Abstract
Axon guidance signaling pathways, including the Eph/ephrin, Semaphorin, and Slit/Robo pathways, have been found to play crucial roles in cardiac development. Netrin signaling is another well-studied signaling pathway important for axon guidance, but its role in the developing heart has not been investigated. Here, we describe the novel expression pattern of Netrin-1 in the developing murine heart. Transcriptomic analysis of embryonic mouse hearts shows dynamic Netrin-1 expression from E8.5 through E14.5, where Netrin-1 expression preferentially co-localizes with developing trabecular cardiomyocytes. We further demonstrate the spatiotemporal expression pattern of Netrin-1 using a combination of RNA in situ hybridization and Netrin-1Bgeo/+ reporter mice. Netrin-1 is expressed in the developing cardiomyocytes with the highest degree of expression within the left ventricular trabecular myocardium, which has not been previously recognized. Additionally, Netrin-1 expression is observed at lower levels in the cardiomyocytes of the right ventricle and atria. This expression pattern supports a role for Netrin signaling in the developing murine myocardium requiring further functional characterization.
Keywords: Netrin, axon guidance signaling, heart development, trabecular myocardium, RNA in situ hybridization
Introduction
Congenital heart disease (CHD) is the leading cause of infant mortality, affecting 1% of live births annually (Pierpont et al., 2018). Chromosomal aneuploidies, copy number variation and established CHD variants capture approximately 40–45% CHD cases (Yasuhara & Garg, 2021; Morton et al., 2021). However, approximately 55–60% of CHD cases remain of unknown etiology, and will require additional investigation to identify novel causal mechanisms. First described in the context of nervous system development, axon guidance signaling has been identified to be crucial for embryogenesis, including heart development (Zhao & Mommersteeg, 2018). Among the axon guidance signaling pathways, disruption of Slit/Robo, Semaphorin and EphrinB2/EphB4 signaling results in CHD (Grego-Bessa et al., 2007; Zhao & Mommersteeg, 2018; Sanchez-Castro et al., 2014; Jaouadi et al., 2023). Loss of function variants in ROBO1 have been identified in CHD patients with ventricular septal defects, tetralogy of Fallot and bicuspid aortic valve (Zhao & Mommersteeg, 2018; Jaouadi et al., 2022). Additionally, a patient with transposition of the great arteries, ventricular septal defect, and coarctation of the aorta was found to have disruption of the SEMA3D gene, a signaling ligand of the Semaphorin pathway (Sanchez-Castro et al., 2014). CHD phenotypes have also been recapitulated in mouse models; Sema3C null mice display interrupted aortic arch and improper septation of the cardiac outflow tract and disrupted Slit/Robo signaling in mice contributes to partially penetrant ventricular septal defects in Robo1−/− and Slit3−/− embryos, while Robo1−/−;Robo2−/− compound mutants display near complete penetrance of bicuspid aortic valve. (Feiner et al., 2001; Mommersteeg, et al., 2015). Additionally, EphrinB2/EphB4 signaling was found to be required for cardiomyocyte differentiation and trabeculation (Gerety et al., 1999; Grego-Bessa et al., 2007).
Netrin signaling is another major pathway involved in axon guidance. Netrins are extracellular, lamin-related proteins that function as chemotropic guidance cues. In mammals, there are four secreted Netrin ligands, Netrin-1, Netrin-3, Netrin-4 and Netrin-5, as well as two membrane-bound glycophosphate idylinositol (GPI)-linked Netrins, Netrin-G1 and Netrin-G2 (Yamagishi et al., 2015; Nakashiba et al., 2000; Serafini et al., 1996; Wang et al., 1999; Yin, Sanes, & Miner, 2000). Due to differences in homology among the Netrin family members, the proteins also exhibit differences in receptor binding (Bruikman et al., 2019). Receptors for secreted Netrins include Mcam, Dcc, Neo1, Unc5A-D, and Dscam (Tu et al., 2015; Andrews et al., 2008; Vries & Cooper, 2008; Geisbrecht et al., 2003; Kruger et al., 2004; Leonardo et al., 1997).
