Acsm5, or Acyl-CoA Synthetase Medium-Chain Family Member 5, is involved in fatty acid metabolism. It plays a role in activating medium-chain fatty acids, which are then available for processes such as β-oxidation, lipid synthesis, and energy production. This gene is associated with pathways related to lipid metabolism and is of biological importance in various tissues and disease contexts [2,3,4].

In the context of ligamentum flavum (LF) hypertrophy, a major cause of lumbar spinal canal stenosis, Acsm5 was found to be significantly down-regulated in LF tissues. In vitro cell experiments showed that overexpression of Acsm5 inhibited free fatty acid (FFA)-induced lipid accumulation and fibrosis in LF cells. In vivo mouse experiments further confirmed that overexpression of Acsm5 inhibited LF thickening, lipid accumulation, and fibrosis. Mechanistically, Acsm5 inhibited lipid accumulation of LF cells by inhibiting the FABP4-mediated PPARγ signaling pathway, thus improving LF hypertrophy and fibrosis [1]. In hepatocellular carcinoma (HCC), Acsm5 was down-regulated in tumor tissues compared with non-tumor tissues. Overexpression of Acsm5 in HCC cell lines reduced fatty acid accumulation, decreased cell proliferation, migration, and invasion in vitro, and inhibited tumor growth in mouse xenografts. ACSM5 overexpression also decreased STAT3 phosphorylation, affecting downstream cytokine levels [2].

In conclusion, Acsm5 is crucial in regulating lipid accumulation through its role in fatty acid metabolism. Its dysregulation is associated with diseases like LF hypertrophy and HCC. Studies using overexpression models in cells and in vivo mouse models have revealed its role in these disease conditions, highlighting its potential as a biomarker and therapeutic target for related diseases.