COL6A6 (collagen type VI alpha 6 chain) is a structural component of the extracellular matrix and epithelial cell basal lamina that functions as a cell-binding protein involved in cell adhesion and extracellular matrix organization 1. The protein contributes to tissue mechanical integrity and exhibits cytoprotective functions including inhibition of apoptosis and oxidative damage 1. COL6A6 acts as a tumor suppressor across multiple cancer types. In breast cancer, COL6A6 downregulation correlates with poorer survival and is associated with reduced immune cell infiltration in the tumor microenvironment 2. In pituitary adenoma, COL6A6 overexpression suppresses tumor growth and metastasis by blocking the PI3K-Akt pathway, with this inhibitory effect reversible by P4HA3 overexpression 3. In colon adenocarcinoma, COL6A6 mutations associate with improved overall survival compared to wild-type carriers 4. Clinically, COL6A6 is relevant to multiple diseases. Mutations in COL6A genes cause congenital muscular dystrophies including Ullrich congenital muscular dystrophy and Bethlem myopathy, though no effective therapies currently exist 1. In atopic dermatitis, reduced epidermal COL6A6 expression contributes to skin barrier damage, while inflammatory cytokines suppress epidermal COL6A6 mRNA 5. A humanized anti-COL6A6 antibody reduces atherosclerosis by promoting monocyte/macrophage polarization from pro-inflammatory to anti-inflammatory phenotypes 6.