MXRA5 (matrix remodeling associated 5) is an extracellular matrix protein with diverse functions in tissue homeostasis and disease progression. In kidney tissues, MXRA5 exhibits anti-inflammatory and anti-fibrotic properties by limiting chemokine induction and reducing fibronectin and collagen expression in response to TGF-β1 and pro-inflammatory stimuli 1. The protein is regulated by TGF-β1, which upregulates MXRA5 expression through TGF-β receptor 1 signaling 1. MXRA5 functions as a key extracellular matrix component that maintains proliferative and migratory abilities of dental pulp stem cells, with loss of MXRA5 drastically decreasing cell proliferation and migration 2. However, MXRA5 also promotes pathological processes in several cancers. In pancreatic cancer, MXRA5 overexpression enhances cell survival, proliferation, migration, invasion, and epithelial-mesenchymal transition through PI3K-Akt-mTOR pathway activation 3. Similarly, in benign prostatic hyperplasia, MXRA5 contributes to cell proliferation via MAPK pathway activation 4. MXRA5 has been identified as a potential biomarker in osteoarthritis, correlating with disease progression and immune cell infiltration 5, and as a risk gene for primary open-angle glaucoma 6.