Slc25a38, a member of the mitochondrial solute carrier family SLC25, functions as a mitochondrial glycine carrier [1,6]. It is crucial for supplying mitochondrial glycine for 5-aminolevulinic acid synthetase 2 (ALAS2) in heme biosynthesis pathway, and is also involved in regulating mitochondrial pyridoxal 5'-phosphate (PLP) levels, which is essential for many enzymatic reactions in amino acid metabolism, one-carbon metabolism, etc [1,3,4].

Mutations in Slc25a38 cause the most common recessive form of congenital sideroblastic anemia (CSA). In a study, 31 individuals from 24 families were described, including 11 novel mutations, which helps understand the phenotypes and genotypes associated with the disease [1]. Murine models of SLC25A38-CSA were developed, showing an extreme hypersensitivity to pyridoxine deficiency, uncovering a conditional synthetic lethality between SLC25A38-related CSA and pyridoxine deficiency [4]. In uveal melanoma, low expression of SLC25A38 promotes angiogenesis and metastasis, serving as a biomarker for metastasis and clinical outcome [2]. In acute lymphoblastic leukemia cells, SLC25A38 is highly expressed and may be a biomarker and therapeutic target [5].

In conclusion, Slc25a38 is essential for mitochondrial functions related to glycine supply and PLP regulation, with its dysfunction leading to CSA. The murine models of SLC25A38-CSA have provided insights into the pathophysiology of CSA and the conditional synthetic lethality with pyridoxine deficiency. Additionally, its role in other diseases like uveal melanoma and acute lymphoblastic leukemia shows its potential as a biomarker and therapeutic target in these areas [1,2,4,5].