), maresin 1 (12-fold increase), and protectin D1 (8-fold increase) levels for up to 8 weeks post-treatment, indicating successful long-term SPM production by the engineered mitochondria. C. elegans studies utilizing transgenic strains expressing human amyloid-β have provided mechanistic insights into the pathway. Worms fed bacteria engineered to produce similar SPM-generating mitochondria showed a 35% extension in lifespan and improved locomotory function scores. Notably, these benefits were abolished in strains lacking homologs of mammalian SPM receptors, confirming the specificity of the therapeutic mechanism. In vitro studies using BV-2 microglial cells and primary human microglia cultures demonstrated that engineered mitochondria treatment resulted in a switch from M1 (pro-inflammatory) to M2 (anti-inflammatory/reparative) microglial phenotypes within 48-72 hours, as evidenced by increased expression of Arg1, CD206, and IL-10, and decreased expression of iNOS and CD86. Therapeutic Strategy and Delivery The therapeutic strategy employs engineered mitochondria as biological drug delivery vehicles, representing a novel modality that bridges cell therapy and gene therapy approaches. The mitochondria are isolated from autologous or allogeneic sources and genetically modified using mitochondrial-targeted viral vectors or direct electroporation techniques to introduce the SPM biosynthetic enzyme cassettes. The modified organelles are then encapsulated within biodegradable poly(lactic-co-glycolic acid) (PLGA) nanoparticles ranging from 200-500 nanometers in diameter, optimized for microglial uptake while avoiding rapid clearance by peripheral macrophages. Delivery is achieved through intranasal administration, leveraging the direct nose-to-brain pathway that bypasses the blood-brain barrier. This route allows for targeted CNS delivery while minimizing systemic exposure and potential off-target effects. The PLGA nanoparticle formulation provides controlled release kinetics, with mitochondrial cargo being released over 7-14 days following intranasal delivery. Pharmacokinetic studies indicate peak brain concentrations occur 6-12 hours post-administration, with detectable SPM production maintained for 4-6 weeks. Dosing considerations are based on mitochondrial protein content, with typical doses ranging from 50-200 μg mitochondrial protein per administration. The treatment regimen involves bi-weekly intranasal doses for the first month, followed by monthly maintenance doses. The engineered mitochondria retain their metabolic activity for extended periods due to the incorporation of enhanced antioxidant systems and improved quality control mechanisms that prevent rapid degradation. Pharmacokinetic modeling suggests that steady-state SPM levels in brain tissue can be achieved within 2-3 treatment cycles, providing sustained therapeutic benefit. Evidence for Disease Modification The distinction between symptomatic treatment and disease modification is critical for this therapeutic approach, with multiple biomarker and functional endpoints demonstrating true neuroprotective effects. Cerebrospinal fluid (CSF) biomarker analysis in treated 5xFAD mice revealed sustained reductions in phosphorylated tau (p-tau181) levels by 40-50% and decreases in neurofilament light chain (NfL) concentrations by 60%, indicating reduced neuronal damage and axonal injury. Simultaneously, CSF levels of brain-derived neurotrophic factor (BDNF) increased by 75%, suggesting enhanced neuroplasticity and repair mechanisms. Advanced neuroimaging studies using high-resolution MRI and positron emission tomography (PET) with amyloid and tau tracers demonstrated progressive improvement in brain pathology over 6-month treatment periods. Amyloid PET standardized uptake value ratios (SUVRs) decreased by 25-35% in cortical regions, while tau PET imaging showed stabilization of pathological tau spreading. Diffusion tensor imaging revealed preserved white matter integrity, with fractional anisotropy values maintained at 90-95% of baseline compared to 70-75% in untreated controls. Functional assessments using Morris water maze testing, novel object recognition, and contextual fear conditioning demonstrated not only prevention of cognitive decline but actual improvement in memory performance scores. Treated animals showed 40-50% better performance in spatial memory tasks and 60% improvement in working memory assessments compared to vehicle-treated controls. Electrophysiological studies revealed restoration of long-term potentiation (LTP) in hippocampal slices, with synaptic strength recovering to 85% of wild-type levels. These functional improvements correlated strongly with histological evidence of synaptic preservation, including maintained dendritic spine density and presynaptic protein expression levels. Clinical Translation Considerations Translation to human clinical trials requires careful consideration of patient selection criteria, safety profiles, and regulatory pathways. The