MTPN

gene
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Also known as MYOTROPHINGCDPV-1

Summary

MTPN (myotrophin, HGNC:15667) is a protein-coding gene on chromosome 7q33, encoding Myotrophin (P58546). Promotes dimerization of NF-kappa-B subunits and regulates NF-kappa-B transcription factor activity.

The transcript produced from this gene is bi-cistronic and can encode both myotrophin and leucine zipper protein 6. The myotrophin protein is associated with cardiac hypertrophy, where it is involved in the conversion of NFkappa B p50-p65 heterodimers to p50-p50 and p65-p65 homodimers. This protein also has a potential function in cerebellar morphogenesis, and it may be involved in the differentiation of cerebellar neurons, particularly of granule cells. A cryptic ORF at the 3’ end of this transcript uses a novel internal ribosome entry site and a non-AUG translation initiation codon to produce leucine zipper protein 6, a 6.4 kDa tumor antigen that is associated with myeloproliferative disease.

Source: NCBI Gene 136319 — RefSeq curated summary.

At a glance

  • GWAS associations: 6
  • Clinical variants (ClinVar): 1 total
  • Druggable target: yes
  • MANE Select transcript: NM_145808

Identifiers

Gene identifiers

FieldValue
HGNC IDHGNC:15667
Approved symbolMTPN
Namemyotrophin
Location7q33
Locus typegene with protein product
StatusApproved
AliasesMYOTROPHIN, GCDP, V-1
Ensembl geneENSG00000105887
Ensembl biotypeprotein_coding
OMIM606484
Entrez136319

Gene structure

Transcript identifiers

Ensembl transcripts: 3 — 3 protein_coding

ENST00000393085, ENST00000435723, ENST00000874999

RefSeq mRNA: 1 — MANE Select: NM_145808 NM_145808

CCDS: CCDS5842

Canonical transcript exons

ENST00000393085 — 4 exons

ExonStartEnd
ENSE00000725079135950599135950682
ENSE00000725085135951517135951630
ENSE00001514152135926760135930012
ENSE00001627701135977029135977359

Expression profiles

Bgee: expression breadth ubiquitous, 256 present calls, max score 99.58.

FANTOM5 (CAGE): breadth ubiquitous, TPM avg 104.2523 / max 872.8772, expressed in 1827 samples.

FANTOM5 promoters (2 alternative TSS)

Promoter IDTPM avgSamples expressed
86379104.25231827
2047840.4978185

Top tissues by expression

256 total, by Bgee expression score (0-100, higher = more expressed):

TissueAnatomy IDExpression scoreQuality
cardiac muscle of right atriumUBERON:000337999.58gold quality
upper arm skinUBERON:000426399.50gold quality
ileal mucosaUBERON:000033199.44gold quality
left ventricle myocardiumUBERON:000656699.08gold quality
superficial temporal arteryUBERON:000161499.00gold quality
kidney epitheliumUBERON:000481998.99gold quality
monocyteCL:000057698.97gold quality
lower lobe of lungUBERON:000894998.95gold quality
trabecular bone tissueUBERON:000248398.93gold quality
Brodmann (1909) area 46UBERON:000648398.93gold quality
tibialis anteriorUBERON:000138598.89gold quality
leukocyteCL:000073898.87gold quality
esophagus squamous epitheliumUBERON:000692098.85gold quality
postcentral gyrusUBERON:000258198.77gold quality
oral cavityUBERON:000016798.73gold quality
cartilage tissueUBERON:000241898.66gold quality
myocardiumUBERON:000234998.63gold quality
parietal lobeUBERON:000187298.62gold quality
nasal cavity epitheliumUBERON:000538498.53gold quality
trigeminal ganglionUBERON:000167598.49gold quality
oviduct epitheliumUBERON:000480498.47gold quality
dorsal root ganglionUBERON:000004498.45gold quality
upper leg skinUBERON:000426298.45gold quality
parietal pleuraUBERON:000240098.44gold quality
superior frontal gyrusUBERON:000266198.44gold quality
cortical plateUBERON:000534398.41gold quality
adult organismUBERON:000702398.40gold quality
pharyngeal mucosaUBERON:000035598.39gold quality
deciduaUBERON:000245098.36gold quality
lateral nuclear group of thalamusUBERON:000273698.36gold quality

Single-cell (SCXA)

Detected in 5 experiment(s), a significant marker in 4.

