CD28

Chr 2AR

CD28 molecule

Also known as: IMD123, Tp44

The protein encoded by this gene is essential for T-cell proliferation and survival, cytokine production, and T-helper type-2 development. Several alternatively spliced transcript variants encoding different isoforms have been found for this gene.[provided by RefSeq, Jul 2011]

OMIMResearchGenerating clinical summary…
MultiplemechanismARLOEUF 0.711 OMIM phenotype
Clinical SummaryCD28
🧬
Gene-Disease Validity (ClinGen)
immunodeficiency 123 with HPV-related verrucosis · ARModerate

Moderate evidence — consider for supplementary testing

Population Constraint (gnomAD)
Constrained for loss-of-function variants (OE-LoF 0.23) despite low pLI — interpret in context.
💊
Clinical Trials
12 active or recruiting trials — potential therapeutic options may be available

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Tolerant — LoF & missense variants common in population
LoF Constraint?
0.71LOEUF
pLI 0.358
Z-score 2.13
OE 0.23 (0.090.71)
Tolerant

Typical tolerance to LoF variation

Missense Constraint?
0.80Z-score
OE missense 0.80 (0.680.94)
103 obs / 128.4 exp
Tolerant

Mild missense constraint

Observed / Expected Ratios?
LoF OE?0.23 (0.090.71)
00.351.4
Missense OE?0.80 (0.680.94)
00.61.4
Synonymous OE?1.07
01.21.6
LoF obs/exp: 2 / 8.9Missense obs/exp: 103 / 128.4Syn Z: -0.39

This gene — mechanism propensity

DN
0.6744th %ile
GOF
0.6541th %ile
LOF
0.3550th %ile

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

DNprediction above median
GOFprediction 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

CD28 · protein map & ClinVar variants

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

Clinical Trials

Active and recruiting trials from ClinicalTrials.gov

Recurrent Mantle Cell LymphomaRefractory Mantle Cell Lymphoma

Modified Immune Cells (CD19 CAR T Cells) and Acalabrutinib for the Treatment of Relapsed or Refractory Mantle Cell Lymphoma

RECRUITING
NCT04484012Phase PHASE2City of Hope Medical CenterStarted 2020-12-31
AcalabrutinibCD19CAR-CD28-CD3zeta-EGFRt-expressing Tn/mem-enriched T-lymphocytes
OsteosarcomaNeuroblastoma

iC9-GD2-CAR-VZV-CTLs/Refractory or Metastatic GD2-positive Sarcoma and Neuroblastoma

ACTIVE NOT RECRUITING
NCT01953900Phase PHASE1Baylor College of MedicineStarted 2014-04
GD2 T cellsVZV vaccineFludarabine
Non-Hodgkin LymphomaChronic Lymphocytic LeukemiaAcute Lymphocytic Leukemia

Activated T-Cells Expressing 2nd or 3rd Generation CD19-Specific CAR, Advanced B-Cell NHL, ALL, and CLL (SAGAN)

RECRUITING
NCT01853631Phase PHASE1Baylor College of MedicineStarted 2014-02
Dose Escalation Phase:CD19.CAR/28 and CD19.CAR/28137 T cellsExpansion Phase: CD19.CAR/28 and CD19.CAR/28137 T cells
Brain Tumor, PediatricMedulloblastoma, ChildhoodEmbryonal Tumor

GD2-CAR T Cells for Pediatric Brain Tumours

RECRUITING
NCT05298995Phase PHASE1Bambino Gesù Hospital and Research InstituteStarted 2023-11-09
GD2-CART01 (iC9-GD2-CAR T-cells)
B-Cell Lymphoma, Unclassifiable, With Features Intermediate Between Diffuse Large B-Cell Lymphoma and Classic Hodgkin LymphomaB-Cell Prolymphocytic LeukemiaHigh Grade B-Cell Lymphoma, Not Otherwise Specified

Cellular Immunotherapy Following Chemotherapy in Treating Patients With Recurrent Non-Hodgkin Lymphomas, Chronic Lymphocytic Leukemia, or B-Cell Prolymphocytic Leukemia

ACTIVE NOT RECRUITING
NCT02153580Phase PHASE1City of Hope Medical CenterStarted 2014-09-24
Autologous CD19CAR-CD28-CD3zeta-EGFRt-expressing Tn/mem-enriched T-lymphocytesBendamustine HydrochlorideCyclophosphamide
Non Hodgkin's Lymphoma

TRAC and Power3 (SPPL3) Genes Knock-out Allogeneic CD19-targeting CAR-T Cell Therapy in r/r B-NHL

RECRUITING
NCT06014073Phase PHASE1, PHASE2Chinese PLA General HospitalStarted 2023-09-06
TRAC and Power3 (SPPL3) Genes Knock-out Allogeneic CD19-targeting CAR-T cell (ATHENA CAR-T)FludarabineCyclophosphamide
Sarcoma

Her2 Chimeric Antigen Receptor Expressing T Cells in Advanced Sarcoma

ACTIVE NOT RECRUITING
NCT00902044Phase PHASE1Baylor College of MedicineStarted 2010-02-11
Autologous HER2-specific T cellsFludarabineCyclophosphamide
Acute Myeloid Leukemia

Chimeric Antigen Receptor T Cell Redirected to Target CD4 Positive Relapsed Refractory Acute Myeloid Leukemia (AML ) as a Bridge to Allogeneic Stem Cell Transplant

RECRUITING
NCT06197672Phase PHASE1Huda SalmanStarted 2024-03-19
CD4CAR
SarcomaHER-2 Protein OverexpressionOsteosarcoma

HER2 Chimeric Antigen Receptor (CAR) T Cells in Combination With Checkpoint Blockade in Patients With Advanced Sarcoma

RECRUITING
NCT04995003Phase PHASE1Baylor College of MedicineStarted 2021-12-07
T cells or CAR T cellsPembrolizumab Injectable ProductNivolumab Injectable Product
Cutaneous Squamous Cell Carcinoma (CSCC)

Next-gen Flow Cytometry to Find Immune Profiles, Treatment Response, and Toxicity Markers in Skin Cancer Patients Treated With Cemiplimab.

RECRUITING
NCT07064330Instituto de Investigación Biomédica de SalamancaStarted 2025-07-17
Cemiplimab
T-cell LymphomaT-cell Leukemia

CD4CAR for CD4+ Leukemia and Lymphoma

RECRUITING
NCT03829540Phase PHASE1Huda SalmanStarted 2020-07-09
CD4CAR
Central Nervous System Lymphoma

Intracerebroventricular Administration of CD19-CAR T Cells (CD19CAR-CD28-CD3zeta-EGFRt-expressing Tn/Mem T-lymphocytes) for the Treatment of Central Nervous System Lymphoma

RECRUITING
NCT05625594Phase PHASE1City of Hope Medical CenterStarted 2023-06-29
AspirationBiospecimen CollectionCatheterization