Neprilysin

Membrane metallo-endopeptidase
The structure of the neprilysin ectodomain in complex with a zinc-chelating inhibitor. The zinc atom is shown as a gray sphere and the inhibitor is shown in green. Rendering based on 1r1h.
Available structures PDB Ortholog search: PDBe, RCSB List of PDB id codes 1DL9​, 1DMT​, 1QVD​, 1R1H​, 1R1I​, 1R1J​, 1Y8J​, 2QPJ​, 2YB9​, 4CTH​
Identifiers
Symbols	MME ; CALLA; CD10; NEP; SFE
External IDs	OMIM: 120520 MGI: 97004 HomoloGene: 5275 ChEMBL: 1944 GeneCards: MME Gene
EC number	3.4.24.11
Gene ontology Molecular function • endopeptidase activity • metalloendopeptidase activity • protein binding • exopeptidase activity • zinc ion binding • peptide binding Cellular component • cytoplasm • plasma membrane • integral component of plasma membrane • brush border • focal adhesion • synaptic vesicle • integral component of membrane • axon • dendrite • neuron projection terminus • synapse • extracellular exosome Biological process • kidney development • angiotensin maturation • proteolysis • peptide metabolic process • sensory perception of pain • cellular protein metabolic process • creatinine metabolic process • beta-amyloid metabolic process • cellular response to cytokine stimulus • cellular response to UV-A • cellular response to UV-B • replicative senescence Sources: Amigo / QuickGO
RNA expression pattern
More reference expression data
Orthologs
Species	Human	Mouse
Entrez	4311	17380
Ensembl	ENSG00000196549	ENSMUSG00000027820
UniProt	P08473	Q61391
RefSeq (mRNA)	NM_000902	NM_001289462
RefSeq (protein)	NP_000893	NP_001276391
Location (UCSC)	Chr 3: 155.02 – 155.18 Mb	Chr 3: 63.24 – 63.39 Mb
PubMed search

Neprilysin (/ˌnɛprᵻˈlaɪsᵻn/), also known as membrane metallo-endopeptidase (MME), neutral endopeptidase (NEP), cluster of differentiation 10 (CD10), and common acute lymphoblastic leukemia antigen (CALLA) is an enzyme that in humans is encoded by the MME gene. Neprilysin is a zinc-dependent metalloprotease that cleaves peptides at the amino side of hydrophobic residues and inactivates several peptide hormones including glucagon, enkephalins, substance P, neurotensin, oxytocin, and bradykinin.^[1] It also degrades the amyloid beta peptide whose abnormal misfolding and aggregation in neural tissue has been implicated as a cause of Alzheimer's disease. Synthesized as a membrane-bound protein, the neprilysin ectodomain is released into the extracellular domain after it has been transported from the Golgi apparatus to the cell surface.

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.^[1]

Hematopoetic progenitors expressing CD10 are considered "common lymphoid progenitors", which means they can differentiate into T, B or natural killer cells.^[2] CD10 is of use in hematological diagnosis since it is expressed by early B, pro-B and pre-B lymphocytes, and by lymph node germinal centers.^[3] Hematologic diseases in which it is positive include ALL, angioimmunoblastic T cell lymphoma, Burkitt lymphoma, chronic myelogenous leukemia in blast crisis (90%), diffuse large B-cell lymphoma (variable), follicular center cells (70%), hairy cell leukemia (10%), and myeloma (some). It tends to be negative in acute myeloid leukemia, chronic lymphocytic leukemia, mantle cell lymphoma, and marginal zone lymphoma. CD10 is found on non-T ALL cells, which derive from pre-B lymphocytes, and in germinal center-related non-Hodgkin lymphoma such as Burkitt lymphoma and follicular lymphoma, but not on leukemia cells or lymphomas, which originate in more mature B cells.^[4]

Amyloid beta regulation

Neprilysin-deficient knockout mice show both Alzheimer's-like behavioral impairment and amyloid-beta deposition in the brain,^[5] 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,^[6] it has been considered a potential therapeutic target; compounds such as the peptide hormone somatostatin have been identified that increase the enzyme's activity level.^[7] 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.^[8] 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.^[9]

Signaling peptides

Neprilysin immunohistochemical staining of normal kidney.

Neprilysin is also associated with other biochemical processes, and is particularly highly expressed in kidney and lung tissues. Inhibitors have been designed with the aim of developing analgesic and antihypertensive agents that act by preventing neprilysin's activity against signaling peptides such as enkephalins, substance P, endothelin, and atrial natriuretic factor.^[10][11]

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 metastatic carcinoma and some advanced melanomas, neprilysin is overexpressed;^[12] 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.^[13] 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.^[14]

Inhibitors

Inhibitors have been designed with the aim of developing analgesic and antihypertensive agents that act by preventing neprilysin's activity against signaling peptides such as enkephalins, substance P, endothelin, and atrial natriuretic factor.^[10][11]

Some are intended to treat heart failure.^[15]

• LCZ696 (which has been tested against enalapril) in patients with heart failure.^[15]

• Sacubitril (AHU-377), a prodrug which is a component of valsartan/sacubitril (Entresto/LCZ696)
• Sacubitrilat (LBQ657), the active form of sacubitril
• RB-101, an enkephalinase inhibitor, used in scientific research.
• UK-414,495

• Omapatrilat (dual inhibitor of NEP and angiotensin-converting enzyme) developed by BMS did not receive FDA approval due to angioedema safety concerns.

