FLNA

protein-coding

filamin A, the group of Filamins

Gene summary

The protein encoded by this gene is an actin-binding protein that crosslinks actin filaments and links actin filaments to membrane glycoproteins. The encoded protein is involved in remodeling the cytoskeleton to effect changes in cell shape and migration. This protein interacts with integrins, transmembrane receptor complexes, and second messengers. Defects in this gene are a cause of several syndromes, including periventricular nodular heterotopias (PVNH1, PVNH4), otopalatodigital syndromes (OPD1, OPD2), frontometaphyseal dysplasia (FMD), Melnick-Needles syndrome (MNS), and X-linked congenital idiopathic intestinal pseudoobstruction (CIIPX). Two transcript variants encoding different isoforms have been found for this gene.[provided by RefSeq, Mar 2009]

Previous symbols:
  • FLN1
  • FLN
  • OPD2
  • OPD1

MANE transcript

NM_001110556.2

Inheritance

XL, AR, AD

ClinVar variants

P:389U:1765B:1696

Top phenotype

Cardiac valvular dysplasia, X-linked; Heterotopia, periventricular, 1; Intestinal pseudoobstruction, neuronal, X-linked/Congenital short bowel syndrome

gnomAD constraint

pLI —, LoF o/e 0.03

Max pathogenic AF

—

Genomic locus

chrX:154,348,524-154,374,634

External References & Databases

Transcript & Mutation Effects

hg38 • Region Span ~26.1 kb
Loading mutation effect viewer...

GenCC Phenotypes & Disease Associations

Curated gene-disease validity assertions and inheritance patterns

terminal osseous dysplasia-pigmentary defects syndromeSTRONG

Inheritance Pattern: XL

Disease ID:MONDO:0010279

Submitter: Labcorp Genetics (formerly Invitae)

heterotopia, periventricular, X-linked dominantSTRONG

Inheritance Pattern: XL

Disease ID:MONDO:0010233

Submitter: Labcorp Genetics (formerly Invitae)

congenital short bowel syndromeSUPPORTIVE

Inheritance Pattern: AR

Disease ID:MONDO:0014097

Submitter: Orphanet

otopalatodigital syndrome type 1SUPPORTIVE

Inheritance Pattern: XL

Disease ID:MONDO:0010704

Submitter: Orphanet

X-linked Ehlers-Danlos syndromeSUPPORTIVE

Inheritance Pattern: XL

Disease ID:MONDO:0010586

Submitter: Orphanet

intestinal pseudoobstruction, neuronal, chronic idiopathic, X-linkedDEFINITIVE

Inheritance Pattern: XL

Disease ID:MONDO:0010232

Submitter: G2P

otopalatodigital syndrome type 2MODERATE

Inheritance Pattern: XL

Disease ID:MONDO:0010571

Submitter: Genomics England PanelApp

intestinal pseudoobstruction, neuronal, chronic idiopathic, X-linkedSTRONG

Inheritance Pattern: XL

Disease ID:MONDO:0010232

Submitter: Labcorp Genetics (formerly Invitae)

otopalatodigital syndrome type 2STRONG

Inheritance Pattern: XL

Disease ID:MONDO:0010571

Submitter: Labcorp Genetics (formerly Invitae)

