ANO4

Chr 12

anoctamin 4

Also known as: TMEM16D

ANO4 encodes a calcium-dependent phospholipid scramblase that translocates phospholipids across the plasma membrane and is highly constrained against loss-of-function variants (LOEUF 0.437). Mutations cause autosomal dominant dystonia-32, a form of focal dystonia that typically presents in adulthood. The gene is associated with movement disorders affecting primarily the nervous system.

OMIMResearchSummary from RefSeq, UniProt
MultiplemechanismLOEUF 0.44
Clinical SummaryANO4
Population Constraint (gnomAD)
Constrained for loss-of-function variants (OE-LoF 0.30) despite low pLI — interpret in context.

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Moderate LoF intolerance
LoF Constraint
0.44LOEUF
pLI 0.000
Z-score 5.20
OE 0.30 (0.210.44)
Moderately constrained

More LoF-intolerant than ~75% of genes

Missense Constraint
2.53Z-score
OE missense 0.68 (0.620.75)
344 obs / 504.0 exp
Mild constraint

Moderately missense-constrained (top ~2.5%)

Observed / Expected Ratios
LoF OE0.30 (0.210.44)
00.351.4
Missense OE0.68 (0.620.75)
00.61.4
Synonymous OE0.80
01.21.6
LoF obs/exp: 19 / 63.8Missense obs/exp: 344 / 504.0Syn Z: 2.04
DN
0.74top 25%
GOF
0.80top 10%
LOF
0.2483th %ile

This gene has evidence for multiple mechanisms of pathogenicity (gain-of-function and dominant-negative). Both the Badonyi & Marsh prediction and the broader genomic evidence point to gain-of-function as the predominant mechanism. Different variants in this gene may act through different mechanisms — interpret in context of the specific variant.

GOFprediction above median
DNprediction above median

Note: In-silico variant effect predictors (SIFT, PolyPhen, REVEL, CADD) may underestimate pathogenicity of missense variants in genes with GOF or DN mechanisms. Consider functional evidence and clinical context.

Predictions from Badonyi M, Marsh JA. PLoS ONE. 2024;19(8):e0307312.

ClinVar Variant Classifications

0 submitted variants in ClinVar

Protein Context — Lollipop Plot

ANO4 · protein map & ClinVar variants

Showing all ClinVar variants across the protein. Search a specific variant to highlight its position.

3D Protein StructureAlphaFold

Clinical Trials

Active and recruiting trials from ClinicalTrials.gov

No active trials found for this gene.

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Clinical Literature
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Recent Gene-Specific Literature
Gene in title · MEDLINE · newest first
Europe PMC