TIMP4 (TIMP metallopeptidase inhibitor 4) is an extracellular matrix regulator that complexes with metalloproteinases and irreversibly inactivates them by binding to their catalytic zinc cofactor, targeting MMP-1, MMP-2, MMP-3, MMP-7, and MMP-9. The gene spans approximately 6-7 kb with five exons and is located on chromosome 3 in humans and chromosome 3 in mice, positioned within intron 5 of the synapsin 2 gene 12. TIMP4 exhibits tissue-specific expression patterns, with highest levels in heart, ovary, and brain, suggesting specialized roles in maintaining extracellular matrix homeostasis in these tissues 2. In cancer contexts, TIMP4 appears to have dual roles - it can be regulated by the LOX/SNAI2 axis and promotes cancer progression through secretion mechanisms 3, while paradoxically showing decreased expression in oral squamous cell carcinoma associated with poor prognosis 4. TIMP4 deficiency has significant clinical implications, with loss-of-function variants associated with early-onset high myopia through disruption of scleral collagen homeostasis and ocular development 5. The protein also shows associations with cardiovascular diseases, fragility fractures, and various psychiatric disorders, highlighting its broad physiological importance 67.