SLC9A6

Chr XX-linkedXLD

solute carrier family 9 member A6

Also known as: MRSA, MRXSCH, NDPACX, NHE6

The protein is a sodium-hydrogen exchanger that localizes to early and recycling endosomes where it regulates endosomal pH and volume. Mutations cause X-linked syndromic intellectual developmental disorder (Christianson type) in males and X-linked neurodegenerative disorder with parkinsonism and cognitive impairment in females. Loss-of-function mutations disrupt endosomal function, leading to these distinct X-linked phenotypes that differ by sex.

OMIMResearchSummary from RefSeq, OMIM, UniProt
LOFmechanismX-linked/XLDLOEUF 0.212 OMIM phenotypes
VCEP Guidelines: Rett/Angelman-like DisordersPilot
View SpecificationsClinGen Panel
Clinical SummarySLC9A6
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Gene-Disease Validity (ClinGen)
Christianson syndrome · XLDefinitive

Definitive — sufficient evidence for diagnostic panels

Population Constraint (gnomAD)
Highly constrained gene — heterozygous loss-of-function variants are very rare in the population (pLI 1.00). One damaged copy is likely sufficient to cause disease.
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Clinical Trials
1 active or recruiting trial — potential therapeutic options may be available

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

LoF intolerant — likely haploinsufficient
LoF Constraint
0.21LOEUF
pLI 0.998
Z-score 4.26
OE 0.04 (0.010.21)
Highly constrained

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

Missense Constraint
2.95Z-score
OE missense 0.50 (0.430.57)
137 obs / 274.8 exp
Mild constraint

Moderately missense-constrained (top ~2.5%)

Observed / Expected Ratios
LoF OE0.04 (0.010.21)
00.351.4
Missense OE0.50 (0.430.57)
00.61.4
Synonymous OE0.96
01.21.6
LoF obs/exp: 1 / 23.1Missense obs/exp: 137 / 274.8Syn Z: 0.36
Curated Mechanism (G2P)Gene2Phenotype (DDG2P) ↗
definitiveSLC9A6-related syndromic intellectual developmental disorder, Christianson typeLOFXLR
DN
0.5082th %ile
GOF
0.6736th %ile
LOF
0.55top 25%

This gene has evidence for multiple mechanisms of pathogenicity (loss-of-function and gain-of-function). The Badonyi & Marsh model scores gain-of-function highest among its predictions, but genomic evidence (constraint, ClinVar variant spectrum, and literature) most strongly supports loss-of-function (haploinsufficiency). Different variants in this gene may act through different mechanisms — interpret in context of the specific variant.

LOFLOEUF 0.21
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. Mechanism ranking also informed by gnomAD constraint, ClinVar, and ClinGen data.

ClinVar Variant Classifications

0 submitted variants in ClinVar

Protein Context — Lollipop Plot

SLC9A6 · protein map & ClinVar variants

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

3D Protein StructureAlphaFold
Clinical Literature
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