Heparanase, an endo-β-D-glucuronidase, is increasingly recognized as a critical modulator of endothelial dysfunction, inflammation, and thrombotic processes through its capacity to cleave heparan sulfate proteoglycans, thereby releasing bioactive molecules and altering the extracellular matrix and cell surface properties (Vlodavsky et al., 2021). The gene discussed is HPSE; the disease is endothelial dysfunction.