UTS2 encodes urotensin II, a highly potent vasoconstrictor undecapeptide hormone that signals through G-protein coupled receptors to regulate blood pressure and vascular function 1. The peptide acts as a hormone with extracellular signaling roles and demonstrates broad tissue expression 2. UTS2 exerts context-dependent physiological effects: it inhibits insulin secretion in pancreatic tissue 3 and exhibits paradoxical actions in the kidney, including both vasoconstrictor and vasodilatory properties alongside profibrotic and antiapoptotic activities 1. UTS2 activation triggers intracellular calcium elevation and MAPK/ERK signaling cascade activation 4. Clinically, UTS2 gene polymorphisms carry disease significance. The Thr21Met polymorphism associates with increased breast cancer risk 2 and diabetic retinopathy development, with the M21M genotype enriched in proliferative diabetic retinopathy 5. Both Thr21Met and Ser89Asn polymorphisms correlate with preeclampsia susceptibility, with dual mutations conferring severe disease risk 6. Notably, UTS2 shows no association with migraine risk 7. Recent evidence indicates UTS2 overexpression in spinal muscular atrophy patients, where UTS2 receptor inhibition modulates cell proliferation and apoptosis, suggesting therapeutic potential 8. These findings establish UTS2 as a multifunctional regulator with implications for metabolic, vascular, and neuromuscular disease pathogenesis.