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POU class 3 homeobox 4 (POU3F4) is a neural transcription factor encoded by a gene on the X chromosome, primarily involved in early neural development and the formation of the middle and inner ear structures[1][2][4]. It is a member of the POU domain family of transcription factors, characterized by distinct DNA-binding domains and primarily active during embryonic development, where it helps regulate gene expression patterns governing neural and ear formation[1][2][4]. Mutations in POU3F4 cause X-linked nonsyndromic hearing loss (DFN3/DFNX2), often presenting as mixed hearing loss with inner and middle ear abnormalities; affected males are at high risk for surgical complications such as perilymphatic gusher during ear surgery[2]. No approved drugs directly target POU3F4, as it is not a classic therapeutic target but a developmental transcription factor whose dysfunction leads to genetic disease.
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