Melnick-Needles syndromeSUPPORTIVE

Inheritance Pattern: XL

Disease ID:MONDO:0010650

Submitter: Orphanet

periventricular nodular heterotopiaSUPPORTIVE

Inheritance Pattern: AD

Disease ID:MONDO:0020341

Submitter: Orphanet

cardiac valvular dysplasia, X-linkedSUPPORTIVE

Inheritance Pattern: XL

Disease ID:MONDO:0010753

Submitter: Orphanet

heterotopia, periventricular, X-linked dominantDEFINITIVE

Inheritance Pattern: XL

Disease ID:MONDO:0010233

Submitter: Ambry Genetics

periventricular nodular heterotopiaDEFINITIVE

Inheritance Pattern: XL

Disease ID:MONDO:0020341

Submitter: ClinGen

Variants in the FLNA gene were first reported in relation to X-linked periventricular nodular heterotopia in 1998 (Fox et al., PMID: 9883725). The majority of the affected individuals are female, while the affected males are typically prenatally or neonatally lethal. Common features include periventricular nodular heterotopia and epilepsy, while additional features such as cardiovascular abnormalities, connective tissue abnormalities, intellectual disability, and developmental delay have also been reported in some patients (Reinstein et al., PMID: 23032111; Parrini et al., PMID: 16684786; Tsuneda et al., PMID: 18427995). Evidence supporting this gene-disease relationship includes case-level data. FLNA variants leading to periventricular nodular heterotopia have been reported in more than one hundred probands in the literature (PMID: 16684786, 18427995, 19917821, 23032111, 24089482, 26471271, and 29449050). Additionally, evidence supporting this gene-disease relationship includes animal models and in vitro rescue experiments (PMID: 16825286, 17172441, 22076441, and 24089482). Defects in the FLNA gene may also result in FG syndrome 2, X-linked cardiac valvular dysplasia, congenital short bowel syndrome, and neuronal intestinal pseudoobstruction, which all share overlapping phenotypes with some patients with periventricular nodular heterotopia (OMIM *300017). Of note, while loss-of-function variants in the FLNA gene lead to periventricular nodular heterotopia, gain-of-function variants cause X-linked otopalatodigital spectrum disorders (https://www.ncbi.nlm.nih.gov/books/NBK1393/). In summary, FLNA is definitively associated with X-linked periventricular nodular heterotopia. This has been repeatedly demonstrated in both the research and clinical diagnostic settings, and has been upheld over time. This classification was approved by the ClinGen Intellectual Disability and Autism Gene Curation Expert Panel on 12/27/20 (SOP Version 8).

heterotopia, periventricular, X-linked dominantDEFINITIVE

Inheritance Pattern: XL

Disease ID:MONDO:0010233

Submitter: Illumina

The FLNA gene is located on the X chromosome at Xq28 and encodes the widely expressed actin-binding protein filamin A. This protein interacts with a large number of binding partners that include membrane proteins like receptors and channels as well as intracellular signaling molecules. Through these interactions, filamin A participates in a diverse array of cellular functions, including a key role in cell migration and adhesion. FLNA was first reported in relation to X-linked periventricular nodular heterotopia in 1998 (9883725: Fox et al. 1998). Evidence supporting this gene-disease relationship includes case-level data and experimental data. At least seven predicted null variants and two missense variants have been reported in eight cases from three publications (9883725: Fox et al. 1998; 26471271: Lange et al. 2015; 19289478: de Wit et al. 2008). In three of these cases the variants occurred de novo. More evidence is available in the literature, but the maximum score for genetic (12 pts.) has been reached. This gene-disease relationship is supported by the expression of Flna in the brain during mouse embryogenesis, particularly in cells involved in neuronal migration as well as in neuronal growth cones (17172441: Feng et al. 2006). This expression pattern, together with the gene function of FLNA, is consistent with the phenotype spectrum associated with disease (21169733: Nakamura et al. 2011). Although heterotopic neurons are not observed in hemizygous FLNA null mice or heterozygous null mice, similar cardiac and vascular defects are observed, and males show embryonic lethality as observed in the human disease (17172441: Feng et al. 2006). In summary, FLNA is definitively associated with X-linked periventricular nodular heterotopia. This has been repeatedly demonstrated in both research and clinical diagnostic settings, and has been upheld over time. Of note, this gene has also been implicated in otopalatodigital (OPD) spectrum disorders. This gene disease association will be assessed separately.

heterotopia, periventricular, X-linked dominantDEFINITIVE

Inheritance Pattern: XL

Disease ID:MONDO:0010233

Submitter: G2P

otopalatodigital syndrome type 2DEFINITIVE

Inheritance Pattern: XL

Disease ID:MONDO:0010571

Submitter: G2P

terminal osseous dysplasia-pigmentary defects syndromeDEFINITIVE

Inheritance Pattern: XL

Disease ID:MONDO:0010279

Submitter: G2P

Melnick-Needles syndromeDEFINITIVE

Inheritance Pattern: XL

Disease ID:MONDO:0010650

Submitter: G2P

cardiac valvular dysplasia, X-linkedMODERATE

Inheritance Pattern: XL

Disease ID:MONDO:0010753

Submitter: Ambry Genetics

genetic developmental and epileptic encephalopathyDEFINITIVE

Inheritance Pattern: XL

Disease ID:MONDO:0100062

Submitter: G2P

familial thoracic aortic aneurysm and aortic dissectionLIMITED

Inheritance Pattern: Unknown

Disease ID:MONDO:0019625

Submitter: ClinGen

frontometaphyseal dysplasia 1DEFINITIVE

Inheritance Pattern: XL

Disease ID:MONDO:0024550

Submitter: G2P

Melnick-Needles syndromeSTRONG

Inheritance Pattern: XL

Disease ID:MONDO:0010650

Submitter: Labcorp Genetics (formerly Invitae)

