### NME4 Gene Overview

**Gene Symbol:** NME4  
**Protein Summary:** NME4 (NME/NM23 Nucleoside Diphosphate Kinase 4) is involved primarily in the synthesis of nucleoside triphosphates other than ATP, playing a critical role in maintaining intracellular nucleotide homeostasis. It utilizes a ping-pong mechanism for catalyzing the transfer of phosphate groups and is associated with the mitochondrial inner membrane, where it interacts with cardiolipin, affecting respiratory functions.

### 1. Associated Genes
NME4 has been reported to interact with several other genes, including but not limited to:

- **OPA1**: As mentioned, NME4 is proposed to enhance GTP-loading on this dynamin-related GTPase, which plays a significant role in mitochondrial dynamics and bioenergetics.
- **ANT (Adenine Nucleotide Translocase)**: Involved in transporting ADP and ATP across the mitochondrial membrane.
- **NME1 and NME2**: Other members of the NME/NM23 family that may share functional similarities or pathways.
- Genes involved in mitochondrial functions, lipid metabolism, and apoptosis, such as BCL2 and caspases, though direct interactions may require further elucidation.

### 2. Aging and Age-Related Diseases
While specific research directly associating NME4 with aging and age-related diseases remains limited, insights can be drawn from its functions:

- Mitochondrial dysfunction, which is a hallmark of aging, can be influenced by NME4 activity in maintaining mitochondrial nucleotide levels and cardiolipin dynamics.
- Its role in promoting intermembrane migration of phospholipids and the regulation of pro-apoptotic signaling suggests potential involvement in age-related apoptosis and nonspecific stress responses.
- Dysregulation of nucleotide metabolism may contribute to age-related diseases, including neurodegenerative disorders, cancer, and metabolic syndromes.

### 3. Drug Interactions
Currently, specific pharmaceutical agents directly targeting NME4 are not well-defined in existing literature. However, as NME4 is involved in mitochondrial function, drugs that affect mitochondrial bioenergetics or lipid metabolism may indirectly influence NME4 activity. Examples of drug classes that could interact include:

- **Mitochondrial modulators**: Compounds like metformin or resveratrol, which influence mitochondrial function, might have downstream effects on NME4.
- **Antioxidants**: Drugs that reduce oxidative stress can indirectly affect the activity of mitochondrial proteins, including NME4.

### 4. Pathways and Biological Processes
The NME4 gene is involved in several biological processes and signaling pathways, including:

- **Nucleotide Metabolism**: Specifically in the biosynthesis of GTP and other nucleoside triphosphates critical for RNA synthesis and energy metabolism.
- **Mitochondrial Dynamics**: Participation in mitochondrial function and structure through lipid regulation.
- **Apoptotic Signaling**: NME4's involvement in cardiolipin redistribution implies roles in mitochondrial-mediated apoptosis.
- **Intracellular Signaling Pathways**: Involvement in pathways that regulate cellular stress responses and metabolic regulation.
  
Further studies would provide clarity on the specific impacts of NME4 within these contexts, particularly regarding its contributions to age-related mechanisms and potential therapeutic opportunities.