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Mesenchyme homeobox 2 (MEOX2) is a non-clustered, diverged, antennapedia-like homeobox-containing transcription factor. It regulates key developmental processes such as the formation of bones, muscles, vasculature, and dermatomes, acting through control of myogenic genes including Pax3 and Myf5. In the adult, it is expressed in multiple tissues (higher in cardiovascular, hepatic, and nervous systems). MEOX2 plays a critical role in endothelial cell cycle regulation, vascular development, angiogenesis, and maintenance of pain sensitivity via modulation of nociceptor gene expression. In cancer (particularly gliomas and lung cancer), MEOX2 can promote tumorigenesis, proliferation, invasion, EMT, angiogenesis, and drug resistance; it acts in part by directly regulating transcription of Cathepsin S (CTSS) and activating FAK/AKT/ERK signaling pathways. Loss of function or mutation is associated with skeletal, craniofacial, cardiovascular, and neurological disorders.
Drugs targeting MEOX2 would likely act via modulation of transcription factor activity and gene expression (e.g., silencing, inhibition, small molecule disruptors), affecting downstream pathways such as AKT/ERK and CTSS regulation in cancer.
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