Our study firstly proposes that CREB1 may regulate CTSB via miR-431 andmiR-411, modulating neutrophil ferroptosis and participating in the process of ICAS.Previous studies have identified the potential interaction between CREB1 and CTSB(Omori et al., 2007; Zhao et al., 2024). This evidence concerns the gene CREB1 and familial isolated congenital asplenia.