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Transmembrane protein 64 (TMEM64) is a membrane protein localized to the endoplasmic reticulum, involved in regulating cellular calcium signaling and differentiation. It interacts with SERCA2 to enhance TNFSF11 (RANKL)-dependent pathways, critical for osteoclast activation and mitochondrial ROS generation, facilitating bone remodeling. TMEM64 suppresses osteoblast differentiation while promoting adipogenesis through inhibition of the Wnt signaling pathway, mediating mesenchymal stem cell lineage selection. TMEM64 is overexpressed in some cancers (notably hepatocellular carcinoma), suggesting a role in disease, but it is not currently the target of approved drugs. This molecule is considered a therapeutic target due to its roles in bone metabolism and cancer.
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