Netrin-1 is the most extensively studied member of this protein class; orthologous genes in mammals along with zebrafish, frog, fruit fly, and nematode have been found to perform a highly conserved role during neural development (Bradford et at., 2019; Bruikman et al., 2019). Netrin-1 functions as both a chemoattractant and repellant of growing axons, depending on which of its receptors are presented by the axonal growth cone (Boyer & Gupton, 2018). Netrin-1 is significant in the central nervous system not only for its role in axon guidance, but for its contribution to axon branching, synaptogenesis, cell migration and axon regeneration (Dent et al., 2004; Dun & Parkinson, 2017; Flores, 2011; Mehlen & Rama, 2007; Ylivinkka, Keski-Oja, & Hyytiäinen, 2016). Outside of the nervous system, Netrins facilitate mammary gland, pancreas and lung morphogenesis as well as angiogenesis (Yebra et al., 2003; Srinivasan, et al., 2003; Liu et al., 2004; Park et al., 2004). Similar to its bifunctional role in axon guidance, Netrin-1 has different effects on the vascular system depending on receptor binding: signaling via UNC5B receptor repulses vascularization while angiogenesis is promoted by DCC binding (Claro & Ferro 2020; Xia et al., 2022; Lu et al., 2004).
Within the landscape of cardiovascular health and disease, Netrin-1 expression is associated with atherosclerosis as well as cardioprotective action against ischemia-reperfusion injury (Layne, Ferro, & Passacquale, 2015). Netrin-1 plays a complex role in atherosclerosis; endothelial Netrin-1 acts as an atheroprotective factor while macrophage-derived expression promotes disease progression (Xia et al., 2022; van Gils et al., 2012). Netrin signaling has also been implicated in CHD; a de novo microdeletion between the second and third exons of NETRIN-1 (NTN1) was identified in a patient with a ventricular septal defect, atrial septal defect, and patent ductus arteriosus (Opitz et al., 2015). In addition, rare damaging genetic variants have been identified in the cognate receptors for NETRIN-1 (UNC5B and NEO1) in patients with conotruncal heart malformations, suggesting a role for Netrin signaling in cardiac development (Jin et al., 2017). Knockdown of ntn1a (paralogous homolog of NTN1) in zebrafish embryos results in abnormal aortic arch artery formation and cardiac laterality defects (Opitz et al., 2015). However, the expression pattern and functional role of Netrin-1 in the developing mammalian heart has not been described and warrants further investigation. Here, we characterize the expression pattern of Netrin-1 during mouse cardiac development.
Results
Netrin-1 is expressed in the developing mouse heart
We sought to determine whether Netrin-1 is expressed in the developing heart by using publicly available single-cell RNA-sequencing data (scRNA-Seq) of wildtype embryonic mouse hearts (Figure 1) (DeLaughter et al., 2016; Li et al., 2016). We merged the datasets and performed unbiased clustering of embryonic day (E)8.5- E14.5 timepoints, then assigned cell types to the clusters based on known cell markers for each cell type, as described in Feng et al (Supplementary Figures 1A–1C). In this analysis, we conducted expression overlap analysis of Netrin-1 in the developing mouse heart from E8.5 to E14.5 with various cell type markers (Figure 1). Utilizing gene markers to label endothelial cells and cardiomyocytes (Pecam1+ and Tnnt2+ cells, respectively), we examined the proportion of cells that show Netrin-1 co-expression with these markers. We observed that Netrin-1 and Tnnt2+ showed a strong overlap in expression pattern. We also noted Netrin-1 predominantly co-localizes with Nppa+;Tnnt2+ cells, which label the developing trabecular cardiomyocytes (Tian et al., 2017). Comparably, there was less overlap of Netrin-1 with Hey2+;Tnnt2 indicating limited Netrin-1 expression in compact myocardium (Supplementary Figures 1D and 1E) (Tian et al., 2017). These results suggest that Netrin-1, the major signaling ligand of the Netrin signaling pathway, is largely expressed in the developing trabecular myocardium of the mouse heart.
Figure 1. scRNA-Seq data derived from publicly available datasets shows Netrin-1 expression during heart development.

