MXRA8

gene
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Also known as DKFZp586E2023

Summary

MXRA8 (matrix remodeling associated 8, HGNC:7542) is a protein-coding gene on chromosome 1p36.33, encoding Matrix remodeling-associated protein 8 (Q9BRK3). Transmembrane protein which can modulate activity of various signaling pathways, probably via binding to integrin ITGAV:ITGB3.

Predicted to be involved in establishment of glial blood-brain barrier. Located in extracellular exosome.

Source: NCBI Gene 54587 — RefSeq curated summary.

At a glance

  • GWAS associations: 4
  • Clinical variants (ClinVar): 106 total — 1 likely-pathogenic
  • MANE Select transcript: NM_032348

Identifiers

Gene identifiers

FieldValue
HGNC IDHGNC:7542
Approved symbolMXRA8
Namematrix remodeling associated 8
Location1p36.33
Locus typegene with protein product
StatusApproved
AliasesDKFZp586E2023
Ensembl geneENSG00000162576
Ensembl biotypeprotein_coding
OMIM617293
Entrez54587

Gene structure

Transcript identifiers

Ensembl transcripts: 14 — 8 protein_coding, 6 retained_intron

ENST00000309212, ENST00000342753, ENST00000445648, ENST00000460473, ENST00000464351, ENST00000473097, ENST00000474033, ENST00000476718, ENST00000477278, ENST00000478517, ENST00000897927, ENST00000953649, ENST00000953650, ENST00000953651

RefSeq mRNA: 5 — MANE Select: NM_032348 NM_001282582, NM_001282583, NM_001282584, NM_001282585, NM_032348

CCDS: CCDS24, CCDS59950, CCDS59951, CCDS59952

Canonical transcript exons

ENST00000309212 — 10 exons

ExonStartEnd
ENSE0000106649913543541354509
ENSE0000113027713552441355345
ENSE0000120898513554501355752
ENSE0000122436513546821355152
ENSE0000122437813566811356704
ENSE0000182967313584561358555
ENSE0000182976113526911353629
ENSE0000346947413541931354232
ENSE0000355881213540301354106
ENSE0000367227513538481353928

Expression profiles

Bgee: expression breadth ubiquitous, 270 present calls, max score 99.32.

FANTOM5 (CAGE): breadth ubiquitous, TPM avg 51.9366 / max 856.3660, expressed in 1167 samples.

FANTOM5 promoters (10 alternative TSS)

Promoter IDTPM avgSamples expressed
977049.21881134
97660.5725352
97670.3829201
97630.3521149
97650.3071172
97620.3012163
97680.2505122
97640.2474127
97690.2102113
97710.093936

Top tissues by expression

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

TissueAnatomy IDExpression scoreQuality
stromal cell of endometriumCL:000225599.32gold quality
tibial nerveUBERON:000132399.19gold quality
deciduaUBERON:000245099.08gold quality
endocervixUBERON:000045898.93gold quality
body of uterusUBERON:000985398.91gold quality
right coronary arteryUBERON:000162598.87gold quality
right ovaryUBERON:000211898.80gold quality
gall bladderUBERON:000211098.79gold quality
ascending aortaUBERON:000149698.68gold quality
left ovaryUBERON:000211998.68gold quality
thoracic aortaUBERON:000151598.67gold quality
descending thoracic aortaUBERON:000234598.59gold quality
mucosa of stomachUBERON:000119998.55gold quality
left coronary arteryUBERON:000162698.26gold quality
left uterine tubeUBERON:000130398.22gold quality
coronary arteryUBERON:000162198.14gold quality
aortaUBERON:000094798.12gold quality
right lobe of thyroid glandUBERON:000111998.12gold quality
left lobe of thyroid glandUBERON:000112098.12gold quality
ectocervixUBERON:001224998.07gold quality
subcutaneous adipose tissueUBERON:000219097.91gold quality
muscle layer of sigmoid colonUBERON:003580597.82gold quality
apex of heartUBERON:000209897.77gold quality
popliteal arteryUBERON:000225097.77gold quality
tibial arteryUBERON:000761097.77gold quality
omental fat padUBERON:001041497.41gold quality
peritoneumUBERON:000235897.35gold quality
adipose tissue of abdominal regionUBERON:000780897.20gold quality
periodontal ligamentUBERON:000826697.06gold quality
calcaneal tendonUBERON:000370196.97gold quality

Single-cell (SCXA)

Detected in 17 experiment(s), a significant marker in 16.