ExperimentMarker?Max mean expression
E-CURD-122yes21.19
E-MTAB-9221yes19.06
E-HCAD-13yes7.54
E-MTAB-7606no798.36
E-ANND-3no0.00

Regulation

Is transcription factor: no

miRNA regulators (miRDB)

188 targeting MTPN, top 30 by miRDB confidence (max_score; target_count = how many genes the miRNA targets in total — lower means more specific):

miRNAMax scoreAvg scoremiRNA target_count
HSA-MIR-3163100.0077.238605
HSA-MIR-4262100.0073.263931
HSA-MIR-340-5P100.0072.504437
HSA-MIR-4668-3P100.0068.742635
HSA-MIR-6873-3P100.0071.422626
HSA-MIR-6833-3P100.0070.633197
HSA-MIR-190A-3P100.0080.355520
HSA-MIR-4768-5P100.0069.492861
HSA-MIR-8485100.0077.574731
HSA-MIR-7110-3P100.0073.182486
HSA-MIR-5692A100.0074.406850
HSA-MIR-4692100.0067.322066
HSA-MIR-9-5P100.0072.282361
HSA-MIR-3646100.0073.565283
HSA-MIR-520G-5P99.9966.76658
HSA-MIR-181A-5P99.9972.962995
HSA-MIR-181B-5P99.9972.972996
HSA-MIR-181C-5P99.9972.952996
HSA-MIR-181D-5P99.9973.042997
HSA-MIR-318599.9968.121959
HSA-MIR-428299.9975.366408
HSA-MIR-548AW99.9972.573559
HSA-MIR-451499.9967.101870
HSA-MIR-366299.9973.825684
HSA-MIR-223-3P99.9970.141140
HSA-MIR-511-3P99.9968.851467
HSA-MIR-548N99.9871.944170
HSA-MIR-314899.9775.066478
HSA-MIR-50799.9770.111915
HSA-MIR-4666A-3P99.9671.713434

Literature-anchored findings (GeneRIF, showing 8)

  • myotrophin/V-1 is a regulatory protein for modulating the levels of activated NFkappaB dimers. (PMID:11971907)
  • a novel internal ribosome entry site-mediated mechanism may be responsible for the translation of unconventional self-Ag MPD6 in response to IFN-alpha stimulation. (PMID:16982933)
  • T allele of rs17168525 in the 3’-UTR of myotrophin influence the level of myotrophin protein by interfering with let-7 binding.The T allele of MTPN rs17168525 is not associated with the left ventricular hypertrophy risk in essential hypertension patients. (PMID:26274321)
  • In our findings 9cRA emerges has a hormone with a regulatory action on miR-375 that in most cases interfere with Mtpn expression. (PMID:28300567)
  • V-1 and CARMIL induce changes in both proteins’ binding sites on the surface of capping proteins, along with a set of internal residues. (PMID:29847807)
  • Lysyl oxidase suppresses the inflammatory response in anterior cruciate ligament fibroblasts and promotes tissue regeneration by targeting myotrophin via the nuclear factor-kappa B pathway. (PMID:32483895)
  • Crystal structure of human V-1 in the apo form. (PMID:33439151)
  • The ATO/miRNA-885-5p/MTPN axis induces reversal of drug-resistance in cholangiocarcinoma. (PMID:34170484)

Cross-species orthologs

3 orthologs

OrganismSymbolGene ID
danio_reriomtpnENSDARG00000104018
mus_musculusMtpnENSMUSG00000029840
rattus_norvegicusMtpnENSRNOG00000011857

Paralogs (1): ANKRD7 (ENSG00000106013)

Protein

Protein identifiers

MyotrophinP58546 (reviewed: P58546)

Alternative names: Protein V-1

All UniProt accessions (3): P58546, C9JL85, Q69YG1

UniProt curated annotations — full annotation on UniProt →

Function. Promotes dimerization of NF-kappa-B subunits and regulates NF-kappa-B transcription factor activity. Plays a role in the regulation of the growth of actin filaments. Inhibits the activity of the F-actin-capping protein complex formed by the CAPZA1 and CAPZB heterodimer. Promotes growth of cardiomyocytes, but not cardiomyocyte proliferation. Promotes cardiac muscle hypertrophy.