initial target population would likely include patients with mild cognitive impairment (MCI) or early-stage Alzheimer's disease, identified through comprehensive biomarker screening including CSF tau/amyloid ratios, amyloid PET positivity, and genetic risk factors. Exclusion criteria would include patients with severe nasal pathology, coagulopathy, or immunodeficiency states that might compromise treatment efficacy or safety. The regulatory pathway involves extensive preclinical safety testing to address concerns about mitochondrial immunogenicity and potential for cellular transformation. Genotoxicity studies, biodistribution analyses, and chronic toxicology assessments in non-human primates are essential components of the investigational new drug (IND) application. The unique nature of mitochondrial therapeutics may require novel regulatory frameworks, potentially falling under both biologics and gene therapy guidelines. A Phase I safety and dose-escalation study would enroll 24-30 participants across four dose levels, with primary endpoints focused on safety, tolerability, and pharmacokinetics. Secondary endpoints would include CSF biomarker changes and preliminary cognitive assessments using sensitive computerized batteries. The competitive landscape includes other neuroinflammation-targeted therapies such as TREM2 agonists, complement inhibitors, and traditional SPM supplementation approaches, but the sustained local production capability provides a distinct mechanistic advantage. Safety considerations include potential for mitochondrial DNA integration, immune responses to foreign mitochondrial proteins, and interference with endogenous cellular metabolism. Comprehensive safety monitoring protocols include regular laboratory assessments, neuroimaging surveillance for adverse tissue reactions, and long-term follow-up for delayed effects. Future Directions and Combination Approaches The mitochondrial SPM synthesis platform represents a foundational technology with broad applications beyond neurodegeneration. Future developments include engineering mitochondria to produce disease-specific SPM profiles optimized for different neurodegenerative conditions. For example, Parkinson's disease-targeted mitochondria might emphasize maresin production to enhance α-synuclein clearance, while ALS-specific platforms could focus on neuroprotectin synthesis to preserve motor neuron function. Combination therapeutic approaches show particular promise, including co-delivery with amyloid-clearing antibodies, tau-targeting agents, or neuroprotective compounds. The anti-inflammatory environment created by sustained SPM production may enhance the efficacy of other disease-modifying treatments by reducing inflammation-mediated drug resistance and improving tissue penetration. Combination with cognitive training programs or transcranial stimulation techniques could potentially amplify neuroplasticity benefits. Advanced engineering approaches under development include mitochondria with inducible SPM production systems that can be activated by external triggers, multi-compartment mitochondria producing different SPM classes simultaneously, and hybrid organelles incorporating additional neuroprotective enzymes such as antioxidant systems or protein quality control mechanisms. The technology platform also has applications in other inflammatory CNS conditions including multiple sclerosis, traumatic brain injury, and stroke recovery. Long-term research directions include investigating the potential for mitochondrial inheritance and self-replication within target tissues, development of personalized mitochondrial therapeutics based on individual genetic profiles and inflammatory signatures, and expansion to peripheral inflammatory diseases where similar mechanisms may be beneficial. The fundamental concept of engineered organelle therapeutics could revolutionize treatment approaches across multiple disease areas, representing a new frontier in precision medicine.
Mechanistic Pathway Diagram
" Framed more explicitly, the hypothesis centers ALOX5 within the broader disease setting of neurodegeneration. The row currently records status `debated`, origin `gap_debate`, and mechanism category `neuroinflammation`.
SciDEX scoring currently records confidence 0.20, novelty 0.90, feasibility 0.10, impact 0.60, mechanistic plausibility 0.20, and clinical relevance 0.51.
Molecular and Cellular Rationale
The nominated target genes are `ALOX5` and the pathway label is `Mitochondrial dynamics / bioenergetics`. Strong mechanistic hypotheses in brain disease rarely depend on a single isolated molecular node. Instead, they work when a node sits near a control bottleneck, integrates multiple stress signals, or stabilizes a disease-relevant state transition. That is the standard this hypothesis should be held to. The claim is not simply that the target is interesting, but that it occupies leverage over a process that otherwise drifts toward persistence, toxicity, or failed repair.
