MMP23B is a zinc-binding matrix metalloproteinase that functions as both an extracellular protease and a regulator of developmental signaling pathways. As a member of the MMP family, MMP23B degrades extracellular matrix components and processes cytokines 1. Mechanistically, MMP23B promotes liver development and hepatocyte proliferation through the tumor necrosis factor (TNF) signaling pathway, with the protein directly interacting with TNF to mediate its release from the cell membrane 1. Clinically, MMP23B has emerged as a significant disease biomarker across multiple cancer types. In bladder cancer, MMP23B protein levels are elevated in plasma and urine, with urinary levels correlating to tumor risk classification and grading, suggesting potential as a non-invasive diagnostic biomarker 2. In endometrial cancer, MMP23B is highly expressed and associated with poor survival prognosis; knockdown of MMP23B reduces cell viability and promotes apoptosis through upregulation of caspases 3. MMP23B also shows dysregulation in other malignancies: it is upregulated in pancreatic neuroendocrine tumors and associated with metastasis 4, and its elevated expression correlates with higher tumor stage in colorectal cancer and head and neck squamous cell carcinoma 56. Additionally, MMP23B haploinsufficiency contributes to 1p36 deletion syndrome phenotypes 7.