PRDM15 is a sequence-specific DNA-binding transcriptional regulator that functions as a molecular node in developmental and stem cell biology. In embryonic stem cells, PRDM15 promotes transcription of SPRY1 and RSPO1 through direct promoter binding, modulating upstream regulators of Wnt/β-catenin and MAPK/ERK signaling pathways essential for pluripotency maintenance 1. During early embryonic development, PRDM15 regulates genes critical for proper A/P patterning by controlling NOTCH and WNT/PCP pathway effectors; loss-of-function mutations cause holoprosencephaly with brain, cardiac, and skeletal defects 2. In renal development, PRDM15 mutations cause either isolated nephrotic syndrome or Galloway-Mowat syndrome depending on affected domains, with zinc-finger variants additionally disrupting transcriptional activation and causing multi-organ developmental abnormalities 3. Beyond development, PRDM15 has emerged as an oncogenic regulator: in cholangiocarcinoma, PRDM15 promotes FGFR4 expression downstream of METTL16-mediated translation 4; in rectal cancer, it facilitates radioresistance by interacting with DNA-PKcs and Ku70/Ku80 complexes to promote DNA damage repair 5; and in B-cell lymphomas, it sustains PI3K/AKT/mTOR and glycolytic pathways critical for survival 6. PRDM15 also functions as a key hub gene regulating gut microbiota composition through immune-related pathways 1.