Expression profile of Netrin-1 (Ntn1), Pecam1 and Tnnt2 overlayed on an UMAP projection of single-cell data from mouse embryonic stage E8.5 to E14.5. In each row, the first three panels show the expression pattern of the three markers (Ntn1, Pecam1, Tnnt2) as log transformed normalized gene expression at each developmental stage. The subsequent panel (Overlap) shows the UMAP projection of cells color coded to reflect the overlap in the expression of Ntn1-alone positive (red), Ntn1-Tnnt2 double positive (purple), Ntn1, Tnnt2, Pecam1 triple positive (orange), and Ntn1-Pecam1 double positive (yellow) cells. Cells that do not show any expression of Netrin1 are shown in Grey. The last panel in each row shows a pie chart quantifying percentage of marker overlap shown in the UMAP projection in Overlap panel as percent of Ntn1 positive cells.
Netrin-1 is highly expressed in the trabecular myocardium of the developing heart
To visualize the spatiotemporal expression pattern of Netrin-1 transcripts in the developing heart, we performed in situ hybridization on embryonic mouse hearts at E11.5 - E14.5 (Figure 2). From E11.5 - E14.5, Netrin-1 expression is observed most prominently in the trabecular myocardium of the left ventricle (Figure 2). As observed in Kathiriya, et al (Kathiriya et al., 2024), a gradient across the interventricular septum was most notable at E13.5 (Figure 2H), but this was not remarkable at earlier timepoints (i.e., E11.5, E12.5). To a lesser extent, Netrin-1 expression is also observed in the right ventricular trabecular myocardium (Figure 2A–B, D–E, G–H, J–K) as well as atrial cardiomyocytes (Figure 2A–B, D–E, G–H, J–K). Notably at E13.5 and E14.5, we also observed Netrin-1 transcript expression in the compact myocardium (Figure 2C, F, I, L) as suggested by our prior transcriptomic analysis (Supplementary Figure 1E). Additionally, Netrin-1 expression was present in the lungs within the epithelium and smooth muscle cells surrounding the airways, as previously described (Figure 2K) (Dalvin et al., 2003).
Figure 2. In situ hybridization of E11.5 – E14.5 embryos shows Netrin-1 transcript expression in the developing myocardium.

RNAscope in situ hybridization assay was performed for Netrin-1 on E11.5-E14.5 embryos utilizing one litter (n=3 embryos) per time point. (A-L) Representative sections were chosen for each timepoint. (A-B, D-E, G-H, J-K) Sections were imaged at 10x and (C, F, I, L) 40x magnification. *, airway smooth muscle, Scale bar = 100 μm.
To further support our observation of the cardiac expression pattern of Netrin-1 in vivo, we utilized the previously described Netrin-1Bgeo/+ reporter mice, in which the N-terminal signal sequence of endogenous Netrin-1 is used to generate an active B-galactosidase fusion protein (Skarnes et al., 1995). We expanded our analysis to earlier timepoints and found Netrin-1 expression in the neural tube from E8.5 to E10.5 (Figures 3A–D). A posterior view of the E8.5 Netrin-1Bgeo/+ embryo shows expression in the otic placode, neural groove and neural fold (Figure 3B; Supplementary Figure 2A). In addition to the neural tube, Netrin-1 was observed in the developing mesencephalon, metencephalon and myelencephalon at E9.5 as well as the diencephalon and telencephalon at E10.5 (Supplementary Figures 2B – 2D). Examination of Netrin-1 expression during early cardiac development demonstrated it to be localized to the left ventricle at timepoints of E9.5 and E10.5 (Figure 3C and 3D). In agreement with our in situ hybridization experiments, Netrin-1 expression predominates in the left ventricle at E11.5, but also has expanded into the right ventricular trabecular myocardium (Figure 3E and F). Atrial expression of Netrin-1 is noted in the right and left atria starting at ~E12.5 and is equally expressed in both atria by E14.5 (Figure 3I, M, Q). Expression of PECAM1 by immunohistochemistry, which labels endothelial and endocardial cells, demonstrated that Netrin-1 is not expressed in these cells during mouse heart development (Figure 3H, L, P, T). Expression was not visualized in the compact myocardium using the Netrin-1Bgeo/+ reporter potentially due to the sensitivity of this methodology or heterozygosity of the Netrin-1Bgeo allele (which results in loss of function) as Netrin-1 RNA transcripts were noted at low levels in the compact myocardium by scRNA-seq analysis and in situ hybridization (Figure 3G, K, O, S). Outside of the heart, expression was observed in the developing somites, kidneys, lungs, renal/ iliac vessels, esophagus and stomach from E12.5-E14.5 in these Netrin-1Bgeo/+ reporter mice (Supplementary Figure 2E–J).
