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NELL1 is a matricellular signaling protein and growth factor involved in the regulation of cell growth and differentiation, with a prominent role in bone formation and tissue regeneration. It is highly expressed during fetal development and promotes osteoblast differentiation and terminal mineralization. Mechanistically, NELL1 binds to Integrin β1 on cell surfaces to activate intracellular signaling cascades that promote cell adhesion, proliferation, osteogenic differentiation (via the canonical Wnt/β-catenin pathway), angiogenesis (formation of new blood vessels), recruitment of stem cells for tissue repair, control of inflammation to prevent chronic conditions or complications after injury, and restoration of tissue mass/volume. These properties make it a promising therapeutic candidate for regenerative medicine applications targeting both soft and hard tissues—including bone defects (such as osteoporosis), cartilage injuries (including osteoarthritis), tendon repair, skeletal muscle regeneration, heart muscle recovery after injury or infarction, viral-induced lung injury (e.g., COVID-19-related damage), systemic inflammation/atrophy disorders—and potentially other severe injuries or degenerative diseases[1][6][8]. NellOne Therapeutics is developing recombinant human NELL1 as an early-stage biopharmaceutical product for these indications[1].
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