ExperimentMarker?Max mean expression
E-GEOD-114530yes2219.60
E-GEOD-124472yes1263.42
E-MTAB-6701yes559.07
E-ANND-5yes490.70
E-GEOD-135922yes337.76
E-MTAB-6678yes266.08
E-MTAB-10287yes119.80
E-HCAD-1yes82.75
E-MTAB-8410yes52.88
E-GEOD-134144yes37.20
E-ANND-3yes32.03
E-HCAD-13yes27.03
E-HCAD-10yes22.44
E-CURD-112yes17.67
E-GEOD-81547yes7.97

Regulation

Is transcription factor: no

miRNA regulators (miRDB)

24 targeting MXRA8, 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-548C-3P99.9974.017587
HSA-MIR-444799.8567.812900
HSA-MIR-453099.6966.471509
HSA-MIR-317599.6566.302031
HSA-MIR-486-3P99.5166.821901
HSA-MIR-448099.4266.02735
HSA-MIR-4786-3P99.3668.351390
HSA-MIR-6846-5P98.8165.861121
HSA-MIR-6848-5P98.8165.491126
HSA-MIR-6852-3P98.5467.601468
HSA-MIR-6810-5P98.2966.21975
HSA-MIR-4664-5P98.1765.071020
HSA-MIR-197297.6767.381172
HSA-MIR-6862-5P97.4864.84713
HSA-MIR-194-3P97.3665.961027
HSA-MIR-148B-5P97.2966.30992
HSA-MIR-6874-3P97.2966.34975
HSA-MIR-342-5P97.2564.10817
HSA-MIR-4652-5P96.4664.22553
HSA-MIR-6782-5P96.4564.42612
HSA-MIR-152-5P96.4266.59960
HSA-MIR-6747-5P96.1764.99743
HSA-MIR-365A-5P94.9163.72471
HSA-MIR-365B-5P94.9163.79470

Literature-anchored findings (GeneRIF, showing 8)

  • new member of the transmembrane-type immunoglobulin superfamily and designated limitrin, localizing selectively to glia limitans in mouse brain (PMID:14603461)
  • MXRA8 is a target gene of the BACH1 transcription factor according to ChIP-seq analysis in HEK 293 cells. (PMID:21555518)
  • exogenous expression of DICAM in human umbilical vein endothelial cells suppressed angiogenesis in vitro Matrigel and in vivo plug assays, and conversely, DICAM knockdown enhanced angiogenesis (PMID:23386276)
  • studies provide insight into how Mxra8 binds CHIKV and creates a path for developing alphavirus entry inhibitors. (PMID:31080061)
  • the stalk region of MXRA8 is critical for CHIKV virus entry. (PMID:31080063)
  • Elevated Expression of miR-200c/141 in MDA-MB-231 Cells Suppresses MXRA8 Levels and Impairs Breast Cancer Growth and Metastasis In Vivo. (PMID:35456497)
  • Loss of MXRA8 Delays Mammary Tumor Development and Impairs Metastasis. (PMID:37762032)
  • Single-cell RNA combined with bulk RNA analysis to explore oxidative stress and energy metabolism factors and found a new prostate cancer oncogene MXRA8. (PMID:38441550)

Cross-species orthologs

4 orthologs

OrganismSymbolGene ID
danio_reriomxra8bENSDARG00000062129
danio_reriomxra8aENSDARG00000062222
mus_musculusMxra8ENSMUSG00000029070
rattus_norvegicusMxra8ENSRNOG00000019244

Paralogs (14): VSIG2 (ENSG00000019102), VSIG1 (ENSG00000101842), VSIR (ENSG00000107738), GPA33 (ENSG00000143167), IGSF11 (ENSG00000144847), ESAM (ENSG00000149564), CXADR (ENSG00000154639), JAM2 (ENSG00000154721), F11R (ENSG00000158769), JAM3 (ENSG00000166086), CLMP (ENSG00000166250), MUC15 (ENSG00000169550), VSTM2B (ENSG00000187135), VSIG8 (ENSG00000243284)

