FGD4

Chr 12AR

FYVE, RhoGEF and PH domain containing 4

Also known as: CMT4H, FRABP, ZFYVE6

This gene encodes a protein that is involved in the regulation of the actin cytoskeleton and cell shape. This protein contains an actin filament-binding domain, which together with its Dbl homology domain and one of its pleckstrin homology domains, can form microspikes. This protein can activate MAPK8 independently of the actin filament-binding domain, and it is also involved in the activation of CDC42 via the exchange of bound GDP for free GTP. The activation of CDC42 also enables this protein to play a role in mediating the cellular invasion of Cryptosporidium parvum, an intracellular parasite that infects the gastrointestinal tract. Mutations in this gene can cause Charcot-Marie-Tooth disease type 4H (CMT4H), a disorder of the peripheral nervous system. Multiple alternatively spliced transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Jan 2015]

Primary Disease Associations & Inheritance

Charcot-Marie-Tooth disease, type 4HMIM #609311
AR
1
Active trials
39
Pathogenic / LP
394
ClinVar variants
4
Pubs (1 yr)
2.1
Missense Z
0.46
LOEUF
Clinical SummaryFGD4
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Gene-Disease Validity (ClinGen)
Charcot-Marie-Tooth disease · ARDefinitive

Definitive — sufficient evidence for diagnostic panels

Population Constraint (gnomAD)
Constrained for loss-of-function variants (OE-LoF 0.28) despite low pLI — interpret in context.
📋
ClinVar Variants
39 Pathogenic / Likely Pathogenic· 175 VUS of 394 total submissions
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Clinical Trials
1 active or recruiting trial — potential therapeutic options may be available
📖
GeneReview available — FGD4
Authoritative clinical overview · Recommended first read
Open GeneReview ↗

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Moderate LoF intolerance
LoF Constraint
0.46LOEUF
pLI 0.010
Z-score 4.30
OE 0.28 (0.180.46)
Moderately constrained

More LoF-intolerant than ~75% of genes

Missense Constraint
2.14Z-score
OE missense 0.70 (0.630.77)
275 obs / 394.8 exp
Mild constraint

Moderately missense-constrained (top ~2.5%)

Observed / Expected Ratios
LoF OE0.28 (0.180.46)
00.351.4
Missense OE0.70 (0.630.77)
00.61.4
Synonymous OE0.94
01.21.6
LoF obs/exp: 12 / 42.1Missense obs/exp: 275 / 394.8Syn Z: 0.58
GOFDNLOF
DN
0.6744th %ile
GOF
0.72top 25%
LOF
0.3163th %ile

This gene has evidence for multiple mechanisms of pathogenicity (gain-of-function, dominant-negative and loss-of-function). 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
LOF36% of P/LP variants are LoF · LOEUF 0.46

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. Mechanism ranking also informed by gnomAD constraint, ClinVar, and ClinGen data.

ClinVar Variant Classifications

394 submitted variants in ClinVar

Classification Summary

Pathogenic33
Likely Pathogenic6
VUS175
Likely Benign147
Benign31
Conflicting2
33
Pathogenic
6
Likely Pathogenic
175
VUS
147
Likely Benign
31
Benign
2
Conflicting

Curated Variants Distribution

Classified variants from ClinVar · 5 ACMG categories

ClassificationLoFMissense + InframeNon-codingSynonymousTotal
Pathogenic
9
0
24
0
33
Likely Pathogenic
5
0
1
0
6
VUS
4
117
52
2
175
Likely Benign
0
6
67
74
147
Benign
0
1
28
2
31
Conflicting
2
Total1812417278394

LoF = frameshift, stop gained/lost, canonical splice · Counts from ClinVar esearch · Updated hourly

View in ClinVar →

FGD4 · protein map & ClinVar variants

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

Clinical Literature
Landmark / reviewRecent case evidence