TIMD4 (T cell immunoglobulin and mucin domain containing 4) is a phosphatidylserine-binding receptor that plays a crucial role in efferocytosis, the clearance of apoptotic cells by macrophages 12. The protein is primarily expressed on tissue-resident macrophages, particularly the TLF+ subset that maintains homeostasis through self-renewal 3. TIMD4 binds phosphatidylserine exposed on apoptotic cell surfaces and facilitates their engulfment and clearance 1. The receptor's expression is regulated by microbiota-derived metabolites like butyrate, with antibiotic treatment reducing TIMD4 levels and impairing efferocytosis 1. Disease relevance includes metabolic dysfunction-associated steatohepatitis (MASH), where impaired TIMD4-mediated efferocytosis leads to accumulation of apoptotic hepatocytes and progression to liver fibrosis 4. In cancer, TIMD4+ cavity-resident macrophages can sequester cytotoxic T cells, limiting immunotherapy efficacy 5. TIMD4 is also essential for proper wound healing, as its inhibition abrogates tissue repair despite being dispensable for efferocytosis itself 2. The receptor represents a potential therapeutic target for inflammatory diseases, fibrotic conditions, and cancer immunotherapy enhancement.