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Myotilin is a muscle-specific structural protein encoded by the MYOT gene, predominantly localized at the Z-discs of sarcomeres in striated muscles (skeletal and cardiac)[1][4][7][8]. It contains two immunoglobulin (Ig)-like domains and a unique serine-rich N-terminal region. Myotilin binds directly to alpha-actinin, actin, filamin C, and other Z-disc proteins, functioning as a scaffold to stabilize actin filaments and maintain structural integrity and alignment within muscle fibers[2][4][7]. Mutations in MYOT can cause inherited muscular disorders such as limb-girdle muscular dystrophy type 1A (LGMD1A) and myofibrillar myopathy, commonly via protein aggregation and disruption of normal sarcomere assembly[1][3][5][8]. Although myotilin is not considered a classical therapeutic target (such as a receptor, transporter, enzyme, or transcription factor), genetic modulation (e.g., RNAi-mediated knockdown) is under investigation as a strategy to treat gain-of-function myotilin-driven myopathies[6].
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