Other dual inhibitors of NEP with ACE/angiotensin receptor are (in 2003) being developed by pharmaceutical companies.^[16]

Immunochemistry

CD10 is used in clinical pathology for diagnostic purpose.

In lymphomas and leukemias

• Acute lymphoblastic leukemia (ALL) cells are CD10⁺.
• Follicular lymphoma (follicle centre cell lymphoma) are CD10⁺.
• Burkitt Lymphoma cells are CD10⁺.
• CD10⁺ diffuse large B cell lymphoma (CD10⁺ DLBLC)^[17]
  • Marker for germinal center phenotype (CD10, HGAL, BCL6, CD38) are considered a favorable prognostic factor,^[18][19] but CD10⁺, BCL2⁺ tumors could have poorer survival.^[20] For some authors, CD10 expression in DLBCL does not influence survival.^[21]
• Angioimmunoblastic T cell lymphoma (AITL) are CD10^+[22][23] and distinguishes AITL from other T cell lymphomas (CD10⁻)^[24]
  • Some benign T cells can be CD10^+[25]

In epithelial tumors

• Clear cell renal cell carcinoma (Clear cell RCC)
  • CD10⁺ distinguishes renal cell carcinoma, conventional type with eosinophilic morphology from its mimickers. Chromophobe carcinoma and oncocytoma are CD10⁻.^[26]
• Pancreatic tumors
  • Solid pseudopapillary tumours are CD10⁺.^[27]
  • CD10⁺ differentiates mucinous cystic neoplasms (CD10⁺/CK20+) from intraductal papillary mucinous neoplasm of branch duct type (CD10⁻/CK20-).^[27]
• Cutaneous tumors
  • CD10 may differentiate basal cell carcinoma (CD10 epithelial staining) from trichoblastoma (CD10 peritumoral stromal staining), basal cell carcinoma with follicular differentiation (CD10 stromal and epithelial staining)^[28] and squamous cell carcinoma (strong stromal staining).^[29]
  • CD10 differentiates CD10⁺ atypical fibroxanthoma from CD10⁻ spindle cell melanoma and sarcomatoid squamous cell carcinoma.
• Urothelial tumors express CD10 (42-67%).^[30]
  • CD10 expression is strongly correlated with high tumor grade and stage in urothelial carcinoma of the bladder. CD10 may be associated with tumor progression in bladder cancer pathogenesis.^[31]

In other tumors

• CD10 expression might be one of the characteristics of müllerian system-derived neoplastic mesenchymal cells.^[32]
  • Normal endometrial stroma^[33]
  • Endometrial stromal sarcoma (ESS) are CD10⁺ (Smooth muscle tumors are usually CD10⁻,^[34] but can be CD10^{+ [32]}
  • Malignant müllerian mixed tumor (MMMT)
  • Müllerian adenosarcoma
  • Uterine high-grade leiomyosarcoma
  • Uterine rhabdomyosarcoma
• Vascular tumors
  • Epithelioid hemangioendothelioma are mostly CD10⁺.^[35]
  • Hemangioblastoma is usually CD10⁻ (metastatic renal cell carcinoma is CD10⁺)^[36][37]

See also

• List of histologic stains that aid in diagnosis of cutaneous conditions

References

1. "Entrez Gene: Membrane metallo-endopeptidase".
2. "Human T, B, natural killer, and dendritic cells arise from a common bone marrow progenitor cell subset.". Immunity 3 (4): 459–73. Oct 1995. doi:10.1016/1074-7613(95)90175-2. PMID 7584137.
3. Singh C (2011-02-25). "CD10". CD Markers. PathologyOutlines.com, Inc.
4. Papandreou CN, Nanus DM (January 2010). "Is methylation the key to CD10 loss?". J. Pediatr. Hematol. Oncol. 32 (1): 2–3. doi:10.1097/MPH.0b013e3181c74aca. PMID 20051779.
5. 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. doi:10.1002/jnr.21074. PMID 16998901.
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21. 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. doi:10.1007/s00428-004-1129-7. PMID 15517363.
22. 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. doi:10.1038/modpathol.2011.53. PMID 21499231.
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External links

• The MEROPS online database for peptidases and their inhibitors: M13.001
• Neprilysin at the US National Library of Medicine Medical Subject Headings (MeSH)

This article incorporates text from the United States National Library of Medicine, which is in the public domain.