COX4I1

Cytochrome C Oxidase Subunit 4I1

Score: 0.518 Price: $0.52 Low Druggability Status: active Wiki: COX4I1
🧠 Neurodegeneration
HYPOTHESES
3
PAPERS
28
KG EDGES
152
DEBATES
1

3D Protein Structure

🧬 COX4I1 — PDB 2DYR Click to expand

Experimental structure from RCSB PDB | Powered by Mol*

Druggability & Clinical Context

Druggability
Low
Score: 0.42
Clinical Stage
Phase II
Target Class
Enzyme
Safety
0.20
Druggability Analysis
Drug Development0.65
Structural Tractability0.70
Target Class0.85
Safety Profile0.20
Key Metrics
PDB Structures:
5
Known Drugs:
4
Approved:
2
In Clinical Trials:
1
Drug Pipeline (4 compounds)
2 Approved · 1 Preclinical
Druggability Rationale: COX4I1 demonstrates medium druggability (0.55) due to its well-characterized structural features (5 PDB structures, cryo-EM data, 3.6 Å resolution) and proven clinical validation through approved agents like Idebenone and CoQ10. However, direct enzymatic targeting is challenging because COX4I1 is a regulatory rather than catalytic subunit, necessitating indirect approaches that modulate electron transport efficiency or stabilize complex IV assembly rather than occupying a classical active site.
Mechanism: Drugs targeting COX4I1 pathway would enhance electron transport chain efficiency or stabilize complex IV assembly, improving ATP production and reducing oxidative stress in mitochondria. These agents work by either promoting mitochondrial bioenergetics, acting as electron donors/acceptors, or preventing complex IV degradation in diseases with impaired oxidative phosphorylation.
Drug Pipeline (4 compounds)
2 Approved · 1 Preclinical
Known Drugs:
Elamipretide (MTP131) (phase3) — Primary mitochondrial myopathy and heart failure
Idebenone (approved) — Leber hereditary optic neuropathy
Coenzyme Q10 (Ubiquinone) (approved) — Mitochondrial disease and statin-induced myopathy
SS-31 (Szeto-Schiller peptide 31) (preclinical) — Mitochondrial dysfunction and oxidative stress
Structural Data:
PDB (5) ✓AlphaFold ✓Cryo-EM ✓
7COH8H8R8H8S9A1K9W2Z
UniProt: H3BN72

🧬 3D Protein Structure

🧬 COX4I1 — PDB 2DYR Click to expand interactive 3D viewer

Experimental structure from RCSB PDB | Powered by Mol* | Rotate: click+drag | Zoom: scroll

Selectivity & Safety Considerations

Selectivity challenges include potential off-target effects on other electron transport chain complexes and difficulty distinguishing between COX4I1 and its isoform COX4I2, which share high sequence homology. The mitochondrial compartmentalization of this target provides a selectivity advantage by limiting systemic exposure, though this also complicates drug delivery and bioavailability.

3D Protein Structure

PDB: Open in RCSB AlphaFold model

Interactive 3D viewer powered by RCSB PDB / Mol*. Use mouse to rotate, scroll to zoom.

Clinical Trials (7)

Relevant trials from ClinicalTrials.gov

Active
0
Completed
5
Total Enrollment
222
By Phase
PHASE1: 2 · PHASE2: 4 · Unknown: 1
Study of Idebenone in the Treatment of Mitochondrial Encephalopathy Lactic Acidosis & Stroke-like Episodes Completed
PHASE2 NCT00887562 n=27
MELAS Syndrome
Interventions: Idebenone, Idebenone, Placebo
Sponsor: Michio Hirano | Started: 2009-05
Long-term Safety, Tolerability and Efficacy of Idebenone in Duchenne Muscular Dystrophy (DELPHI Extension) Completed
PHASE2 NCT00758225 n=21
Duchenne Muscular Dystrophy
Interventions: Idebenone
Sponsor: Santhera Pharmaceuticals | Started: 2008-09
Efficacy and Tolerability of Idebenone in Boys With Cardiac Dysfunction Associated With Duchenne Muscular Dystrophy Completed
PHASE2 NCT00654784 n=21
Duchenne Muscular Dystrophy (DMD)
Interventions: idebenone, placebo
Sponsor: Santhera Pharmaceuticals | Started: 2005-10
Study of Oral Idebenone to Treat Non-Alcoholic Steatohepatitis Completed
PHASE1 NCT04669158 n=53
Non Alcoholic Steatohepatitis, Fibrosis
Interventions: Idebenone, Placebo
Sponsor: Stanford University | Started: 2021-07-30
Safety Study of Idebenone to Treat Friedreich's Ataxia Completed
PHASE1 NCT00015808 n=100
Friedreich Ataxia
Interventions: Idebenone
Sponsor: National Institute of Neurological Disorders and Stroke (NIN | Started: 2001-05
A Study of Efficacy and Safety of Idebenone Vs. Placebo in Prodromal Parkinson Disease Withdrawn
PHASE2 NCT04152655
REM Sleep Behavior Disorder, Parkinson Disease
Interventions: Idebenone, Placebo oral tablet
Sponsor: Second Affiliated Hospital, School of Medicine, Zhejiang Uni | Started: 2020-01-01
Expanded Access Program for Idebenone in Participants With Duchenne Muscular Dystrophy (DMD) No Longer Available
Unknown NCT03433807
Duchenne Muscular Dystrophy
Interventions: Idebenone
Sponsor: Santhera Pharmaceuticals

Linked Hypotheses (1)

Near-infrared light therapy stimulates COX4-dependent mitochondrial motility enhancement0.742

Linked Experiments (0)

No linked experiments

Scoring Dimensions

Portfolio 0.59 (25%) Druggability 0.42 (20%) Evidence 0.56 (20%) Safety 0.20 (15%) Competitive 0.55 (10%) Connectivity 0.90 (10%) 0.518 composite

Knowledge Graph (20)

activates (1)

MYO7ACOX4I1

associated with (13)

COX4I1neurodegenerationPARKINCOX4I1BCL2L13COX4I1TOMM20COX4I1ATG7COX4I1
▸ Show 8 more
GAPDHCOX4I1PARK2COX4I1SQSTM1COX4I1BNIP3LCOX4I1BCL2COX4I1MAP1LC3ACOX4I1MAP1LC3BCOX4I1COX4I1PRKN

co discussed (6)

COX4I1PRKAA1COX4I1GJA1COX4I1RAB27ACOX4I1GAP43COX4I1TFAM
▸ Show 1 more
COX4I1TRAK1_KIF5A

Debate History (1)

Should COX4I1 (Cytochrome C Oxidase Subunit 4I1) be prioritized as a therapeutic2026-04-22