IRX1 (Iroquois homeobox 1) is a transcription factor that functions as both a tumor suppressor and developmental regulator with tissue-specific roles. As a transcriptional regulator, IRX1 exhibits DNA-binding activity and can act as both an activator and repressor of target genes 1. In gastric tissue, IRX1 functions as a tumor suppressor, directly regulating genes involved in angiogenesis (BDKRB2), cell proliferation (HIST2H2BE), and invasion (FGF7) 1. IRX1 expression is frequently silenced in gastric cancer through promoter hypermethylation, which can be induced by Helicobacter pylori infection 2. In oral epithelium, IRX1 plays a crucial role in stem cell plasticity and wound healing by activating SOX9 to promote cell proliferation and stimulating EGF signaling for cell migration 3. Paradoxically, IRX1 shows oncogenic properties in certain contexts, being overexpressed in high-grade IDH-mutant astrocytomas where higher expression correlates with poor prognosis 4. IRX1 inactivation is also commonly found in myeloid leukemia associated with Down syndrome, contributing to MYC pathway upregulation 5. Additionally, IRX1 variants are associated with Raynaud's syndrome, where the gene appears to function in microvasculature regulation 6.