TBXAS1 encodes thromboxane A synthase 1, a cytochrome P450 enzyme localized to the endoplasmic reticulum that catalyzes the conversion of prostaglandin H2 (PGH2) to thromboxane A2 (TXA2), a potent platelet aggregator and vasoconstrictor 1. The enzyme simultaneously cleaves PGH2 to produce 12-hydroxy-heptadecatrienoic acid (12-HHT) and malondialdehyde in stoichiometric amounts with TXA2 2. TBXAS1 also displays dehydratase activity toward 15(S)-HPETE, producing 15-KETE and 15-HETE 2. The gene spans >75 kb on chromosome 7-q34 and contains 13 exons with tissue-wide expression, particularly abundant in peripheral blood leukocytes, spleen, lung, and liver 2. Clinically, TBXAS1 dysfunction associates with multiple pathologies. Reduced TBXAS1 expression correlates with aggressive breast cancer phenotypes and poor prognosis 3. TBXAS1 downregulation occurs in malignant mesothelioma, particularly under iron-induced conditions 4. Genetic variants in TBXAS1 influence depression risk through altered gene expression in the arachidonic acid cascade 5 and modulate ischemic stroke susceptibility in metabolic syndrome populations, with protective C alleles 6. TBXAS1 polymorphisms also predict nonsteroidal anti-inflammatory drug hypersensitivity reactions 7. As a dual cardio-oncology biomarker, TBXAS1 emerges in proteomics studies linking atherosclerosis and prostate cancer pathogenesis 8.