Protein

Protein identifiers

Matrix remodeling-associated protein 8Q9BRK3 (reviewed: Q9BRK3)

Alternative names: Limitrin

All UniProt accessions (1): Q9BRK3

UniProt curated annotations — full annotation on UniProt →

Function. Transmembrane protein which can modulate activity of various signaling pathways, probably via binding to integrin ITGAV:ITGB3. Mediates heterophilic cell-cell interactions in vitro. Inhibits osteoclastogenesis downstream of TNFSF11/RANKL and CSF1, where it may function by attenuating signaling via integrin ITGB3 and MAP kinase p38. Plays a role in cartilage formation where it promotes proliferation and maturation of growth plate chondrocytes. Stimulates formation of primary cilia in chondrocytes. Enhances expression of genes involved in the hedgehog signaling pathway in chondrocytes, including the hedgehog signaling molecule IHH; may also promote signaling via the PTHLH/PTHrP pathway. Plays a role in angiogenesis where it suppresses migration of endothelial cells and also promotes their apoptosis. Inhibits VEGF-induced activation of AKT and p38 MAP kinase in endothelial cells. Also inhibits VTN (vitronectin)-mediated integrin ITGAV:ITGB3 signaling and activation of PTK2/FAK. May play a role in the maturation and maintenance of the blood-brain barrier. (Microbial infection) Contributes to arthritogenic alphavirus pathogenesis and acts as a receptor for these viruses.

Subunit / interactions. Homodimer in cis. Does not appear to form trans-homodimers. Interacts with ITGB3; the interaction inhibits ITGAV:ITGB3 heterodimer formation. (Microbial infection) Interacts with chikungunya virus spike glycoproteins E2 and E1. The interaction involves 2 adjacent E2-E1 heterodimers.

Subcellular location. Cell membrane. Cell junction. Tight junction. Cytoplasm. Cell projection. Cilium membrane. Nucleus.

Tissue specificity. Detected in endothelial cells in mammary tissue, in both large vessels (left internal mammary artery) and small capillaries (vasa vasorum of the adventitia).

Domain organisation. The RGD motif is involved in integrin ITGAV:ITGB3 binding.

Induction. Up-regulated in vein endothelial cells (HUVECs) in response to VEGF signaling.

Isoforms (4)

UniProt IDNamesCanonical?
Q9BRK3-11yes
Q9BRK3-22
Q9BRK3-33
Q9BRK3-44

RefSeq proteins (5): NP_001269511, NP_001269512, NP_001269513, NP_001269514, NP_115724* (*=MANE)

Domains & families (InterPro)

IDNameType
IPR003599Ig_subDomain
IPR007110Ig-like_domDomain
IPR013106Ig_V-setDomain
IPR013783Ig-like_foldHomologous_superfamily
IPR036179Ig-like_dom_sfHomologous_superfamily
IPR042472MXRA8Family

Pfam: PF07686

UniProt features (50 total): strand 18, turn 7, splice variant 4, helix 4, glycosylation site 2, disulfide bond 2, topological domain 2, domain 2, signal peptide 1, chain 1, modified residue 1, sequence variant 1, sequence conflict 1, transmembrane region 1, region of interest 1, short sequence motif 1, site 1

Structure

Experimental structures (PDB)

1 structures.

PDBMethodResolution (Å)
6JO8X-RAY DIFFRACTION3.5

Predicted structure (AlphaFold)

ModelpLDDTFraction very-high
AF-Q9BRK3-F176.460.48

Functional residue map

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

Catalytic / active sites (1): 325–326 (cleavage)

Post-translational modifications (1): 228

Disulfide bonds (2): 54–137, 186–272

Glycosylation sites (2): 119, 306

Function

Pathways and Gene Ontology

Reactome pathways

4 pathways

IDPathway
R-HSA-381426Regulation of Insulin-like Growth Factor (IGF) transport and uptake by Insulin-like Growth Factor Binding Proteins (IGFBPs)
R-HSA-8957275Post-translational protein phosphorylation
R-HSA-392499Metabolism of proteins
R-HSA-597592Post-translational protein modification