Subunit / interactions. Interacts with RELA. Interacts with the heterodimer formed by CAPZA1 and CAPZB.

Subcellular location. Cytoplasm. Nucleus. Perinuclear region.

Tissue specificity. Ubiquitous.

Induction. Up-regulated in heart left ventricle of patients with severe coronary artery disease and history of myocardial ischemia. Up-regulated in heart left ventricle of patients with dilated cardiomyopathy.

Miscellaneous. This protein is produced by a bicistronic gene which also produces the MPD6 protein from a non-overlapping reading frame. MPD6 belongs to a group of cryptic antigens without conventional genomic structure. It is encoded by a cryptic open reading frame located in the 3’-untranslated region of MTPN.

Similarity. Belongs to the myotrophin family.

RefSeq proteins (1): NP_665807* (*=MANE)

Domains & families (InterPro)

IDNameType
IPR002110Ankyrin_rptRepeat
IPR036770Ankyrin_rpt-contain_sfHomologous_superfamily

Pfam: PF12796

UniProt features (19 total): helix 8, modified residue 5, repeat 3, initiator methionine 1, chain 1, turn 1

Structure

Experimental structures (PDB)

4 structures.

PDBMethodResolution (Å)
3AAAX-RAY DIFFRACTION2.2
7DF7X-RAY DIFFRACTION2.3
7DSBX-RAY DIFFRACTION2.44
7DSAX-RAY DIFFRACTION2.8

Predicted structure (AlphaFold)

ModelpLDDTFraction very-high
AF-P58546-F188.220.42

Functional residue map

Curated UniProt residues grouped by drug-discovery relevance — catalytic, ligand-binding, modification, and mutation-validated positions. Source: UniProtKB sequence features.

Post-translational modifications (5): 2, 4, 11, 24, 31

Function

Pathways and Gene Ontology

Reactome pathways

0 pathways

MSigDB gene sets: 235 (showing top): GOBP_NEGATIVE_REGULATION_OF_PROTEIN_CONTAINING_COMPLEX_ASSEMBLY, AAGCAAT_MIR137, HORIUCHI_WTAP_TARGETS_DN, GOBP_REGULATION_OF_PROTEIN_POLYMERIZATION, GOBP_MUSCLE_TISSUE_DEVELOPMENT, TGCGCANK_UNKNOWN, MODULE_151, CHUNG_BLISTER_CYTOTOXICITY_DN, GOBP_NEGATIVE_REGULATION_OF_PROTEIN_POLYMERIZATION, GOBP_BARBED_END_ACTIN_FILAMENT_CAPPING, GOBP_GROWTH, GOBP_NEGATIVE_REGULATION_OF_ACTIN_FILAMENT_DEPOLYMERIZATION, GOBP_NEUROGENESIS, ATGCAGT_MIR217, GOBP_REGULATION_OF_CELLULAR_COMPONENT_BIOGENESIS

GO Biological Process (10): regulation of translation (GO:0006417), regulation of cell size (GO:0008361), positive regulation of macromolecule biosynthetic process (GO:0010557), positive regulation of cardiac muscle hypertrophy (GO:0010613), regulation of striated muscle tissue development (GO:0016202), neuron differentiation (GO:0030182), positive regulation of cell growth (GO:0030307), obsolete positive regulation of NF-kappaB transcription factor activity (GO:0051092), positive regulation of protein metabolic process (GO:0051247), regulation of barbed-end actin filament capping (GO:2000812)

GO Molecular Function (1): protein binding (GO:0005515)

GO Cellular Component (5): nucleus (GO:0005634), cytoplasm (GO:0005737), cytosol (GO:0005829), F-actin capping protein complex (GO:0008290), perinuclear region of cytoplasm (GO:0048471)

GO top-level categories

Rollup of top GO terms by namespace:

CategoryTerms
cellular anatomical structure3
regulation of protein metabolic process2
positive regulation of macromolecule metabolic process2
cytoplasm2
translation1
post-transcriptional regulation of gene expression1
regulation of cellular component size1
macromolecule biosynthetic process1
positive regulation of biosynthetic process1
regulation of macromolecule biosynthetic process1
cardiac muscle hypertrophy1
regulation of cardiac muscle hypertrophy1
positive regulation of muscle hypertrophy1
striated muscle tissue development1
regulation of muscle organ development1
regulation of muscle tissue development1
cell differentiation1
generation of neurons1
regulation of cell growth1
cell growth1
positive regulation of growth1
positive regulation of cellular process1
protein metabolic process1
regulation of actin filament polymerization1
regulation of actin filament depolymerization1
barbed-end actin filament capping1
binding1
intracellular membrane-bounded organelle1
intracellular anatomical structure1
actin cytoskeleton1
protein-containing complex1

