NECAB1 (N-terminal EF-hand calcium binding protein 1) is a brain-specifically expressed calcium-binding protein that functions in neuronal calcium signaling. The 351 amino acid protein contains two EF-hand motifs and an antibiotic biosynthesis monooxygenase domain 1, characteristic of the EF-hand calcium-binding protein superfamily whose members regulate intracellular calcium dynamics and act as calcium sensors triggering protein-protein interactions 2. NECAB1 exhibits region-specific abundance in the brain, with highest expression in the temporal lobe 1, and localizes to excitatory neuron populations in the spinal cord, particularly in the dorsal horn and commissural interneurons 3. The protein's spatial and temporal expression patterns suggest roles in determining synaptic neurotransmission fidelity and neuronal responsiveness 3. Clinically, NECAB1 has emerged as a novel diagnostic biomarker in multiple disease contexts. It is significantly upregulated in idiopathic pulmonary fibrosis tissues and associated with immune cell infiltration 4. NECAB1 is a consensus biomarker for aggressive prostate adenocarcinoma 5 and a genetic variant (rs74569896) associates with major adverse cardiovascular events in acute coronary syndrome patients 6. Additionally, NECAB1 has been identified as an autoantigen in neuroimmunological disorders 7 and is downregulated in the endocannabinoid signaling pathway in both Alzheimer's disease and COVID-19 8, suggesting broader pathophysiological relevance.