ATP5PF (ATP synthase peripheral stalk subunit F6) is a structural component of mitochondrial ATP synthase complex (Complex V), which catalyzes ATP synthesis from ADP using the proton gradient generated by the electron transport chain 1. As part of the peripheral stalk, ATP5PF acts as a stator, maintaining the static position of the catalytic α3β3 subcomplex relative to rotating central stalk elements during the rotary mechanism of ATP synthesis 1. ATP5PF is highly expressed in keratinocytes and plays a role in oxidative phosphorylation (OXPHOS) pathway activation. In pemphigus vulgaris, an autoimmune bullous disease, ATP5PF expression is elevated along with other OXPHOS components, and OXPHOS inhibition with metformin attenuates disease-induced cell detachment 2. In non-small cell lung cancer, ATP5PF transcription is activated by the transcription factor POU3F3 downstream of RAS-ERK1 signaling, promoting ATP production and enhancing tumor proliferation and migration 3. During labor, SERPINE1 interacts with ATP5PF to maintain ATP production under hypoxic conditions, supporting myometrial contractility 4. ATP5PF is also dysregulated in Down syndrome amniocytes and associated with mitochondrial dysfunction in ankylosing spondylitis, where its overexpression correlates with shared neurodegenerative disease pathways 5, 6. Additionally, ATP5PF functions as a serum biomarker for monitoring disease progression in Duchenne muscular dystrophy 7.