MSigDB gene sets: 148 (showing top): BERTUCCI_MEDULLARY_VS_DUCTAL_BREAST_CANCER_DN, MODULE_255, GOBP_GLIAL_CELL_DEVELOPMENT, MODULE_317, GOCC_CELL_SURFACE, GOBP_NEUROGENESIS, FOXO1_01, LIEN_BREAST_CARCINOMA_METAPLASTIC, FERREIRA_EWINGS_SARCOMA_UNSTABLE_VS_STABLE_DN, LI_WILMS_TUMOR_VS_FETAL_KIDNEY_1_UP, KINSEY_TARGETS_OF_EWSR1_FLII_FUSION_DN, HFH8_01, TGACATY_UNKNOWN, ATF3_Q6, HFH1_01

GO Biological Process (3): cell adhesion (GO:0007155), cell differentiation (GO:0030154), establishment of glial blood-brain barrier (GO:0060857)

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

GO Cellular Component (11): nucleus (GO:0005634), endoplasmic reticulum lumen (GO:0005788), bicellular tight junction (GO:0005923), cell surface (GO:0009986), ciliary membrane (GO:0060170), extracellular exosome (GO:0070062), cytoplasm (GO:0005737), plasma membrane (GO:0005886), membrane (GO:0016020), cell projection (GO:0042995), anchoring junction (GO:0070161)

Reactome top-level categories

Rollup of top-2 pathways:

CategoryPathways
Metabolism of proteins2
Post-translational protein modification1

GO top-level categories

Rollup of top GO terms by namespace:

CategoryTerms
cellular anatomical structure4
cellular process1
cellular developmental process1
glial cell development1
establishment of blood-brain barrier1
binding1
intracellular membrane-bounded organelle1
endoplasmic reticulum1
intracellular organelle lumen1
apical junction complex1
tight junction1
cilium1
cell projection membrane1
bounding membrane of organelle1
extracellular vesicle1
intracellular anatomical structure1
membrane1
cell periphery1
cell junction1

Protein interactions and networks

STRING

1016 interactions, top by confidence (×1000):

Protein AProtein BPartner UniProtScore
MXRA8BACE1P56817583
MXRA8RHOP08100578
MXRA8JAG2Q9Y219568
MXRA8ADRB2P07550566
MXRA8NAPSAO96009541
MXRA8MXRA7P84157537
MXRA8ARG2P78540535
MXRA8FAM20AQ96MK3525
MXRA8VIPP01282505
MXRA8LDLRAD3Q86YD5495
MXRA8AASDHPPTQ9NRN7484
MXRA8TPM3P06753476
MXRA8PHB1P35232465
MXRA8PRSS23O95084452
MXRA8ADRA2AP08913451

IntAct

50 interactions, top by confidence:

ABTypeScore
IL13RA2CHEK1psi-mi:“MI:0914”(association)0.640
TRDNTMEM223psi-mi:“MI:0914”(association)0.640
CABP2MXRA8psi-mi:“MI:0915”(physical association)0.560
DTX2MXRA8psi-mi:“MI:0915”(physical association)0.560
GMEB2MXRA8psi-mi:“MI:0915”(physical association)0.560
MXRA8GMEB2psi-mi:“MI:0915”(physical association)0.560
MXRA8CABP2psi-mi:“MI:0915”(physical association)0.560
MXRA8ANKRD11psi-mi:“MI:0915”(physical association)0.560
TTC19MXRA8psi-mi:“MI:0915”(physical association)0.560
NTAQ1MXRA8psi-mi:“MI:0915”(physical association)0.560
CCT8L2ACSL4psi-mi:“MI:0914”(association)0.530
CLEC4ASEMA7Apsi-mi:“MI:0914”(association)0.530
EVA1CSTK25psi-mi:“MI:0914”(association)0.530
LPAR1TMEM223psi-mi:“MI:0914”(association)0.530
SLC7A1STXBP3psi-mi:“MI:0914”(association)0.530
TNFSF8LGALS8psi-mi:“MI:0914”(association)0.530
psi-mi:“MI:0914”(association)0.350
ESYT2psi-mi:“MI:0914”(association)0.350
HAX1psi-mi:“MI:0914”(association)0.350
CELA3APIK3C2Apsi-mi:“MI:0914”(association)0.350
CLGNTMEM131Lpsi-mi:“MI:0914”(association)0.350
CUEDC1WWP2psi-mi:“MI:0914”(association)0.350
GDPD5TMEM120Bpsi-mi:“MI:0914”(association)0.350

