Neprilysin is expressed in a wide variety of tissues and is particularly abundant in kidney. It is also a common acute lymphocytic leukemia antigen that is an important cell surface marker in the diagnosis of human acute lymphocytic leukemia (ALL). This protein is present on leukemic cells of pre-B phenotype, which represent 85% of cases of ALL.
Neprilysin-deficient knockout mice show both Alzheimer's-like behavioral impairment and amyloid-beta deposition in the brain, providing strong evidence for the protein's association with the Alzheimer's disease process. Because neprilysin is thought to be the rate-limiting step in amyloid beta degradation, it has been considered a potential therapeutic target; compounds such as the peptide hormonesomatostatin have been identified that increase the enzyme's activity level. One hypothesis for the strong dependence of Alzheimer's incidence on age focuses on the declining production of somatostatin in the brains of elderly people, which thus depresses the activity of neprilysin and promotes aggregation of unprocessed amyloid beta. Declining neprilysin activity with increasing age may also be explained by oxidative damage, known to be a causative factor in Alzheimer's disease; higher levels of inappropriately oxidized neprilysin have been found in Alzheimer's patients compared to cognitively normal elderly people.
Associations have been observed between neprilysin expression and various types of cancer; however, the relationship between neprilysin expression and carcinogenesis remains obscure. In cancer biomarker studies, the neprilysin gene is often referred to as CD10 or CALLA. In some types of cancer, such as metastaticcarcinoma and some advanced melanomas, neprilysin is overexpressed; in other types, most notably lung cancers, neprilysin is downregulated, and thus unable to modulate the pro-growth autocrine signaling of cancer cells via secreted peptides such as mammalian homologs related to bombesin. Some plant extracts (methanol extracts of Ceropegia rupicola, Kniphofia sumarae, Plectranthus cf barbatus, and an aqueous extract of Pavetta longiflora) were found able to inhibit the enzymatic activity of neutral endopeptidase.
CD10+ diffuse large B cell lymphoma (CD10+ DLBLC)
Marker for germinal center phenotype (CD10, HGAL, BCL6, CD38) are considered a favorable prognostic factor, but CD10+, BCL2+ tumors could have poorer survival. For some authors, CD10 expression in DLBCL does not influence survival.
^Madani R, Poirier R, Wolfer DP, Welzl H, Groscurth P, Lipp HP, Lu B, El Mouedden M, Mercken M, Nitsch RM, Mohajeri MH (December 2006). "Lack of neprilysin suffices to generate murine amyloid-like deposits in the brain and behavioral deficit in vivo". J. Neurosci. Res. 84 (8): 1871–8. PMID16998901. doi:10.1002/jnr.21074.
^Iwata N, Tsubuki S, Takaki Y, Watanabe K, Sekiguchi M, Hosoki E, Kawashima-Morishima M, Lee HJ, Hama E, Sekine-Aizawa Y, Saido TC (February 2000). "Identification of the major Abeta1-42-degrading catabolic pathway in brain parenchyma: suppression leads to biochemical and pathological deposition". Nat. Med. 6 (2): 143–50. PMID10655101. doi:10.1038/72237.
^Wang DS, Iwata N, Hama E, Saido TC, Dickson DW (October 2003). "Oxidized neprilysin in aging and Alzheimer's disease brains". Biochem. Biophys. Res. Commun. 310 (1): 236–41. PMID14511676. doi:10.1016/j.bbrc.2003.09.003.
^ abSahli S, Stump B, Welti T, Schweizer WB, Diederich R, Blum-Kaelin D, Aebi JD, Böhm HJ (April 2005). "A New Class of Inhibitors for the Metalloprotease Neprilysin Based on a Central Imidazole Scaffold". Helvetica Chimica Acta. 88 (4): 707–730. doi:10.1002/hlca.200590050.
^ abOefner C, Roques BP, Fournie-Zaluski MC, Dale GE (February 2004). "Structural analysis of neprilysin with various specific and potent inhibitors". Acta Crystallogr. D. 60 (Pt 2): 392–6. PMID14747736. doi:10.1107/S0907444903027410.
^McGowan P, Nelles N, Wimmer J, Williams D, Wen J, Li M, Ewton A, Curry C, Zu Y, Sheehan A, Chang CC (2012). "Differentiating between Burkitt lymphoma and CD10+ diffuse large B-cell lymphoma: the role of commonly used flow cytometry cell markers and the application of a multiparameter scoring system". Am. J. Clin. Pathol. 137 (4): 665–70. PMID22431545. doi:10.1309/AJCP3FEPX5BEEKGX.
