COX7B encodes a subunit of cytochrome c oxidase (complex IV), the terminal enzyme in the mitochondrial electron transport chain that catalyzes oxygen reduction to water during oxidative phosphorylation 1. The protein functions as part of the respiratory machinery that generates ATP through electron transfer from cytochrome c to molecular oxygen 1. COX7B plays important roles in cellular energy metabolism, with upregulation observed in highly proliferative cells where it promotes OXPHOS pathway activity and increases ROS production through glucose metabolism 2. In cardiac muscle, COX7B expression correlates positively with cardiomyocyte size and energy synthesis capacity, with compensatory upregulation in early-stage hypertrophic cardiomyopathy but downregulation in heart failure 1. The gene serves as a prognostic biomarker in multiple cancers, where low COX7B expression correlates with platinum chemotherapy resistance and poor patient outcomes 34. COX7B has also been identified as a sepsis-associated mitochondrial gene, with overexpression linked to poor 28-day survival rates 5. Additionally, altered COX7B expression has been associated with ADHD pathophysiology and can differentiate patients from healthy controls 6. These findings highlight COX7B's central role in mitochondrial bioenergetics and its potential as both a therapeutic target and diagnostic biomarker.