TRIO

Chr 5AD

trio Rho guanine nucleotide exchange factor

Also known as: ARHGEF23, MEBAS, MRD44, MRD63, tgat

TRIO encodes a guanine nucleotide exchange factor that activates RHOA and RAC1 GTPases to coordinate actin cytoskeleton remodeling essential for cell migration, neurite outgrowth, and synaptic function in developing neurons. Mutations cause autosomal dominant intellectual developmental disorders that can present with either microcephaly or macrocephaly. The gene is extremely intolerant to loss-of-function variants (pLI ~1.0, LOEUF 0.139), indicating that even heterozygous loss significantly impacts neurodevelopment.

OMIMResearchSummary from RefSeq, OMIM, UniProt
MultiplemechanismADLOEUF 0.142 OMIM phenotypes
Clinical SummaryTRIO
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Gene-Disease Validity (ClinGen)
syndromic intellectual disability · ADDefinitive

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
12 active or recruiting trials — potential therapeutic options may be available

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Dual constrained — LoF & missense intolerant
LoF Constraint
0.14LOEUF
pLI 1.000
Z-score 10.61
OE 0.09 (0.060.14)
Highly constrained

Among the most LoF-intolerant genes (~top 3%)

Missense Constraint
5.32Z-score
OE missense 0.64 (0.610.68)
1143 obs / 1772.9 exp
Constrained

Extremely missense-constrained (top ~0.01%)

Observed / Expected Ratios
LoF OE0.09 (0.060.14)
00.351.4
Missense OE0.64 (0.610.68)
00.61.4
Synonymous OE1.04
01.21.6
LoF obs/exp: 14 / 157.8Missense obs/exp: 1143 / 1772.9Syn Z: -0.92
Curated Mechanism (G2P)Gene2Phenotype (DDG2P) ↗
strongTRIO-related intellectual disabilityOTHERAD
DN
0.4289th %ile
GOF
0.6052th %ile
LOF
0.65top 25%

This gene has evidence for multiple mechanisms of pathogenicity (loss-of-function and gain-of-function). Both the Badonyi & Marsh prediction and the broader genomic evidence point to loss-of-function as the predominant mechanism. Different variants in this gene may act through different mechanisms — interpret in context of the specific variant.

LOFprediction above median · 1 literature citation · LOEUF 0.14
GOF1 literature citation

Literature Evidence

GOFTransfection of the mutations into neuroblastoma cells caused enhanced neurite outgrowth and increased lamellipodia formation compared to controls. The findings were consistent with a gain-of-function effect.PMID:27418539
LOFLarge-scale discovery of novel genetic causes of developmental disordersPMID:25533962

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

TRIO · 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

Specific Language and Learning Disorders (SLLD)

Study of the Value of Trio Exome Sequencing in the Etiological Assessment of Specific Non-syndromic Language and Learning Disorders

RECRUITING
NCT05939739Phase NACentre Hospitalier Universitaire DijonStarted 2023-08-07
Blood samplesConsultation for results deliveryStudy Humanities and Social Sciences
Pediatric TumorFamilial CancerSolid Tumor, Childhood

Analyse of Tumour and Constitutional DNA for the Study of the Determinism in Child Neoplasia

ACTIVE NOT RECRUITING
NCT04471961Phase NAUniversity Hospital, MontpellierStarted 2020-07-09
Exome sequencing in pediatrics cancers
Neurodevelopmental Disorders and Developmental Abnormalities

Transcriptomic Approach for the Identification and Prioritization of Genome Variants in Neurodevelopmental Disorders With Malformation

NOT YET RECRUITING
NCT06762678Phase NAUniversity Hospital, AngersStarted 2025-02-01
RNA sequencing and whole genome sequencing in a trio way
16P11.2 Deletion Syndrome16p11.2 Duplications1Q21.1 Deletion

Online Study of People Who Have Genetic Changes and Features of Autism: Simons Searchlight

RECRUITING
NCT01238250Simons SearchlightStarted 2010-10
Cerebral Palsy

CP-EDIT: Cerebral Palsy - Early Diagnosis and Intervention Trial

RECRUITING
NCT05835674Rigshospitalet, DenmarkStarted 2023-04-01
Early intervention program
Heart Defects, Congenital

Genetics of Ventriculo-arterial Discordance

ACTIVE NOT RECRUITING
NCT05330338Phase NANantes University HospitalStarted 2022-09-07
Genetic analyses: whole genome sequencing
EpilepsySeizuresSyncope

Genetic Markers of Cardiovascular Disease in Epilepsy

RECRUITING
NCT02824822Mayo ClinicStarted 2016-05
Neoplastic Syndromes, HereditaryCancerGenetic Predisposition to Disease

Cancer Predisposition Testing by Family-based Whole-genome Sequencing (WGS) in Every Child With Newly Diagnosed Cancer

RECRUITING
NCT04903782Sydney Children's Hospitals NetworkStarted 2021-03-08
Family-based whole genome sequencing
Neuromuscular Diseases

The Neuroimage Study of the Neuromuscular Disorders.

RECRUITING
NCT05048862National Taiwan University HospitalStarted 2021-08-01
Neuromuscular ultrasoundMuscle MRINerve conduction studies and autonomic function tests
Infant, Newborn, DiseaseGenetic Disease

Genome Sequencing in the Intensive Care Unit Population

ENROLLING BY INVITATION
NCT04848090Phase NAJerry Vockley, MD, PhDStarted 2020-07-13
Neonate WGS Testing
Cerebellar Ataxias

The Benefits of Long-read High-throughput Genomic Sequencing for the Causal Diagnosis of Cerebellar Ataxias

RECRUITING
NCT06467175Phase NACentre Hospitalier Universitaire DijonStarted 2024-12-11
blood sampling for high molecular weight DNA extraction
Idiopathic Short Stature

Multidisciplinary Evaluation and a Genome-wide Analysis in a Cohort of Idiopathic Short Stature Patients

RECRUITING
NCT05858606Phase NAUniversity Hospital, MontpellierStarted 2026-03-16
Evaluation of the prevalence of truly (authentified) idiopathic short stature after multidisciplinary clinico-radiological evaluationanalysis in a multidisciplinary consultation meeting via a secure platform (ShareConfrère) for evaluation by multidisciplinary teamWhole genome analysis for authentified idiopathic short stature
Clinical Literature
Open Research Assistant →
Full-Text Mentions
NLP-detected gene mentions in article bodies · via PubTator3
PubTator3
A Rare Iatrogenic Trio
Satyavolu B et al.·JACC Case Rep
2021
Origins of the seed: The "golden-trio hypothesis"
Bai SN et al.·Front Plant Sci
2022
Hospital Information Systems: From Trio to Quartet.
Shifrin M et al.·Stud Health Technol Inform
2025
TRIO Risk Score: Simple, Yet Complex.
Balakrishna AM et al.·Mayo Clin Proc
2022
Top 5 full-text resultsSearch PubTator3 ↗