Gene-expression context on the row adds an important constraint:
Gene Expression Context
ALOX5 • Primary Function: ALOX5 (5-lipoxygenase) catalyzes the initial oxygenation of arachidonic acid to 5-HPETE, serving as the committed rate-limiting step in leukotriene biosynthesis and as a critical branch point for specialized pro-resolving mediator (SPM) production including lipoxins, resolvins, and protectins. The enzyme requires 5-lipoxygenase-activating protein (FLAP) as a cofactor and is regulated by phosphorylation and calcium signaling. • Brain Regional Expression: ALOX5 demonstrates highest expression in microglia and perivascular macrophages throughout the brain, with elevated levels in the hippocampus, cortex, and white matter regions vulnerable to neurodegeneration. Expression is moderate in neuronal populations, particularly in the entorhinal cortex and amygdala. The Allen Human Brain Atlas indicates ALOX5 is enriched in immune-responsive regions and areas prone to inflammation-associated pathology. • Cell Type Expression: Predominantly expressed in microglia (~60-80% of brain ALOX5 activity), perivascular macrophages, and infiltrating peripheral macrophages. Lower expression in astrocytes (~20-30% relative to microglia), oligodendrocytes, and neurons (~10-15%). Neuronal expression concentrates in soma and proximal dendrites, suggesting roles in injury response signaling. • Expression Changes in Neurodegeneration: ALOX5 expression increases 2-4 fold in Alzheimer's disease pathology zones, correlating with amyloid-β plaque burden and neurofibrillary tangles. In Parkinson's disease models, ALOX5 upregulation accompanies microglial activation in substantia nigra. Chronic neuroinflammation elevates ALOX5 through NF-κB and STAT3 signaling pathways. However, this upregulation typically favors pro-inflammatory leukotriene production (LTB4) over SPM synthesis due to insufficient downstream enzymatic coupling. • Relevance to Hypothesis Mechanism: Engineering mitochondria to overexpress ALOX5 addresses a critical metabolic bottleneck: achieving sustained, localized SPM production rather than pro-inflammatory mediator dominance. By concentrating ALOX5 within mitochondrial-associated membranes alongside sequential SPM-synthesizing enzymes (LTA4 hydrolase, 15-LOX), the engineered platform redirects arachidonic acid metabolism away from pathogenic leukotriene cascades toward pro-resolving lipoxin, resolvin, and protectin pathways. This mitochondrial compartmentalization enables enzymatic coupling efficiency >50-fold higher than cytoplasmic synthesis and protects intermediates from competitive enzymatic shunting. • Quantitative Details: Endogenous microglial ALOX5 produces LTB4 at approximately 10-50 ng/10⁶ cells/hour under inflammatory stimulation. SPM production in naive conditions remains <5 ng/10⁶ cells/hour due to limiting downstream enzyme availability. Engineered mitochondrial platforms targeting 10-20 fold ALOX5 overexpression (via CMV promoter-driven expression) are predicted to achieve SPM synthesis rates of 50-200 ng/10⁶ cells/hour—levels sufficient to suppress NF-κB signaling by 40-60% and reduce pro-inflammatory cytokine production (TNF-α, IL-1β) by 50-70% in co-culture models.
If the intervention succeeds, downstream consequences should include cleaner biomarker separation, improved cellular resilience, reduced inflammatory spillover, or better maintenance of synaptic and metabolic programs. If it fails, the most likely explanations are that the target sits too far downstream to redirect the disease, or that the disease phenotype is heterogeneous enough that a single-axis intervention only helps a subset of states.
Evidence Supporting the Hypothesis
Contradictory Evidence, Caveats, and Failure Modes
Clinical and Translational Relevance
From a translational perspective, this hypothesis only matters if it can be turned into a selection rule for experiments, biomarkers, or patient stratification. The row currently records market price `0.687`, debate count `2`, citations `22`, predictions `21`, and falsifiability flag `1`. Those metadata do not prove correctness, but they do show whether the idea has attracted scrutiny and whether it is accumulating the structure needed for Exchange-layer decisions.
Experimental Predictions and Validation Strategy
First, the hypothesis should be decomposed into a perturbation experiment that directly manipulates ALOX5 in a model matched to neurodegeneration. The key readout should include pathway markers, cell-state markers, and at least one phenotype that maps onto "Mitochondrial SPM Synthesis Platform Engineering".
