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NADH:ubiquinone oxidoreductase complex assembly factor 2 (NDUFAF2) is a mitochondrial matrix protein that acts as a molecular chaperone supporting the assembly of mitochondrial respiratory complex I (NADH:ubiquinone oxidoreductase), the first and largest enzyme of the mitochondrial electron transport chain[3][5]. NDUFAF2 specifically mediates the recruitment and stabilization of the NADH-dehydrogenase module (N-module) during complex I biogenesis; it is later replaced by NDUFA12 in the mature complex, in a tightly coordinated process[2][5]. Mutations in NDUFAF2 block proper assembly of complex I, resulting in mitochondrial complex I deficiency, most commonly manifesting as Leigh syndrome and other severe neurometabolic disorders[3]. NDUFAF2 is also implicated in primary cilia formation by regulating the docking of ciliary membrane vesicles and the establishment of the transition zone, potentially linking mitochondrial function and cellular signaling[1]. There are no drugs in clinical use directly targeting NDUFAF2, but its diagnostic and mechanistic significance in mitochondrial disease is well established.
Drugs would hypothetically modulate mitochondrial complex I assembly by affecting NDUFAF2’s chaperone or scaffolding activity, but there are no approved drugs directly targeting NDUFAF2.
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