otopalatodigital syndrome type 2SUPPORTIVE

Inheritance Pattern: XL

Disease ID:MONDO:0010571

Submitter: Orphanet

cardiac valvular dysplasia, X-linkedSTRONG

Inheritance Pattern: XL

Disease ID:MONDO:0010753

Submitter: Labcorp Genetics (formerly Invitae)

otopalatodigital syndromeSTRONG

Inheritance Pattern: XL

Disease ID:MONDO:0019027

Submitter: PanelApp Australia

periventricular nodular heterotopiaSTRONG

Inheritance Pattern: XL

Disease ID:MONDO:0020341

Submitter: PanelApp Australia

terminal osseous dysplasia-pigmentary defects syndromeSUPPORTIVE

Inheritance Pattern: XL

Disease ID:MONDO:0010279

Submitter: Orphanet

frontometaphyseal dysplasiaSUPPORTIVE

Inheritance Pattern: AD

Disease ID:MONDO:0015942

Submitter: Orphanet

Clinical Genomic Database (CGD)

Cardiac valvular dysplasia, X-linked; Heterotopia, periventricular, 1; Intestinal pseudoobstruction, neuronal, X-linked/Congenital short bowel syndromeXL

Manifestation: Audiologic/Otolaryngologic; Cardiovascular; Craniofacial; Dermatologic; Gastrointestinal; Genitourinary; Hematologic; Musculoskeletal; Neurologic; Pulmonary; Renal

Intervention: Audiologic/Otolaryngologic; Cardiovascular; Gastrointestinal

Rationale: In Cardiac valvular dysplasia, X-linked, surveillance for and correction of valvular anomalies can be beneficial; Individuals with Heterotopia, periventricular may have cardiac and vascular anomalies, which may warrant surveillance and medical/surgical management; For hearing loss, early recognition may allow beneficial interventions that can help with speech and language development; In Intestinal pseudoobstruction, neuronal, X-linked/Congenital short bowel syndrome, individuals have been described as benefiting from early introduction of enteral feeds, with later weaning from parenteral nutrition, and awareness of the risk of other GI-related complications may allow prompt recognition and management

Refs: 5938049; 5807657; 8230166; 8290091; 8644737; 9883725; 9800904; 9497244; 10982965; 11857561; 11914408; 12612583; 15249610; 14988809; 15864382; 15940695; 15654694; 15523633; 15917206; 15654694; 15668422; 16299064; 16538226; 16596676; 16926860; 17152064; 17190868; 17264970; 17357080; 17431908; 17632775; 18209785; 18427995; 18854860; 19917821; 20301567; 20014127; 20598277; 20730588; 20888935; 21031081; 21194575; 21412975; 21484998; 21815255; 21960593; 22238415; 22366253; 22740120; 23037936; 23873601Source: CGD (NHGRI)

ClinVar Associated Diseases & Phenotypes

Reported disease conditions connected to FLNA variants in ClinVar

87 Conditions Cataloged
Heterotopia, periventricular, X-linked dominantTotal: 3224
Melnick-Needles syndromeTotal: 3154
Oto-palato-digital syndrome, type IITotal: 3154
Frontometaphyseal dysplasiaTotal: 3122
not providedTotal: 1392
Familial thoracic aortic aneurysm and aortic dissectionTotal: 1221
not specifiedTotal: 672
FLNA-related disorderTotal: 391

ClinVar Variants & Pathogenicity by Type

Statistics based on transcript NM_001110556.2. Only rare variants are included.

We include only reliable ClinVar variants with their consequences to MANE Select, MANE Plus Clinical transcripts, or transcripts with TSL equal to 1. Click a count to filter the variants table below.

Slight differences between displayed counts and ClinVar may occur due to a different transcript/consequence chosen by our variant effect predictor, or because we classify Benign/Likely benign as Likely benign and Pathogenic/Likely pathogenic as Likely pathogenic.

EffectPLPVUSLBBSum
synonymous
2
clinvar
2
clinvar
99
clinvar
1078
clinvar
43
clinvar
1224
missense
17
clinvar
44
clinvar
1542
clinvar
508
clinvar
67
clinvar
2178
nonsense
54
clinvar
29
clinvar
26
clinvar
109
start loss
1
clinvar
1
frameshift
115
clinvar
60
clinvar
2
clinvar
177
splice donor/acceptor (+/-2bp)
23
clinvar
42
clinvar
96
clinvar
161
Total211178176515861103850

Highest pathogenic variant AF is 0.000009011851

Loading ClinVar variants...