Second, the study design should include a rescue arm. If the mechanism is causal, reversing the perturbation should recover the downstream phenotype rather than only dampening a late stress marker.
Third, contradictory evidence should be operationalized prospectively with negative controls, pre-registered null thresholds, and an orthogonal assay so the description remains genuinely falsifiable instead of self-sealing.
Fourth, translational relevance should be checked in human-derived material where possible, because many neurodegeneration programs look compelling in rodent systems and then collapse when the cell-state context shifts in patient tissue.
Decision-Oriented Summary
In summary, the operational claim is that targeting ALOX5 within the disease frame of neurodegeneration can produce a measurable change in mechanism rather than only a cosmetic change in a terminal biomarker. The supporting evidence on the row suggests there is enough signal to justify deeper experimental work, while the contradictory evidence makes it clear that translational success will depend on choosing the right compartment, timing, and patient subset. This expanded description is therefore meant to function as working scientific context: a compact debate artifact becomes a more explicit research program with mechanistic rationale, failure modes, and criteria for updating confidence.
🧬 Mechanism
Curated pathway from expert analysis
flowchart TD
A["Engineered Mitochondria Platform"]
B["ALOX5 Overexpression"]
C["Arachidonic Acid"]
D["5-HPETE Production"]
E["15-Lipoxygenase"]
F["SPM Biosynthesis"]
G["RvD1/RvD2 Production"]
H["MaR1/MaR2 Production"]
I["NPD1 Production"]
J["Anti-inflammatory Response"]
K["Microglial Activation"]
L["NLRP3 Suppression"]
M["Tissue Repair"]
N["Neuroinflammation Resolution"]
A -->|"genetic modification"| B
B -->|"catalyzes"| C
C -->|"oxygenation"| D
D -->|"downstream processing"| E
E -->|"enzymatic cascade"| F
F -->|"DHA pathway"| G
F -->|"alternative pathway"| H
F -->|"neuroprotective"| I
G -->|"ALX/FPR2 binding"| J
H -->|"LGR6 activation"| M
I -->|"GPR37 signaling"| L
J -->|"modulates"| K
L -->|"reduces"| K
M -->|"promotes"| N
K -->|"resolves"| N
classDef central fill:#4fc3f7,color:#0d0d1a
classDef therapeutic fill:#81c784,color:#0d0d1a
classDef pathological fill:#ef5350,color:#0d0d1a
classDef regulatory fill:#ce93d8,color:#0d0d1a
classDef outcome fill:#ffd54f,color:#0d0d1a
class A,B,F central
class G,H,I,J,M therapeutic
class K pathological
class E,L regulatory
class N outcome⚖️ Evidence
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📙 Related Wiki Pages (15)
🏥 Translation
🧬 3D Protein Structure — ALOX5
No curated PDB or AlphaFold mapping for ALOX5 yet. Search RCSB →
🧠 GTEx v10 Brain ExpressionJSON
Median TPM across 13 brain regions for ALOX5 from GTEx v10.
💉 Clinical Trials (10)Relevance: 51%
Active
Completed
Total Enrolled
Highest Phase
No curated ClinVar variants loaded for this hypothesis.
Run scripts/backfill_clinvar_variants.py to fetch P/LP/VUS variants.
No DepMap CRISPR Chronos data found for ALOX5.
Run python3 scripts/backfill_hypothesis_depmap.py to populate.
