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Integral membrane protein 2A (ITM2A) is a type II transmembrane protein and member of the BRICHOS domain-containing protein family, expressed in various tissues including musculoskeletal, immune, and neural tissues[1][3][6]. ITM2A plays multifunctional roles: in cartilage and bone, it is implicated in chondrogenic and osteogenic differentiation, with tightly regulated expression necessary for proper development, while altered expression is associated with cartilage pathology like osteoarthritis[1][2]. In the immune system, ITM2A is involved in T-cell maturation and acts downstream of the GATA-3 transcription factor, with altered expression found in autoimmune conditions[1][6]. It negatively regulates both canonical and non-canonical Hedgehog signaling, interferes with autophagic flux through interaction with vacuolar ATPase, and modulates adipogenesis and myogenesis[1]. In cancer, ITM2A functions as a tumor suppressor, with loss of expression linked to increased proliferation, resistance to cell cycle arrest, and chemoresistance; restoring ITM2A expression can sensitize cells to chemotherapy[1]. Additionally, ITM2A has been observed as a potential biomarker in kidney allograft rejection and is associated with several disease contexts, including dementia and ankylosing spondylitis[1][2][6].
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