Protein interactions and networks

STRING

1621 interactions, top by confidence (×1000):

Protein AProtein BPartner UniProtScore
MTPNLUZP6Q538Z0925
MTPNTMOD4Q9NZQ9721
MTPNCAPZA1P52907602
MTPNCAPZA2P47755596
MTPNCARMIL1Q5VZK9505
MTPNTLR3O15455474
MTPNTLR8Q9NR97463
MTPNONECUT2O95948457
MTPNSYTL4Q96C24434
MTPNNFKB1P19838426
MTPNINSP01308405
MTPNNFKBIAP25963402
MTPNRPH3ALQ9UNE2397
MTPNZFP90Q8TF47386
MTPNBDNFP23560377
MTPNWWP1Q9H0M0377

IntAct

59 interactions, top by confidence:

ABTypeScore
CAPZA1CAPZBpsi-mi:“MI:0407”(direct interaction)0.750
CAPZA1CAPZBpsi-mi:“MI:0915”(physical association)0.750
CFTRESYT2psi-mi:“MI:0914”(association)0.710
MTPNCAPZA2psi-mi:“MI:0914”(association)0.530
CFTRPLEKHG3psi-mi:“MI:0914”(association)0.480
HIF1ANMTPNpsi-mi:“MI:0210”(hydroxylation reaction)0.440
MTPNAKTIPpsi-mi:“MI:0915”(physical association)0.370
OTUB1psi-mi:“MI:0914”(association)0.350
OTUB1EPM2Apsi-mi:“MI:0914”(association)0.350
KSR1FBLL1psi-mi:“MI:0914”(association)0.350
ORF69PEPDpsi-mi:“MI:0914”(association)0.350
SOD1NPEPPSL1psi-mi:“MI:0914”(association)0.350
ARHGAP35CSTBpsi-mi:“MI:0914”(association)0.350
ARHGAP11BRPN1psi-mi:“MI:0914”(association)0.350
TRIM24DDTLpsi-mi:“MI:0914”(association)0.350
SHTN1psi-mi:“MI:0914”(association)0.350
HTRA4PSMD12psi-mi:“MI:0914”(association)0.350
MAP3K7ACOT7psi-mi:“MI:0914”(association)0.350
GABARAPL2psi-mi:“MI:0914”(association)0.350
MAPTSHTN1psi-mi:“MI:0914”(association)0.350
CAPZBENAHpsi-mi:“MI:0914”(association)0.350
G3BP2RPS3Apsi-mi:“MI:0914”(association)0.350
MTPNPLCG1psi-mi:“MI:0914”(association)0.350
VCPSHTN1psi-mi:“MI:0914”(association)0.350
VCPFAM171A2psi-mi:“MI:0914”(association)0.350

BioGRID (169): DPY30 (Co-fractionation), GARS (Co-fractionation), MTPN (Co-fractionation), NPLOC4 (Co-fractionation), PIP4K2A (Co-fractionation), PIP4K2C (Co-fractionation), UBA1 (Co-fractionation), MTPN (Proximity Label-MS), MTPN (Proximity Label-MS), MTPN (Proximity Label-MS), MTPN (Proximity Label-MS), MTPN (Proximity Label-MS), MTPN (Proximity Label-MS), MTPN (Proximity Label-MS), MTPN (Proximity Label-MS)

ESM2 similar proteins: B0S794, O15084, O75832, P0A2U4, P0A2U5, P31968, P50086, P58546, P62774, P62775, P77736, Q0V9D9, Q10311, Q3T0F7, Q4R3S3, Q505D1, Q54HW1, Q54KH3, Q55FM5, Q5EA33, Q5FWY3, Q5RCK5, Q5TYQ3, Q5VYY1, Q5ZJJ9, Q62422, Q66KY0, Q6P1S6, Q6P686, Q6TGW5, Q6XJU9, Q7T0Q1, Q7T2B9, Q7ZYG4, Q83N02, Q83NH7, Q863Z4, Q8MJ49, Q8MJ50, Q8VE42

Diamond homologs: P58546, P62774, P62775, Q3T0F7, Q6P1S6, Q7T0Q1, Q7T2B9, Q863Z4, Q91955, O95271, Q3UES3, Q55FM5, Q6PFX9, Q8VD46, Q93650, Q9H2K2, Q9VBP3, Q54BA2

SIGNOR signaling

0 interactions.