^Berglund M, Thunberg U, Amini RM, Book M, Roos G, Erlanson M, Linderoth J, Dictor M, Jerkeman M, Cavallin-Ståhl E, Sundström C, Rehn-Eriksson S, Backlin C, Hagberg H, Rosenquist R, Enblad G (2005). "Evaluation of immunophenotype in diffuse large B-cell lymphoma and its impact on prognosis". Mod. Pathol. 18 (8): 1113–20. PMID15920553. doi:10.1038/modpathol.3800396.
^Xu Y, McKenna RW, Molberg KH, Kroft SH (2001). "Clinicopathologic analysis of CD10+ and CD10- diffuse large B-cell lymphoma. Identification of a high-risk subset with coexpression of CD10 and bcl-2". Am. J. Clin. Pathol. 116 (2): 183–90. PMID11488064. doi:10.1309/J7RN-UXAY-55GX-BUNK.
^Fabiani B, Delmer A, Lepage E, Guettier C, Petrella T, Brière J, Penny AM, Copin MC, Diebold J, Reyes F, Gaulard P, Molina TJ (2004). "CD10 expression in diffuse large B-cell lymphomas does not influence survival". Virchows Arch. 445 (6): 545–51. PMID15517363. doi:10.1007/s00428-004-1129-7.
^Baseggio L, Traverse-Glehen A, Berger F, Ffrench M, Jallades L, Morel D, Goedert G, Magaud JP, Salles G, Felman P (2011). "CD10 and ICOS expression by multiparametric flow cytometry in angioimmunoblastic T-cell lymphoma". Mod. Pathol. 24 (7): 993–1003. PMID21499231. doi:10.1038/modpathol.2011.53.
^Yuan CM, Vergilio JA, Zhao XF, Smith TK, Harris NL, Bagg A (2005). "CD10 and BCL6 expression in the diagnosis of angioimmunoblastic T-cell lymphoma: utility of detecting CD10+ T cells by flow cytometry". Hum. Pathol. 36 (7): 784–91. PMID16084948. doi:10.1016/j.humpath.2005.05.008.
^Attygalle AD, Diss TC, Munson P, Isaacson PG, Du MQ, Dogan A (2004). "CD10 expression in extranodal dissemination of angioimmunoblastic T-cell lymphoma". Am. J. Surg. Pathol. 28 (1): 54–61. PMID14707864. doi:10.1097/00000478-200401000-00005.
^Yasir S, Herrera L, Gomez-Fernandez C, Reis IM, Umar S, Leveillee R, Kava B, Jorda M (2012). "CD10+ and CK7/RON- immunophenotype distinguishes renal cell carcinoma, conventional type with eosinophilic morphology from its mimickers". Appl. Immunohistochem. Mol. Morphol. 20 (5): 454–61. PMID22417859. doi:10.1097/PAI.0b013e31823fecd3.
^ abNotohara K, Hamazaki S, Tsukayama C, Nakamoto S, Kawabata K, Mizobuchi K, Sakamoto K, Okada S (2000). "Solid-pseudopapillary tumor of the pancreas: immunohistochemical localization of neuroendocrine markers and CD10". Am. J. Surg. Pathol. 24 (10): 1361–71. PMID11023097. doi:10.1097/00000478-200010000-00005.
^Córdoba A, Guerrero D, Larrinaga B, Iglesias ME, Arrechea MA, Yanguas JI (2009). "Bcl-2 and CD10 expression in the differential diagnosis of trichoblastoma, basal cell carcinoma, and basal cell carcinoma with follicular differentiation". Int. J. Dermatol. 48 (7): 713–7. PMID19570076. doi:10.1111/j.1365-4632.2009.04076.x.
^McCluggage WG, Sumathi VP, Maxwell P (2001). "CD10 is a sensitive and diagnostically useful immunohistochemical marker of normal endometrial stroma and of endometrial stromal neoplasms". Histopathology. 39 (3): 273–8. PMID11532038. doi:10.1046/j.1365-2559.2001.01215.x.
^Kabbinavar FF, Hambleton J, Mass RD, Hurwitz HI, Bergsland E, Sarkar S (2005). "Combined analysis of efficacy: the addition of bevacizumab to fluorouracil/leucovorin improves survival for patients with metastatic colorectal cancer". J. Clin. Oncol. 23 (16): 3706–12. PMID15867200. doi:10.1200/JCO.2005.00.232.
^Weinreb I, Cunningham KS, Perez-Ordoñez B, Hwang DM (2009). "CD10 is expressed in most epithelioid hemangioendotheliomas: a potential diagnostic pitfall". Arch. Pathol. Lab. Med. 133 (12): 1965–8. PMID19961253. doi:10.1043/1543-2165-133.12.1965.
^Jung SM, Kuo TT (2005). "Immunoreactivity of CD10 and inhibin alpha in differentiating hemangioblastoma of central nervous system from metastatic clear cell renal cell carcinoma". Mod. Pathol. 18 (6): 788–94. PMID15578072. doi:10.1038/modpathol.3800351.