ADH6 (alcohol dehydrogenase class V) is a NAD+-dependent oxidoreductase that catalyzes the oxidation of primary alcohols to aldehydes and secondary alcohols to ketones 1. Located on chromosome 4, ADH6 represents a distinct enzymatic class with approximately 60% sequence identity to other human ADH family members 2. The enzyme exhibits distinctive kinetic properties, with lower affinity for ethanol compared to benzyl alcohol and optimal activity at pH 10, characteristics consistent with gastric alcohol dehydrogenase isozymes 1. ADH6 expression is detected in liver and stomach tissues 2. MicroRNA hsa-miR-1301-3p epigenetically suppresses ADH6 expression in hepatocytes and blocks ethanol-induced upregulation, establishing miRNA-mediated regulation of alcohol metabolism 3. Unlike classical ADH enzymes, ADH6 likely lacks significant ethanol dehydrogenase activity, suggesting alternative physiological roles 4. Clinically, ADH6 downregulation correlates with hepatocellular carcinoma progression, where high ADH6 expression associates with improved patient survival 5. Reduced ADH6 expression in follicular fluid of endometriosis patients correlates with decreased fertility outcomes in assisted reproduction 6. ADH6 may also participate in broader metabolic adaptations, including lipid metabolism and non-alcoholic fatty liver disease pathogenesis 7.