Enriched among interaction partners

Reactome pathways and GO biological processes over-represented among this gene’s 72 IntAct physical interaction partners (hypergeometric vs the genome-wide background, BH-FDR, gene-set size 15–500, ranked by fold). A functional readout of the neighbourhood — distinct from this gene’s own memberships above, and biased toward well-studied / hub proteins, so read it as themes rather than proof.

Reactome pathways:

PathwayPartnersFoldFDR
Signaling by BRAF and RAF1 fusions517.4×2e-03
Loss of Nlp from mitotic centrosomes516.2×2e-03
Loss of proteins required for interphase microtubule organization from the centrosome516.2×2e-03
AURKA Activation by TPX2515.5×2e-03
Recruitment of mitotic centrosome proteins and complexes513.9×3e-03
Regulation of PLK1 Activity at G2/M Transition512.9×3e-03
Recruitment of NuMA to mitotic centrosomes511.9×4e-03
Anchoring of the basal body to the plasma membrane511.5×4e-03

Disease & clinical

Clinical variants and AI predictions

ClinVar

1 variants total. Per-class counts are floors (≥ shown; pagination cap):

ClassificationCount (floor)
Pathogenic0
Likely pathogenic0
Uncertain significance1
Likely benign0
Benign0

Top pathogenic / likely-pathogenic (0)

SpliceAI

600 predictions. Top by Δscore:

VariantEffectΔscore
7:135930008:GCACC:Gacceptor_gain1.0000
7:135930009:CACC:Cacceptor_gain1.0000
7:135930009:CACCC:Cacceptor_gain1.0000
7:135930010:ACC:Aacceptor_gain1.0000
7:135930011:CC:Cacceptor_gain1.0000
7:135930011:CCC:Cacceptor_gain1.0000
7:135930012:CC:Cacceptor_gain1.0000
7:135930013:C:CCacceptor_gain1.0000
7:135930013:C:CGacceptor_loss1.0000
7:135930013:C:Tacceptor_gain1.0000
7:135930014:T:Aacceptor_loss1.0000
7:135950680:AGCCT:Aacceptor_gain1.0000
7:135950682:CC:Cacceptor_loss1.0000
7:135950682:CCTA:Cacceptor_gain1.0000
7:135950683:C:Aacceptor_loss1.0000
7:135950684:T:Gacceptor_loss1.0000
7:135951505:T:TAdonor_gain1.0000
7:135951512:CGTA:Cdonor_gain1.0000
7:135951513:GTA:Gdonor_loss1.0000
7:135951514:TACAT:Tdonor_loss1.0000
7:135951515:A:ACdonor_gain1.0000
7:135951516:C:CAdonor_gain1.0000
7:135951516:CA:Cdonor_gain1.0000
7:135951516:CAT:Cdonor_gain1.0000
7:135951516:CATT:Cdonor_gain1.0000
7:135951516:CATTA:Cdonor_gain1.0000
7:135951627:CTCC:Cacceptor_gain1.0000
7:135951629:CC:Cacceptor_gain1.0000
7:135951630:CCTGA:Cacceptor_gain1.0000
7:135951631:C:CCacceptor_gain1.0000

AlphaMissense

764 scored. Top likely-pathogenic:

