PRKACA

Chr 19AD

protein kinase cAMP-activated catalytic subunit alpha

Also known as: CAFD1, PKACA, PPNAD4

This gene encodes a catalytic subunit of protein kinase A, which phosphorylates numerous substrates in the cytoplasm and nucleus to regulate cellular processes including differentiation, proliferation, and apoptosis. Mutations cause cardioacrofacial dysplasia 1 and ACTH-independent adrenal Cushing syndrome, with autosomal dominant inheritance. The gene is highly constrained against loss-of-function variation (pLI 0.97), indicating that such mutations are likely pathogenic.

OMIMResearchSummary from RefSeq, OMIM, UniProt
MultiplemechanismADLOEUF 0.322 OMIM phenotypes
Clinical SummaryPRKACA
Population Constraint (gnomAD)
Highly constrained gene — heterozygous loss-of-function variants are very rare in the population (pLI 0.97). One damaged copy is likely sufficient to cause disease.

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

LoF intolerant — likely haploinsufficient
LoF Constraint
0.32LOEUF
pLI 0.971
Z-score 3.71
OE 0.10 (0.040.32)
Highly constrained

Highly LoF-intolerant (top ~10% of genes)

Missense Constraint
2.97Z-score
OE missense 0.43 (0.360.51)
92 obs / 214.5 exp
Mild constraint

Moderately missense-constrained (top ~2.5%)

Observed / Expected Ratios
LoF OE0.10 (0.040.32)
00.351.4
Missense OE0.43 (0.360.51)
00.61.4
Synonymous OE1.03
01.21.6
LoF obs/exp: 2 / 19.8Missense obs/exp: 92 / 214.5Syn Z: -0.22
Curated Mechanism (G2P)Gene2Phenotype (DDG2P) ↗
strongPRKACA-related multiple congenital malformation syndromeOTHERAD
DN
0.7132th %ile
GOF
0.73top 25%
LOF
0.59top 25%

This gene has evidence for multiple mechanisms of pathogenicity (gain-of-function, loss-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 · 1 literature citation
LOFLOEUF 0.32
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.

Literature Evidence

GOFOne in three CPAs carries a recurrent gain-of-function mutation (L206R) in the PRKACA gene, encoding the catalytic subunit of PKA.PMID:27445978

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

0 submitted variants in ClinVar

Protein Context — Lollipop Plot

PRKACA · 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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