In conclusion, the overexpression of DHRS4, and its synergistic DHRS3, may be primarily associated with the activation of the complement cascade in the immune system (C1QA, C1QB, C1QC, C3, and ITGB2), which may be a novel mechanism that induces spinal neurodegeneration in ALS. The gene discussed is DHRS3; the disease is amyotrophic lateral sclerosis.