HINT1 (histidine triad nucleotide binding protein 1) is a multifunctional protein with both enzymatic and scaffolding activities. Its primary enzymatic function involves adenosine 5'-monophosphoramidase activity, hydrolyzing purine nucleotide phosphoramidates to yield AMP and NH2 1. HINT1 also exhibits SUMO-specific isopeptidase activity and functions as a scaffolding protein modulating transcriptional activation and p53-mediated apoptosis 1. The protein plays important roles in cardiovascular pathophysiology, where it attenuates cardiac hypertrophy by suppressing HOXA5 expression through inhibition of the PKCβ1/MEK/ERK/YY1 signaling pathway 2. In aortic aneurysm, HINT1 promotes vascular smooth muscle cell phenotypic switching through nuclear translocation and interaction with TFAP2A, triggering ITGA6 transcription and downstream FAK/STAT3 activation 3. HINT1 mutations cause autosomal recessive axonal neuropathy with neuromyotonia (ARAN-NM), a rare disorder characterized by motor axonal degeneration and neuromyotonic discharges 41. The phenotypic spectrum includes not only peripheral neuropathy but also neuropsychiatric features such as anxiety, mood disorders, and ADHD 1. Additionally, HINT1 has been implicated in inflammatory bowel disease pathogenesis through mitochondrial dysfunction pathways 5.