NDNF (neuron derived neurotrophic factor) is a secreted glycoprotein that plays critical roles in neuronal development and cellular protection. The protein functions as a chemorepellent for gonadotropin-releasing hormone (GnRH) neurons, regulating their migration to the hypothalamus, and promotes general neuron migration, growth, survival, and neurite outgrowth 123. NDNF also supports endothelial cell survival and angiogenesis through NOS3-dependent mechanisms 2. Beyond its neurotrophic functions, NDNF demonstrates tumor suppressor activity in renal cell carcinoma by inhibiting cell proliferation, migration, and invasion through suppression of epithelial-mesenchymal transition 4. The protein has emerged as a significant pathogenic antigen in membranous nephropathy, where anti-NDNF antibodies form immune complexes that deposit along glomerular basement membranes, particularly in syphilis-associated secondary membranous nephropathy 56. Recent genetic studies have identified NDNF as a potential risk gene for Alzheimer's disease and related dementia 7. Therapeutically, NDNF overexpression enhances the cytoprotective effects of aged bone marrow mesenchymal stem cells by modulating oxidative stress and apoptosis pathways 8.