miRNA 145 is established to suppress stem cell pluripotency markers, such as OCT4, SOX2, and NANOG, and increases levels of SMA in SMCs; thus, disruption of this miRNA likely causes MMD-like cerebrovascular disease through a similar mechanism to ACTA2 p.R179 variants51,52. This evidence concerns the gene POU5F1 and multiminicore myopathy.