CDH4

Chr 20

cadherin 4

Also known as: CAD4, R-CAD, RCAD

The encoded protein is a calcium-dependent cell adhesion glycoprotein that mediates cell-cell adhesion through homophilic interactions and plays important roles in brain segmentation, neuronal outgrowth, and retinal development. Mutations cause autosomal recessive neurodevelopmental disorders including intellectual disability and retinal dystrophy. This gene shows significant constraint against loss-of-function variants, indicating that complete loss of protein function is likely deleterious.

OMIMResearchSummary from RefSeq, UniProt
MultiplemechanismLOEUF 0.36
Clinical SummaryCDH4
Population Constraint (gnomAD)
Moderately constrained gene (pLI 0.74) — some intolerance to loss-of-function variants.

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Moderate LoF intolerance
LoF Constraint
0.36LOEUF
pLI 0.743
Z-score 4.66
OE 0.20 (0.120.36)
Moderately constrained

More LoF-intolerant than ~75% of genes

Missense Constraint
2.02Z-score
OE missense 0.77 (0.710.83)
480 obs / 622.0 exp
Mild constraint

Moderately missense-constrained (top ~2.5%)

Observed / Expected Ratios
LoF OE0.20 (0.120.36)
00.351.4
Missense OE0.77 (0.710.83)
00.61.4
Synonymous OE1.07
01.21.6
LoF obs/exp: 8 / 39.7Missense obs/exp: 480 / 622.0Syn Z: -0.88
DN
0.6454th %ile
GOF
0.6639th %ile
LOF
0.51top 25%

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

CDH4 · 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.

Search ClinicalTrials.gov →
Clinical Literature
Open Research Assistant →