Transcript Catalog

Annotated transcript isoforms across RefSeq and Ensembl databases

Showing 4 of 40 transcripts
Transcript IDSourceProtein IDCoding ExonsMANE Status
NM_001110556.2RefSeqNP_001104026.147MANE Select
ENST00000369850.10EnsemblENSP00000358866.347MANE Select
NM_001456.4RefSeqNP_001447.246Standard
ENST00000360319.10EnsemblENSP00000353467.446Standard

Gene Ontology (GO) Annotations & Pathways

Biological processes, molecular functions, cellular components and pathways

Pathways ConsensusPathDB

  • Focal adhesion - Homo sapiens (human)
  • Salmonella infection - Homo sapiens (human)
  • MAPK signaling pathway - Homo sapiens (human)
  • Proteoglycans in cancer - Homo sapiens (human)
  • EGF-Ncore

Biological Process

  • platelet degranulation
  • adenylate cyclase-inhibiting dopamine receptor signaling pathway
  • negative regulation of transcription by RNA polymerase I
  • formation of radial glial scaffolds
  • cerebral cortex development

Molecular Function

  • G protein-coupled receptor binding
  • RNA binding
  • protein binding
  • transcription factor binding
  • potassium channel regulator activity

Cellular Component

  • extracellular region
  • nucleus
  • nucleolus
  • cytoplasm
  • cytosol

gnomAD Constraint

Source: gnomAD

Gene type
protein_coding
Transcript type
protein_coding
Transcript
ENST00000369850
Coding exons
47
Length
26115
Individuals with no LoFs
124778
Homozygous LoFs
1
Heterozygous LoFs
4
Defined
124783
p
0.0000200
Z-ScoreObservedExpectedObserved/ExpectedMutation RateTotal Possible
Missense3.788671.24e+30.6980.00011317220
Missense (PolyPhen)219444.50.492696188
Synonymous-2.986655741.160.00006045512
Loss of Function7.89276.50.02610.000005331304

Population LoF Frequency

PopulationCAFp-valueStatus
African00.0absent
Latino/Admixed American0.0000370.000029rare
Ashkenazi Jewish00.0absent
East Asian00.0absent
Finnish00.0absent
European (Non-Finnish)0.0000500.000035rare
South Asian00.0absent
Other00.0absent

