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MutS protein homolog 4 (MSH4) is a member of the MutS family of DNA mismatch repair–related proteins, but unlike classical mismatch repair proteins, MSH4 is a meiosis-specific protein and does not participate in DNA mismatch correction in somatic cells[3][8]. It is essential for reciprocal recombination and chromosome pairing during meiosis, acting with MSH5 to promote proper synapsis and crossover formation by binding and stabilizing the Holliday junction intermediate structures formed during double-strand break repair[2][3][8]. Inactivation of MSH4 disrupts meiotic recombination, leading to chromosomal missegregation and infertility in both sexes[1][3][4][8]. There is currently no established evidence that MSH4 is a direct therapeutic target or is targeted by any approved drugs. MSH4 is not a drug target in therapeutics such as receptors, enzymes, or channels, and there are no drugs known to interact with it or mechanisms of action described for pharmacological targeting. It is mainly of genetic and developmental research interest, notably in the context of meiosis and fertility.
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