NPTX1 (neuronal pentraxin 1) is a secreted pentraxin family protein primarily expressed in the nervous system 1 with established roles in synaptic function and emerging disease relevance beyond neurology. **Primary Function and Mechanism:** NPTX1 mediates synaptic material uptake and AMPA glutamate receptor clustering at excitatory synapses 1. The protein functions through receptor-ligand interactions; it binds AMIGO2 to regulate cellular signaling 2 and stabilizes β-catenin protein levels to control cell proliferation via MEK-mediated pathways 3. **Disease Relevance:** NPTX1 mutations cause spinocerebellar ataxia 50 (SCA50), an autosomal dominant cerebellar ataxia 4. Beyond neurological disease, NPTX1 is overexpressed in pancreatic ductal adenocarcinoma (PDAC) where NPTX1-AMIGO2 signaling drives metastatic colonization by enhancing HIF1α nuclear retention under hypoxic conditions 2. NPTX1 hypermethylation occurs in lung cancer, correlating with reduced expression and poor prognosis 5. Additionally, plasma NPTX1 shows tau pathology-dependent changes in preclinical Alzheimer's disease, emerging as a novel synaptic and neuroinflammation biomarker 6. **Clinical Significance:** NPTX1-targeting monoclonal antibodies substantially reduced PDAC liver metastasis in preclinical models 2. NPTX1 upregulation in hypoxic adipocytes enhances stem cell activation and adipose graft survival 7, suggesting therapeutic applications in regenerative medicine.