BioGRID (17): MXRA8 (Affinity Capture-MS), MXRA8 (Proximity Label-MS), MXRA8 (Two-hybrid), MXRA8 (Two-hybrid), MXRA8 (Two-hybrid), MXRA8 (Two-hybrid), ANKRD11 (Two-hybrid), CABP2 (Two-hybrid), MXRA8 (Affinity Capture-RNA), MXRA8 (Affinity Capture-MS), MXRA8 (Affinity Capture-MS), MXRA8 (Negative Genetic), MXRA8 (Affinity Capture-MS), MXRA8 (Proximity Label-MS), MXRA8 (Proximity Label-MS)

ESM2 similar proteins: A0A140LHF2, A0JPB1, A2AJ76, A7LCJ3, A8E0Y8, E7FF10, O00241, O60500, P01874, P03988, P04221, P0DOX2, P0DOX3, P0DOX4, P0DOX6, P0DP72, P32507, P35590, P43121, P50895, Q06805, Q06806, Q148M6, Q15109, Q5TFQ8, Q5U5A3, Q5XI43, Q62230, Q62786, Q8HW98, Q8NDA2, Q8R2Y2, Q92154, Q923P0, Q93033, Q95KI3, Q96MS0, Q9BRK3, Q9BZZ2, Q9DBV4

Diamond homologs: Q148M6, Q5XI43, Q7T0R0, Q90WI4, Q9BRK3, Q9DBV4

SIGNOR signaling

0 interactions.

Disease & clinical

Clinical variants and AI predictions

ClinVar

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

ClassificationCount (floor)
Pathogenic0
Likely pathogenic1
Uncertain significance78
Likely benign12
Benign3

Top pathogenic / likely-pathogenic (1)

Variant IDHGVSClassification
402162NM_032348.4(MXRA8):c.1238T>A (p.Ile413Asn)Likely pathogenic

SpliceAI

1037 predictions. Top by Δscore:

VariantEffectΔscore
1:1353924:GTAAT:Gacceptor_gain1.0000
1:1353925:TAAT:Tacceptor_gain1.0000
1:1353925:TAATC:Tacceptor_loss1.0000
1:1353926:AAT:Aacceptor_gain1.0000
1:1353927:AT:Aacceptor_gain1.0000
1:1353928:TCTGT:Tacceptor_loss1.0000
1:1353929:C:CCacceptor_gain1.0000
1:1353930:T:Cacceptor_loss1.0000
1:1354025:CTCAC:Cdonor_loss1.0000
1:1354026:TCA:Tdonor_loss1.0000
1:1354028:ACCTA:Adonor_loss1.0000
1:1354029:CCTAG:Cdonor_gain1.0000
1:1354033:G:Cdonor_gain1.0000
1:1354046:ACT:Adonor_gain1.0000
1:1354047:CTC:Cdonor_gain1.0000
1:1354351:CA:Cdonor_loss1.0000
1:1354352:ACC:Adonor_loss1.0000
1:1354353:C:CAdonor_loss1.0000
1:1354506:GGGTC:Gacceptor_loss1.0000
1:1354507:GGTC:Gacceptor_loss1.0000
1:1354509:TCT:Tacceptor_loss1.0000
1:1354510:C:CAacceptor_loss1.0000
1:1354510:C:CCacceptor_gain1.0000
1:1354511:T:Aacceptor_loss1.0000
1:1355343:CCG:Cacceptor_gain1.0000
1:1355344:CGC:Cacceptor_gain1.0000
1:1355346:C:CCacceptor_gain1.0000
1:1355355:C:Tacceptor_gain1.0000
1:1358454:A:ACdonor_gain1.0000
1:1358455:C:CCdonor_gain1.0000

AlphaMissense

2824 scored. Top likely-pathogenic:

VariantProtein changeam_pathogenicity
1:1355010:C:AW207C1.000
1:1355010:C:GW207C1.000
1:1355012:A:GW207R1.000
1:1355012:A:TW207R1.000
1:1355052:C:AW193C1.000
1:1355052:C:GW193C1.000
1:1354795:C:TC279Y0.999
1:1354810:A:GL274P0.999
1:1354815:G:CC272W0.999
1:1354816:C:GC272S0.999
1:1354816:C:TC272Y0.999
1:1354817:A:GC272R0.999
1:1354817:A:TC272S0.999
1:1354820:A:GS271P0.999
1:1354823:A:CY270D0.999
1:1354882:A:CF250C0.999
1:1355011:C:GW207S0.999
1:1355290:G:CC144W0.999
1:1355291:C:AC144F0.999
1:1355291:C:GC144S0.999
1:1355291:C:TC144Y0.999
1:1355292:A:TC144S0.999
1:1355311:G:CC137W0.999
1:1355312:C:GC137S0.999
1:1355312:C:TC137Y0.999
1:1355313:A:TC137S0.999
1:1355319:A:CY135D0.999
1:1355482:A:CF115C0.999
1:1355601:C:AW75C0.999
1:1355601:C:GW75C0.999

dbSNP variants (sampled 300 via entrez): RS1000015240 (1:1362918 C>T), RS1000102657 (1:1364390 C>T), RS1000610776 (1:1358208 C>T), RS1000784544 (1:1360285 GGGGGCAGCTGACCCCCAT>G), RS1000806936 (1:1364428 G>A), RS1000911771 (1:1354666 G>A,C,T), RS1001047036 (1:1354970 G>A,T), RS1001390176 (1:1354017 A>C), RS1001649313 (1:1362079 C>A), RS1001678785 (1:1361875 A>G), RS1001986381 (1:1361176 A>T), RS1002098834 (1:1357607 G>A), RS1002101488 (1:1352269 A>G), RS1002357556 (1:1361333 G>C), RS1002626981 (1:1355587 G>A,C)

Disease associations

OMIM: gene MIM:617293 | disease phenotypes:

GenCC curated gene-disease

Mondo (0):

Orphanet (0):

HPO phenotypes

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

GWAS associations

4 associations (top):

StudyTraitp-value
GCST004131_103Inflammatory bowel disease2.000000e-07
GCST004133_40Ulcerative colitis3.000000e-06
GCST005580_249Intraocular pressure1.000000e-10
GCST005580_72Intraocular pressure1.000000e-11

EFO canonical traits (1, from GWAS)

EFO IDTrait name
EFO:0004695intraocular pressure measurement

Drugs & pharmacology

Drug and pharmacology data

Is drug target: no

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

CTD chemical–gene interactions

35 total (human), top 30 by PubMed support.

ChemicalActions (top 5)PubMed papers
Valproic Acidaffects expression, decreases expression, increases expression, increases methylation5
Tetrachlorodibenzodioxinaffects expression, increases expression3
Benzo(a)pyrenedecreases methylation, increases expression, affects methylation2
aristolochic acid Iincreases expression1
FR900359increases phosphorylation1
bisphenol Faffects cotreatment, increases expression1
bisphenol Adecreases methylation1
perfluorooctane sulfonic aciddecreases expression1
entinostatincreases expression1
bisphenol Sincreases expression1
MT19c compounddecreases expression1
bisphenol AFincreases expression1
Resveratrolaffects cotreatment, decreases expression1
Sunitinibdecreases expression1
Acetaminophendecreases expression1
Calcitrioldecreases expression1
Dexamethasoneaffects cotreatment, increases expression1
Doxorubicinincreases expression1
Folic Aciddecreases expression1
Formaldehydedecreases expression1
Indomethacinaffects cotreatment, increases expression1
Plant Extractsaffects cotreatment, decreases expression1
Potassium Dichromateincreases expression1
Rotenoneincreases expression1
Smokedecreases expression1
Testosteroneincreases expression1
Thimerosaldecreases expression1
Tobacco Smoke Pollutiondecreases expression1
Tretinoindecreases expression1
1-Methyl-3-isobutylxanthineaffects cotreatment, increases expression1

Clinical trials (associated diseases)

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

No linked Atlas pages yet — the cross-entity mesh grows as the corpus expands.