CD28

Chr 2AR

CD28 molecule

Also known as: IMD123, Tp44

The CD28 protein is a T-cell receptor that is essential for T-cell activation, proliferation, and survival, and plays a critical role in cytokine production and maintaining immune homeostasis. Mutations cause primary immunodeficiency with autosomal recessive inheritance, leading to severe T-cell dysfunction and recurrent infections. The gene shows moderate constraint against loss-of-function variants (LOEUF 0.711), suggesting some tolerance to heterozygous loss.

OMIMResearchSummary from RefSeq, UniProt
MultiplemechanismARLOEUF 0.711 OMIM phenotype
Clinical SummaryCD28
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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.
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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 OE0.23 (0.090.71)
00.351.4
Missense OE0.80 (0.680.94)
00.61.4
Synonymous OE1.07
01.21.6
LoF obs/exp: 2 / 8.9Missense obs/exp: 103 / 128.4Syn Z: -0.39
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.

3D Protein StructureAlphaFold

Clinical Trials

Active and recruiting trials from ClinicalTrials.gov

Acute Myeloid Leukemia

Chimeric Antigen Receptor T-cells for The Treatment of AML Expressing CLL-1 Antigen

ACTIVE NOT RECRUITING
NCT04219163Phase PHASE1Baylor College of MedicineStarted 2020-07-09
CLL-1.CAR T cells
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
B-cell NHLCLL

Allogeneic CARCIK-CD19 in Adults/Pediatric B-cell NHL or Chronic Lymphocytic Leukemia

RECRUITING
NCT05869279Phase PHASE1, PHASE2Fondazione Matilde Tettamanti Menotti De Marchi OnlusStarted 2023-12-01
CARCIK-CD19
T-cell Acute Lymphoblastic LymphomaT-non-Hodgkin LymphomaT-cell Acute Lymphoblastic Leukemia

Cell Therapy for High Risk T-Cell Malignancies Using CD7-Specific CAR Expressed On Autologous T Cells

RECRUITING
NCT03690011Phase PHASE1Baylor College of MedicineStarted 2021-08-02
CD7.CAR/28zeta CAR T cells
HIV InfectionsAlcohol DrinkingAging

Precision Microbiota Interventions for Senoreduction Trial

NOT YET RECRUITING
NCT07462767Phase PHASE1, PHASE2Louisiana State University Health Sciences Center in New OrleansStarted 2026-04-01
Limosilactobacillus reuteriBlueberry extract
Non-Hodgkin's LymphomaB-Cell ALLB-Cell CLL

Activated T Lymphocytes Expressing CARs, Relapsed CD19+ Malignancies Post-Allo HSCT(CARPASCIO)

ACTIVE NOT RECRUITING
NCT02050347Phase PHASE1Baylor College of MedicineStarted 2014-04
CD19.CAR-CD28Z T Cells - dose escalation 2CD19.CAR-CD28Z T Cells - dose escalation 1
Neuroblastoma

GD2 Specific CAR and Interleukin-15 Expressing Autologous NKT Cells to Treat Children With Neuroblastoma

RECRUITING
NCT03294954Phase PHASE1Baylor College of MedicineStarted 2018-01-18
GINAKIT CellsGINAKIT cells + Etanercept
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)
Refractory B-Cell Non-Hodgkin LymphomaRefractory B-Cell Small Lymphocytic LymphomaRelapsed Adult ALL

CD19.CAR Allogeneic NKT for Patients With Relapsed or Refractory B-Cell Malignancies (ANCHOR)

ACTIVE NOT RECRUITING
NCT03774654Phase PHASE1Baylor College of MedicineStarted 2020-06-22
CD19.CAR-aNKT cells
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
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
Mantle Cell LymphomaFollicular LymphomaSplenic Marginal Zone Lymphoma

Study of Kappa Chimeric Antigen Receptor (CAR) T Lymphocytes Co-Expressing the Kappa and CD28 CARs for Relapsed/Refractory Kappa+ Non-Hodgkin Lymphoma and Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma.

RECRUITING
NCT04223765Phase PHASE1UNC Lineberger Comprehensive Cancer CenterStarted 2020-11-12
CAR.k.28FludarabineCyclophosphamide
Clinical Literature
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