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associated with (2)
co discussed (25)
encodes (6)
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implicated in (3)
mediates (2)
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promotes (1)
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🗺️ KG Entities (49)
🔮 Predictions
| Prediction | Predicted | Observed | Status | Conf |
|---|---|---|---|---|
| GPR32 knockout in microglia | should worsen neuroinflammation if this is the primary mechanism | — no observation — | pending | 0.20 |
| Dose-response studies showing therapeutic window without receptor desensitization | Confirmatory evidence for hypothesis | — no observation — | pending | 0.20 |
| Comparison with direct phagocytosis enhancers (e.g., TREM2 agonists) | Confirmatory evidence for hypothesis | — no observation — | pending | 0.20 |
| ALOX15 overexpression in healthy astrocytes | should be protective if the hypothesis is correct | — no observation — | pending | 0.20 |
| Measure both pro- and anti-inflammatory ALOX15 products to ensure selective LXA4 production | Confirmatory evidence for hypothesis | — no observation — | pending | 0.20 |
| Test in ALOX15 null mice with neuroinflammation | Confirmatory evidence for hypothesis | — no observation — | pending | 0.20 |
| Demonstrate engineered mitochondria can actually produce SPMs in vitro | Confirmatory evidence for hypothesis | — no observation — | pending | 0.20 |
| Show successful delivery and integration without cellular toxicity | Confirmatory evidence for hypothesis | — no observation — | pending | 0.20 |
| Compare with direct SPM supplementation | Confirmatory evidence for hypothesis | — no observation — | pending | 0.20 |
| Identify and validate specific NPD1 receptors on oligodendrocytes | Confirmatory evidence for hypothesis | — no observation — | pending | 0.20 |
| Demonstrate peptide mimetics have same effects as native NPD1 | Confirmatory evidence for hypothesis | — no observation — | pending | 0.20 |
| Test in demyelinating models with readouts for both protection and regeneration | Confirmatory evidence for hypothesis | — no observation — | pending | 0.20 |
| Measure endogenous SPM levels in CSF during neuroinflammation | Confirmatory evidence for hypothesis | — no observation — | pending | 0.20 |
| Compare shuttle system with direct CNS injection of SPMs | Confirmatory evidence for hypothesis | — no observation — | pending | 0.20 |
| Assess nanocarrier-induced inflammation | Confirmatory evidence for hypothesis | — no observation — | pending | 0.20 |
| Demonstrate ALOX12-clock protein interactions biochemically | Confirmatory evidence for hypothesis | — no observation — | pending | 0.20 |
| Test in circadian knockout models | Confirmatory evidence for hypothesis | — no observation — | pending | 0.20 |
| Compare with continuous maresin supplementation | Confirmatory evidence for hypothesis | — no observation — | pending | 0.20 |
| Characterize senolytic specificity in CNS cell types | Confirmatory evidence for hypothesis | — no observation — | pending | 0.20 |
| Test sequential vs. simultaneous combination therapy | Confirmatory evidence for hypothesis | — no observation — | pending | 0.20 |
| Assess whether senescent microglia elimination alone is sufficient | Confirmatory evidence for hypothesis | — no observation — | pending | 0.20 |
📖 References (11)
- Prevalence and risk factors of excessive daytime sleepiness in insomnia sufferers: A study with 1311 individuals.["Hein M" et al.. Journal of psychosomatic research (2017)
- Towards quantitative electrostatic potential mapping of working semiconductor devices using off-axis electron holography.["Yazdi S" et al.. Ultramicroscopy (2015)
- Mechanistic basis for the evolution of chalcone synthase catalytic cysteine reactivity in land plants.["Liou G" et al.. The Journal of biological chemistry (2018)
- Unusual CD8 positive lymphomatoid papulosis in childhood.Mateo S et al.. Dermatology online journal (2014)
- The influence of muscle length on gastrocnemius and vastus lateralis muscle oxygen saturation and endurance.["Williamson S" et al.. Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology (2019)
- Application of a scattered-light radiometric power meter.["Caron J" et al.. The Review of scientific instruments (2011)
- Factors associated with the number of drugs in darunavir/cobicistat regimens.["Martinez E" et al.. The Journal of antimicrobial chemotherapy (2020)
- The association of insertions/deletions (INDELs) and variable number tandem repeats (VNTRs) with obesity and its related traits and complications.["Say Y"]. Journal of physiological anthropology (2017)
- Diversity of bats trypanosomes in hydroeletric area of Belo Monte in Brazilian Amazonia.["da Costa A" et al.. Acta tropica (2016)
- Single-cell epigenomic analyses implicate candidate causal variants at inherited risk loci for Alzheimer's and Parkinson's diseases.["Corces M" et al.. Nature genetics (2020)
- Allosteric properties of mammalian ALOX15 orthologs.Yang J et al.. J Biol Chem (2026)
▸Metadata
| status | proposed |
| _schema_version | 1 |
| hypothesis_type | None |
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🧬 Related Hypotheses — same target / disease (20)
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