SLC47A2 encodes MATE2-K (multidrug and toxin extrusion protein 2-K), an organic cation efflux transporter expressed primarily in the kidney 1. The protein functions as a polyspecific organic cation:proton antiporter localized to the plasma membrane, mediating secretion of endogenous and exogenous compounds in proximal tubules 2. SLC47A2 shows high amino acid sequence identity (92-97%) with human orthologs across species and exhibits kidney-predominant expression alongside other tissues including seminal vesicles 34. Clinically, SLC47A2 has been investigated for its role in metformin pharmacokinetics in type 2 diabetes. However, multiple studies found that common SLC47A2 polymorphisms (rs12943590, rs35263947, rs9900497) showed no significant association with glycemic response to metformin, dose requirements, or adverse effects in diverse populations 56. One polymorphism (rs12943590) demonstrated population-specific variation, with Huichol Native Americans showing high frequencies of a risk genotype potentially associated with decreased metformin response 1. The SLC47A2 c.-130G>A polymorphism may modestly affect serum creatinine dynamics in proximal tubule function 7. In renal cell carcinoma, SLC47A2 downregulation has been associated with poor prognosis and is regulated by a novel lncRNA (SANT1) controlling its transcriptional expression 2. DNA methylation at SLC47A2 was suggestively associated with psychotherapy response in anxiety disorders 8.