LHFPL4

Chr 3

LHFPL tetraspan subfamily member 4

Also known as: GARLH4

LHFPL4 encodes a tetraspan transmembrane protein that maintains GABA receptor clustering and associated scaffold proteins at inhibitory synapses, working with neuroligin-2 to recruit or stabilize these receptors. Mutations cause autosomal recessive neurodevelopmental disorders with intellectual disability, seizures, and behavioral abnormalities. The gene shows moderate constraint against loss-of-function variants, reflecting its important role in inhibitory neurotransmission.

OMIMResearchSummary from RefSeq, UniProt
GOFmechanismLOEUF 0.62
Clinical SummaryLHFPL4
Population Constraint (gnomAD)
Moderately constrained gene (pLI 0.65) — some intolerance to loss-of-function variants.
📋
ClinVar Variants
51 unique Pathogenic / Likely Pathogenic· 33 VUS of 89 total submissions

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Moderate LoF intolerance
LoF Constraint
0.62LOEUF
pLI 0.652
Z-score 2.23
OE 0.13 (0.040.62)
Moderately constrained

Typical tolerance to LoF variation

Missense Constraint
2.10Z-score
OE missense 0.53 (0.440.63)
82 obs / 155.7 exp
Mild constraint

Moderately missense-constrained (top ~2.5%)

Observed / Expected Ratios
LoF OE0.13 (0.040.62)
00.351.4
Missense OE0.53 (0.440.63)
00.61.4
Synonymous OE0.87
01.21.6
LoF obs/exp: 1 / 7.7Missense obs/exp: 82 / 155.7Syn Z: 0.85
DN
0.5966th %ile
GOF
0.74top 25%
LOF
0.4430th %ile

The highest-scoring mechanism for this gene is gain-of-function.

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

89 submitted variants in ClinVar

Classification Summary

Pathogenic47
Likely Pathogenic4
VUS33
Likely Benign3
47
Pathogenic
4
Likely Pathogenic
33
VUS
3
Likely Benign

Curated Variants Distribution

Classified variants from ClinVar · 5 ACMG categories

ClassificationLoFMissense + InframeNon-codingSynonymousTotal
Pathogenic
0
0
47
0
47
Likely Pathogenic
0
0
4
0
4
VUS
0
18
15
0
33
Likely Benign
0
2
1
0
3
Benign
0
0
0
0
0
Total02067087

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

View in ClinVar →

Protein Context — Lollipop Plot

LHFPL4 · 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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