MAP2K4 and triple-A syndrome: Studies have shown that upregulation of XIST can competitively interact with miR-1264 in the WNT/β-catenin signaling pathway and competitively interact with miR-762-mediated mitogen-activated protein kinase kinase 4 (MAP2K4) pathway, thereby inhibiting apoptosis and promoting the proliferation of VSMCs, contributing to the development of AAA (72, 73).