Figure 3. Pattern of cardiac expression of Netrin-1 in E8.5 -E14.5 Netrin-1Bgeo/+ mouse embryos using X-gal staining.

(A-D) Staining of E8.5 - E10.5 whole Netrin-1Bgeo/+ embryos was performed (n of at least 3 embryos examined per each timepoint). Positive X-gal staining is noted by dark blue precipitate. A representative image of an excised E10.5 Netrin-1Bgeo/+ stained heart is shown to the right of (D). (E, I, M, Q) Embryonic hearts were dissected from E11.5 - E14.5 Netrin-1Bgeo/+ embryos and stained. (F-G, J-K, N-O, R-S) Histological tissue sections derived from E11.5 – E14.5 stained hearts were counterstained using Nuclear Fast Red and imaged at 10x and 40x magnification. (H,L,P,T) Immunohistochemistry shows that PECAM does not colocalize with positive X-gal stains at the timepoints examined. Scale bar: A, B, E, I, M, Q = 200 μm, C, D = 500 μm, F, J, N, R = 100 μm, G, H, K, L, O, S, T = 50 μm.
Discussion
Through this study, we have characterized the expression pattern of Netrin-1 in the developing murine myocardium. By utilizing publicly available scRNA-Seq datasets, we were able to identify Netrin-1 as a novel gene expressed in the developing mouse heart. Through performing in situ hybridization on wildtype mice and utilizing the Netrin-1Bgeo/+ reporter mouse line, we were able to spatiotemporally characterize this expression pattern in vivo and found Netrin-1 has the highest expression in the left ventricular trabecular myocardium throughout multiple stages of murine cardiac development expanding upon the expression pattern found by others (Kathiriya et al., 2024).
This embryonic cardiac expression pattern suggested a potential functional role for Netrin-1 for normal heart development. As previously reported, global knockout of Netrin-1 results in embryonic and/or early neonatal lethality (Bin et al. 2015; Yung, Nishitani, & Goodrich, 2015). We uncovered embryonic lethality in Netrin-1 null mice and failed to recover null embryos past E11.5 in a C57Bl/6J background strain (Supplemental Table 1). Therefore, we also investigated if cardiomyocyte-specific deletion of Netrin-1 expression leads to a cardiac phenotype. Surprisingly, mice with conditional deletion of Netrin-1 (Myh6Cre+;Netrin-1flox/flox) in the myocardium survived postnatally with normal cardiac function (Supplemental Table 2). Echocardiography of 8-week-old Myh6Cre+;Netrin-1flox/flox mice demonstrated no differences in ventricular size and function between mutants and controls except for mutants having an increased but clinical insignificant interventricular septal thickness during systole only (Supplementary Figure 3C–K) and similarly, histologic analysis of 12 week old Myh6Cre+;Netrin-1flox/flox murine hearts showed no obvious cardiac phenotype (Supplementary Figure 3A–B). The finding that conditional deletion of Netrin-1 in developing cardiomyocytes does not result in an overt cardiac phenotype is similar to previous functional analysis of Netrin-1 and Netrin-4 in lung morphogenesis, in which no significant morphological difference was observed in murine lungs lacking genes encoding either Netrin ligand (Liu et al., 2004). Additionally, they found no obvious phenotype in mutants lacking Netrin receptor Dcc. Our findings may be in part due to functional redundancy of the axon guidance molecules; analysis of scRNA-Seq datasets predicts intermittent expression of Netrin-3 and Netrin-4 during mouse embryonic heart development (Supplementary Figures 4A - 4B). Comparison of Netrin family expression at different developmental stages shows Netrin-1 expression is primarily restricted to myocardial cells and expression is noted through all studied stages (Supplementary Figures 5A and 5B). We hypothesize that deletion of multiple genes within the Netrin family may be required to observe a cardiac phenotype. As the function of Netrin-1 in other tissues and pathologies is highly specific to the presence of its receptors, further investigation into the receptor expression could determine the significance of Netrin signaling in heart development. Future work should focus on characterizing ligand-receptor interaction in the developing heart and identify mechanisms that might compensate for Netrin-1 function in developing cardiomyocytes.
