LRRC4C is a leucine-rich repeat protein functioning as an axon guidance molecule with roles in neuronal development and synaptic transmission. As a member of the netrin G family, it mediates cell-cell adhesion and promotes neurite outgrowth in developing thalamic neurons, operating at glutamatergic synapses and the postsynaptic density membrane 1. Diseases associated with LRRC4C dysfunction span multiple systems. In neurodevelopmental disorders, LRRC4C disruptions correlate with autism and sensory processing disorders, with deletions potentially modifying disease severity when inherited alongside other variants 1. GWAS studies identify LRRC4C as a novel susceptibility locus for late-onset Alzheimer's disease (11p12 locus) 2 and pediatric central nervous system tumors, where its axon guidance function during CNS development may influence tumorigenesis 3. In ophthalmology, LRRC4C knockouts show increased axial length and myopic shifts in zebrafish, indicating involvement in refractive error development 4. Educational interactions with LRRC4C variants enhance myopia susceptibility, suggesting gene-environment interactions in neuronal development 5. Clinically, LRRC4C variants influence chr11 migraine treatment response to anti-CGRP monoclonal antibodies, with rs116870564 showing the strongest association 6. Expression levels correlate with poor prognosis in colon and gastric cancers, linked to immune microenvironment alterations 7. Additionally, LRRC4C copy number variations associate with male infertility and meiotic arrest 8.