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D-2-hydroxyglutarate dehydrogenase, mitochondrial (D2HGDH), is an FAD-dependent oxidoreductase enzyme that catalyzes the oxidation of D-2-hydroxyglutarate (D-2-HG) to alpha-ketoglutarate within the mitochondria. It is critical for preventing the toxic accumulation of D-2-HG, which, when elevated, acts as an "oncometabolite" by competitively inhibiting alpha-ketoglutarate–dependent dioxygenases, thereby contributing to epigenetic dysregulation, metabolic reprogramming, and tumorigenesis, especially in IDH-mutant cancers. Mutations in the D2HGDH gene cause D-2-hydroxyglutaric aciduria, a neurometabolic disorder characterized by increased D-2-HG in body fluids. The enzyme is a member of the FAD-binding oxidoreductase/transferase type 4 family and is expressed in mitochondria where it supports essential cellular energy and metabolic processes. Currently, there are no approved drugs that directly target D2HGDH, but its product and interconnected pathways serve as diagnostic and prognostic biomarkers in clinical settings.
For theoretical drugs: enzyme inhibition or activation, altering D-2-hydroxyglutarate levels (no currently approved modulators)
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