VariantProtein changeam_pathogenicity
7:135950609:A:GL87P0.985
7:135950646:C:GA75P0.983
7:135950606:A:GL88P0.980
7:135951542:A:GL54P0.980
7:135951576:C:GA43P0.978
7:135950645:G:TA75D0.977
7:135951539:A:GL55P0.975
7:135950675:T:AD65V0.973
7:135950609:A:TL87H0.972
7:135929964:C:GA107P0.971
7:135950642:A:TV76D0.970
7:135951578:G:TA42E0.968
7:135950651:A:GL73P0.967
7:135950676:C:GD65H0.967
7:135951544:A:CF53L0.967
7:135951544:A:TF53L0.967
7:135951546:A:GF53L0.967
7:135951595:C:AR36S0.967
7:135951595:C:GR36S0.967
7:135977072:A:GL10P0.967
7:135950654:A:GL72P0.966
7:135950654:A:TL72H0.965
7:135950657:G:TP71H0.964
7:135950620:A:CC83W0.963
7:135977084:A:GF6S0.962
7:135950676:C:AD65Y0.961
7:135929933:A:GL117P0.960
7:135930009:C:GA92P0.960
7:135951575:G:TA43E0.959
7:135950649:A:GS74P0.956

dbSNP variants (sampled 300 via entrez): RS1000031670 (7:135977455 G>GTGCGCA), RS1000104844 (7:135977363 G>A,C), RS1000132480 (7:135964943 A>G), RS1000209192 (7:135960240 A>G), RS1000230659 (7:135971935 G>A), RS1000242953 (7:135958473 T>C), RS1000254504 (7:135965390 A>G), RS1000255845 (7:135952128 C>T), RS1000334399 (7:135964905 A>T), RS1000385848 (7:135952440 T>C), RS1000395179 (7:135977479 G>A,T), RS1000436545 (7:135958381 A>G), RS1000495128 (7:135960205 C>T), RS1000710150 (7:135966274 C>T), RS1000770163 (7:135959441 G>A)

Disease associations

OMIM: gene MIM:606484 | disease phenotypes:

GenCC curated gene-disease

Mondo (0):

Orphanet (0):

HPO phenotypes

0 total (0 of 0 shown, HPO-id order):

GWAS associations

6 associations (top):

StudyTraitp-value
GCST004068_1Venous thromboembolism adjusted for sickle cell variant rs77121243-T9.000000e-06
GCST004603_73Platelet count6.000000e-09
GCST004616_192Platelet distribution width4.000000e-12
GCST004860_4Alcoholic chronic pancreatitis6.000000e-06
GCST90002395_704Mean platelet volume3.000000e-10
GCST90002401_495Platelet distribution width2.000000e-23

EFO canonical traits (2, from GWAS)

EFO IDTrait name
EFO:0004309platelet count
EFO:0007984platelet component distribution width

Drugs & pharmacology

Drug and pharmacology data

Is drug target: yes

ChEMBL targets (1): CHEMBL6067232 (SINGLE PROTEIN)

PharmGKB: 1 entry (VIP=true, CPIC=false)

CTD chemical–gene interactions

21 total (human), top 21 by PubMed support.

ChemicalActions (top 5)PubMed papers
Tobacco Smoke Pollutionaffects expression, increases expression2
FR900359increases phosphorylation1
triphenyl phosphateaffects expression1
bisphenol Aincreases expression1
decabromobiphenyl etherincreases expression1
sodium arseniteincreases expression1
chloropicrinincreases expression1
4-(5-benzo(1,3)dioxol-5-yl-4-pyridin-2-yl-1H-imidazol-2-yl)benzamideaffects cotreatment, increases expression1
ICG 001increases expression1
LDN 193189affects cotreatment, increases expression1
bisphenol AFincreases expression1
4-(4-((5-(4,5-dimethyl-2-nitrophenyl)-2-furanyl)methylene)-4,5-dihydro-3-methyl-5-oxo-1H-pyrazol-1-yl)benzoic acidincreases expression1
Resveratroldecreases expression1
Temozolomidedecreases expression1
Doxorubicinincreases expression1
Endosulfandecreases expression1
Enzyme Inhibitorsincreases O-linked glycosylation, decreases activity1
Tretinoinincreases expression1
Valproic Aciddecreases methylation1
Okadaic Acidincreases expression1
Copper Sulfateincreases expression1

ChEMBL screening assays

1 unique, capped per target: 1 binding

Representative assays (with source publication via chembl_document):

Assay IDTypeDescriptionSource paper
CHEMBL5651840BindingBinding affinity to human MTPN incubated for 45 mins by Kinobead based pull down assayNVP-BHG712: Effects of Regioisomers on the Affinity and Selectivity toward the EPHrin Family. — ChemMedChem

Clinical trials (associated diseases)

0 trials via MONDO — disease-level, not drug-specific.