dbNSFP Gene Annotations

Source: dbNSFP

Function
FUNCTION: Promotes orthogonal branching of actin filaments and links actin filaments to membrane glycoproteins. Anchors various transmembrane proteins to the actin cytoskeleton and serves as a scaffold for a wide range of cytoplasmic signaling proteins. Interaction with FLNA may allow neuroblast migration from the ventricular zone into the cortical plate. Tethers cell surface- localized furin, modulates its rate of internalization and directs its intracellular trafficking (By similarity). Involved in ciliogenesis. Plays a role in cell-cell contacts and adherens junctions during the development of blood vessels, heart and brain organs. Plays a role in platelets morphology through interaction with SYK that regulates ITAM- and ITAM-like-containing receptor signaling, resulting in by platelet cytoskeleton organization maintenance (By similarity). {ECO:0000250, ECO:0000250|UniProtKB:Q8BTM8, ECO:0000269|PubMed:22121117}.;
Disease
DISEASE: Periventricular nodular heterotopia 1 (PVNH1) [MIM:300049]: A developmental disorder characterized by the presence of periventricular nodules of cerebral gray matter, resulting from a failure of neurons to migrate normally from the lateral ventricular proliferative zone, where they are formed, to the cerebral cortex. PVNH1 is an X-linked dominant form. Heterozygous females have normal intelligence but suffer from seizures and various manifestations outside the central nervous system, especially related to the vascular system. Hemizygous affected males die in the prenatal or perinatal period. {ECO:0000269|PubMed:11532987, ECO:0000269|PubMed:11914408, ECO:0000269|PubMed:15249610, ECO:0000269|PubMed:15668422, ECO:0000269|PubMed:15994863, ECO:0000269|PubMed:16299064}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Otopalatodigital syndrome 1 (OPD1) [MIM:311300]: X-linked dominant multiple congenital anomalies disease mainly characterized by a generalized skeletal dysplasia, mild mental retardation, hearing loss, cleft palate, and typical facial anomalies. OPD1 belongs to a group of X-linked skeletal dysplasias known as oto-palato-digital syndrome spectrum disorders that also include OPD2, Melnick-Needles syndrome (MNS), and frontometaphyseal dysplasia (FMD). Remodeling of the cytoskeleton is central to the modulation of cell shape and migration. FLNA is a widely expressed protein that regulates re-organization of the actin cytoskeleton by interacting with integrins, transmembrane receptor complexes and second messengers. Males with OPD1 have cleft palate, malformations of the ossicles causing deafness and milder bone and limb defects than those associated with OPD2. Obligate female carriers of mutations causing both OPD1 and OPD2 have variable (often milder) expression of a similar phenotypic spectrum. {ECO:0000269|PubMed:12612583, ECO:0000269|PubMed:15940695, ECO:0000269|PubMed:27193221}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Otopalatodigital syndrome 2 (OPD2) [MIM:304120]: Congenital bone disorder that is characterized by abnormally modeled, bowed bones, small or absent first digits and, more variably, cleft palate, posterior fossa brain anomalies, omphalocele and cardiac defects. {ECO:0000269|PubMed:12612583, ECO:0000269|PubMed:17431908, ECO:0000269|PubMed:27193221}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Frontometaphyseal dysplasia 1 (FMD1) [MIM:305620]: An X- linked disease characterized by generalized skeletal dysplasia, deafness, and urogenital defects. {ECO:0000269|PubMed:12612583, ECO:0000269|PubMed:16596676, ECO:0000269|PubMed:27193221}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Melnick-Needles syndrome (MNS) [MIM:309350]: Severe congenital bone disorder characterized by typical facies (exophthalmos, full cheeks, micrognathia and malalignment of teeth), flaring of the metaphyses of long bones, s-like curvature of bones of legs, irregular constrictions in the ribs, and sclerosis of base of skull. {ECO:0000269|PubMed:12612583, ECO:0000269|PubMed:27193221}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Intestinal pseudoobstruction, neuronal, chronic idiopathic, X-linked (IPOX) [MIM:300048]: A disease characterized by a severe abnormality of gastrointestinal motility due to primary qualitative defects of enteric ganglia and nerve fibers. Affected individuals manifest recurrent signs of intestinal obstruction in the absence of any mechanical lesion. {ECO:0000269|PubMed:17357080}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: FG syndrome 2 (FGS2) [MIM:300321]: FG syndrome (FGS) is an X-linked disorder characterized by mental retardation, relative macrocephaly, hypotonia and constipation. {ECO:0000269|PubMed:17632775}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Terminal osseous dysplasia (TOD) [MIM:300244]: A rare X- linked dominant male-lethal disease characterized by skeletal dysplasia of the limbs, pigmentary defects of the skin and recurrent digital fibroma during infancy. A significant phenotypic variability is observed in affected females. {ECO:0000269|PubMed:20598277}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Cardiac valvular dysplasia X-linked (CVDX) [MIM:314400]: A rare X-linked heart disease characterized by mitral and/or aortic valve regurgitation. The histologic features include fragmentation of collagenous bundles within the valve fibrosa and accumulation of proteoglycans, which produces excessive valve tissue leading to billowing of the valve leaflets. {ECO:0000269|PubMed:17190868}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Note=Defects in FLNA may be a cause of macrothrombocytopenia, a disorder characterized by subnormal levels of blood platelets. Blood platelets are abnormally enlarged (PubMed:21960593). {ECO:0000269|PubMed:21960593}.; DISEASE: Congenital short bowel syndrome, X-linked (CSBSX) [MIM:300048]: A disease characterized by a shortened small intestine, and malabsorption. The mean length of the small intestine in affected individuals is approximately 50 cm, compared with a normal length at birth of 190-280 cm. It is associated with significant mortality and morbidity. Infants usually present with failure to thrive, recurrent vomiting, and diarrhea. {ECO:0000269|PubMed:23037936}. Note=The disease is caused by mutations affecting the gene represented in this entry.;

Recessive Scores

pRec
0.644

Intolerance Scores

LoFtool
0.000896
RVIS EVS
-3.24
RVIS percentile EVS
0.44

Essentials

Essential (CRISPR)
N
Essential (CRISPR2)
N
Essential (gene trap)
N
Indispensability pred.
E
Indispensability score
0.972

Gene Damage Prediction

AllRecessiveDominant
MendelianMediumMediumMedium
Primary ImmunodeficiencyMediumMediumMedium
CancerMediumMediumMedium
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