MRPS18B (mitochondrial ribosomal protein S18B) is a structural constituent of the mitochondrial small ribosomal subunit (40S) essential for mitochondrial protein synthesis 1. As a core component of mitoribosomes, MRPS18B participates in mitochondrial translation and maintains proper mitochondrial function 2. The protein exhibits evolutionary conservation across species, with orthologous sequences identified in both human and swine genomes 3. At the disease level, MRPS18B variants associate with multiple pathological conditions. A damaging missense mutation (688C>G, P230A) appears significantly enriched in Chagas disease megaesophagus patients (38.4%) compared to asymptomatic carriers (2.2%), correlating with impaired mitochondrial function and nitro-oxidative stress in affected neurons 4. GWAS analysis identified MRPS18B as associated with pediatric neuroblastoma risk in Korean populations 5. Aberrant DNA methylation patterns at MRPS18B have prognostic significance in tuberculosis, where hypomethylation associates with reduced one-year survival 6. Additionally, MRPS18B appears dysregulated in nicotine-induced metabolic effects 7 and shows epigenetic association with cognitive function 8. These findings suggest MRPS18B dysfunction impairs mitochondrial homeostasis, with clinical implications for cardiac development, infectious disease pathogenesis, and neurological disorders.