Methods
Single-cell RNA-Sequencing data visualization
Publicly available single-cell data from wildtype, embryonic mouse heart were collected from gene expression omnibus (GEO). (Feng et al, 2022; Xiao et al, 2018; Li et al, 2016). Raw counts were processed using Seurat (v5) (Hao et al, 2024) and integrated using harmony (Korsunsky et al, 2019). Data were log normalized and clustered using the first 30 harmony-generated principal components. Dimensionality reduction was also performed on the first 30 harmony-generated principal components to create uniform manifold approximation and projection (UMAP) coordinates for each cell. Cells were clustered using 30 harmony-generated principal components using Louvain clustering algorithm with a resolution of 0.5. Cluster makers were determined using Wilcoxon rank sum test using Seurat (v5). These markers were used to identify cell types as described in Feng et al., 2022. For expression overlap analysis, a cell was considered as positive for a gene if normalized expression of a gene was greater than 0. For the quantification of overlap, the percentage of cells that were single, double or triple positive for the three markers were evaluated. Cells that did not express the first marker genes (Ntn1 or Ntn3 or Ntn4) in their corresponding analysis were excluded from this overlap quantifications shown in the pie chart.
Mouse embryo collection
All mice were maintained on a 12-hour-light/dark cycle and fed a standard western diet. For timed breeding, noon of the day of observation of the vaginal plug was defined as E0.5. Pregnant dams were anesthetized using inhalation of 3% isoflurane in accordance with IACUC protocols; cervical dislocation and organ removal used as a secondary method of euthanasia. Netrin-1+/− mice (Jackson Laboratories # 028070) were bred in a heterozygous cross (Netrin-1+/− × Netrin-1+/−) and embryos collected at E8.5, E9.25, E9.5, E10.5, E11.5, and E12.5 to establish embryonic lethality of Netrin-1−/− in a C57BL6/J background. Wildtype C57BL6/J males were bred to wildtype C57BL6/J females (Jackson Laboratories # 000664) and embryos were collected at E11.5 – E14.5 for RNAscope assay. Previously described Netrin-1Bgeo/+ animals were provided by Dr. Alex Jaworski’s laboratory at Brown University (Skarnes et al., 1995). Netrin-1Bgeo/+ males were time bred to wildtype CD1 and C57BL6/J females (Charles River # 022, Jackson Laboratories # 000664). Embryos were collected at E8.5 – E14.5 for β-galactosidase staining and genotyped for the Netrin-1-Bgeo allele utilizing forward primer 5’-TCGTCTGCTCATCCATGACC and reverse primer 5’-GTCTCGTTGCTGCATAAACC. Mice harboring the Netrin-1 floxed (Netflox/flox) allele (Jackson Laboratories #028038), and Myh6-Cre allele (Jackson Laboratories #011038) were generated as previously described and genotyped according to Jackson Laboratory genotyping protocol (Bin et al., 2015; Agah et al., 1997). Heterozygous males were generated for the Myh6-Cre line and bred continuously to Netrin-1flox/flox females to establish Mendelian inheritance of Netrin-1.
Histological analysis of embryos
Whole embryos or adult hearts were harvested and fixed in 4% paraformaldehyde (Electron Microscopy Sciences) overnight, washed with 1X PBS and processed using the Leica ASP2065 tissue processor and standard protocol. All tissue collected was paraffin embedded and sectioned at 6μm. A subset of β-galactosidase-stained embryos were cleared using an ethanol series prior to 4-hour processing.
