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TOG array regulator of axonemal microtubules protein 2 (TOGARAM2) is a large cytoskeletal protein (1019 amino acids) containing two TOG-like domains that are structurally related to tubulin-binding domains found in other microtubule-associated proteins such as Crescerin-1. TOGARAM2 is predicted to mediate microtubule binding and participate in microtubule cytoskeleton organization, with crucial roles in the function of the cilium and in the organization of the kinocilium and stereocilia of cochlear hair cells—structures essential for hearing. Genetic variants in TOGARAM2 cause autosomal recessive non-syndromic sensorineural hearing loss, likely through disruption of ciliary microtubule stability or organization. Expression of TOGARAM2 is especially prominent in the cochlea during early development, localizing to the base of the kinocilium in both outer and inner hair cells, and less so in other adult tissues. TOGARAM2 has no known direct small-molecule drug interactions, is not a classical therapeutic target (e.g., receptor, enzyme), and there are currently no established drugs, mechanisms of action, or clinical biomarkers associated with it.
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