OTUD4 and neoplasm: Secondly, OTUD4 deficiency might lead to the activation of pro-tumoral pathways in epithelial cells, as it has been shown that OTUD4 is downregulated in some tumor cells and that overexpression of OTUD4 sensitizes tumor cells to death by modulating AKT, p53 or pyroptosis pathways (Di et al., 2022; Wu et al., 2019; Zhao et al., 2020).