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Cytochrome c oxidase assembly factor 7 (COA7) is a soluble mitochondrial intermembrane space protein required for the proper assembly and stability of cytochrome c oxidase (complex IV) in the mitochondrial respiratory chain[1][2][3]. The protein contains Sel1-like repeat domains and forms part of the molecular machinery that enables the biogenesis of functional respiratory complex IV, and to some extent is implicated in the assembly of complexes I and III as well[1][2]. Pathogenic variants in the *COA7* gene are causative for complex IV deficiency, clinically manifesting as mitochondrial myopathy, spinocerebellar ataxia with axonal neuropathy, and leukoencephalopathy of variable severity, ranging from isolated myopathy to early-onset developmental regression[1][2][3]. COA7 interacts with the MIA40 import pathway in the mitochondrial intermembrane space, where it is stabilized through disulfide bonds[2]. There are currently no approved drugs directly targeting COA7 or its pathway, but proteasome inhibition has been proposed as a way to rescue COA7 stability and function in cellular models[2].
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