RNA in situ hybridization
The RNAscope assay was performed on 6μm paraffin embedded tissue sections using the 2.5 HD-Red kit (Advanced Cell Diagnostics; ACD) (Cat#322350) according to manufacturer’s instructions. An n of 3 embryos per each timepoint were examined in this experiment. Tissue pretreatment was performed in accordance with manufacturer recommendation for mouse embryo tissue: tissue was boiled in Target Retrieval Reagents for 15 minutes and treated with Protease Plus for 30 minutes. The Netrin-1 probe used was Mm-Ntn1 (Cat#407621), designed and synthesized by the manufacturer. Universal negative control probe targeting the dapB gene (Cat# 310043) and a positive control probe targeting murine PPIB (Cat#313911), both generated by ACD, were used as reference. Images were taken using the Keyence BZ-X810 Fluorescence Microscope.
β-galactosidase staining
A modified β- galactosidase staining protocols based upon prior publications was used (Dodou, Xu, & Black, 2003; Yamagishi, Olson, & Srivastava, 2000). Embryos were harvested in sterile, 4°C 1X PBS. The tissue was fixed using a solution made of 2% formaldehyde, 0.02% glutaraldehyde, 1X sterile PBS over ice for 30 minutes – 1 hour depending on the size of the embryo. Embryos (n of at least 3 embryos per each timepoint) were permeabilized using a solution, referred henceforth as rinse buffer, composed of 1X sterile PBS, 2mM magnesium chloride (Sigma-Aldrich), 0.01% sodium deoxycholate (Acros Organics), 0.02% NP-40 (Abcam) for thirty minutes – 1 hour depending on the size of the embryo. Embryos were incubated at room temperature overnight on a shaker in stain solution made up of 0.1% X-gal (Fisher), 5mM Potassium hexacyanoferrate(II) trihydrate (Sigma-Aldrich), 5mM Potassium ferricyanide (Acros Organics), 2mM MgCl2 (Sigma Aldrich) in rinse buffer (see previous), protected from the light. The following day, embryos were rinsed in 1X PBS for 30 minutes, fixed overnight in 4% formaldehyde and washed with 1X PBS. Embryos were dehydrated in glass scintillation vials using 50%, 70% and 100% ethanol in 30-minute intervals and stored in 100% ethanol overnight. To clear, embryos were incubated in 100% ethanol for 30-minutes and later cleared in a 1:1 benzyl benzoate and benzyl alcohol mixture. Tissue was imaged using Olympus BX51.
Echocardiography
Transthoracic echocardiography was performed using a Vevo 2100 Imaging System equipped with 18- to 38-MHz linear-array transducer with a digital ultrasound system (VisualSonics Inc., Canada), as previously described (Majumdar et al., 2021). Mice examined by echocardiogram included Myh6Cre+;Ntn1fl/+(n=4), Myh6Cre+;Ntn1fl/fl (n=6), with Myh6Cre-;Ntn1fl/fl (n=11) and Myh6Cre-;Ntn1fl/+ (n=8) included as controls. The mice were anesthetized with isoflurane (2% in 100% oxygen at a flow rate of 1.0 liters/min) and body temperature was monitored throughout the procedure using a rectal probe thermometer. Pulse-wave Doppler analysis of three consecutive cardiac cycles across the aortic valve was performed and averaged along the parasternal long axis to obtain maximal transvalvular velocity along with additional measurements of ventricular function. All echocardiographic experiments and analyses were performed by an experienced investigator in a genotype blinded fashion.
Statistics
Statistical analysis was performed utilizing GraphPad Prism. The Shapiro-Wilk test was applied to quantitative data to test for normality. Echocardiogram measurements were analyzed using Student’s t-test for normally distributed data. Additionally, we performed the Mann-Whitney U test for nonparametric comparisons on the echocardiographic data to strengthen our statistical analysis. Chi-squared test was performed on categorical data. P-value ≤ 0.05 was considered significant.
Supplementary Material
Acknowledgments
The authors would like to acknowledge Dr. Tessier-Lavigne and Dr. Jaworski for sharing the Netrin-1Bgeo/+ reporter animals. In addition, we would like to thank Dr. Fang Bu for assistance in anatomical analysis of mouse embryos.
Funding:
Research reported in this publication was supported by the National Heart, Lung, and Blood Institute, National Institutes of Health Award Number T32HL134616 (AMN), Award Number T32HL098039 (SM), Award Number T32HL166149 (ASR), and Award Number R01-HL121797 (VG).
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