Adenylate kinase (hereinafter referred to as AK) catalyzes a reversible high-energy phosphoryl transfer reaction between adenine nucleotides. The enzyme contributes to the homeostasis of cellular adenine nucleotide composition in addition to the nucleotide biosynthesis. So far, six AK isozymes, AK1, AK2, AK3, AK4, AK5, and AK6, were identified. AK1 is localized in neuronal processes, sperm tail and on the cytoskeleton in cardiac cells at high concentrations, suggesting its regulatory function as a high-energy β-phosphoryl transfer chain from ATP-synthesizing sites to the ATP-utilizing sites in the cell. AK2, AK3 and AK4 are mitochondrial proteins. AK2 is expressed in the intermembrane space, while AK3 and AK4 are localized in the mitochondrial matrix. AK3 is expressed in all tissues except for red blood cells indicating that AK3 gene is a housekeeping-type gene. On the other hand, AK4 is tissue-specifically expressed mainly in kidney, brain, heart, and liver although its enzymatic activity is not yet detected. AK5 is solely expressed in a limited area of brain. AK6 is recently identified in nucleus, suggesting its role in nuclear nucleotide metabolism. All data, so far reported, indicated the function of AK is associated with the mechanism of efficient transfer of high-energy phosphate in micro-compartment within the cell. J. Med. Invest. 52: 127-136, August, 2005