KRAS

protein-coding

KRAS proto-oncogene, GTPase, the group of RAS type GTPase family

Gene summary

This gene, a Kirsten ras oncogene homolog from the mammalian ras gene family, encodes a protein that is a member of the small GTPase superfamily. A single amino acid substitution is responsible for an activating mutation. The transforming protein that results is implicated in various malignancies, including lung adenocarcinoma, mucinous adenoma, ductal carcinoma of the pancreas and colorectal carcinoma. Alternative splicing leads to variants encoding two isoforms that differ in the C-terminal region. [provided by RefSeq, Jul 2008]

Previous symbols:
  • KRAS2

MANE transcript

NM_004985.5

Inheritance

AD

ClinVar variants

P:93U:153B:100

Top phenotype

Noonan syndrome; Cardiofaciocutaneous syndrome 2

gnomAD constraint

pLI —, LoF o/e 0.63

Max pathogenic AF

—

Genomic locus

chr12:25,205,246-25,250,936

External References & Databases

Transcript & Mutation Effects

hg38 • Region Span ~45.7 kb
Loading mutation effect viewer...

GenCC Phenotypes & Disease Associations

Curated gene-disease validity assertions and inheritance patterns

cardiofaciocutaneous syndrome 2STRONG

Inheritance Pattern: AD

Disease ID:MONDO:0014112

Submitter: Genomics England PanelApp

cardiofaciocutaneous syndrome 2STRONG

Inheritance Pattern: AD

Disease ID:MONDO:0014112

Submitter: Labcorp Genetics (formerly Invitae)

cardiofaciocutaneous syndromeSUPPORTIVE

Inheritance Pattern: AD

Disease ID:MONDO:0015280

Submitter: Orphanet

autoimmune lymphoproliferative syndrome type 4STRONG

Inheritance Pattern: AD

Disease ID:MONDO:0013767

Submitter: PanelApp Australia

cardiofaciocutaneous syndrome 2STRONG

Inheritance Pattern: AD

Disease ID:MONDO:0014112

Submitter: PanelApp Australia

Noonan syndrome 3DEFINITIVE

Inheritance Pattern: AD

Disease ID:MONDO:0012371

Submitter: G2P

Noonan syndrome 3STRONG

Inheritance Pattern: AD

Disease ID:MONDO:0012371

Submitter: PanelApp Australia

Noonan syndrome 3STRONG

Inheritance Pattern: AD

Disease ID:MONDO:0012371

Submitter: Labcorp Genetics (formerly Invitae)

linear nevus sebaceous syndromeSTRONG

Inheritance Pattern: AD

Disease ID:MONDO:0008097

Submitter: Labcorp Genetics (formerly Invitae)

cardiofaciocutaneous syndrome 2MODERATE

Inheritance Pattern: AD

Disease ID:MONDO:0014112

Submitter: Ambry Genetics

Noonan syndrome 3DEFINITIVE

Inheritance Pattern: AD

Disease ID:MONDO:0012371

Submitter: Ambry Genetics

cardiofaciocutaneous syndrome 2DEFINITIVE

Inheritance Pattern: AD

Disease ID:MONDO:0014112

Submitter: G2P

Noonan syndromeSUPPORTIVE

Inheritance Pattern: AD

Disease ID:MONDO:0018997

Submitter: Orphanet

cardiofaciocutaneous syndromeSTRONG

Inheritance Pattern: AD

Disease ID:MONDO:0015280

Submitter: ClinGen

The maximum amount of scorable genetic evidence has been published showing de novo as well as non-de novo variants occur in KRAS in patients with cardiofaciocutaneous (CFC) syndrome (Adachi, Abe, Aoki, & Matsubara, 2012; Nava et al., 2007; Niihori et al., 2006; Nystrom et al., 2008; Sovik et al., 2007; Zenker et al., 2007). However, variable expressivity, age of ascertainment, and outdated clinical assessments of affected individuals may complicate the clinical diagnosis of Noonan syndrome (NS) versus CFC. Furthermore, there is sufficient variant overlap between KRAS-associated Noonan and CFC phenotypes. Additional genotype-phenotype correlations are necessary to solidify the association of KRAS with CFC syndrome, therefore it cannot yet be classified as Definitive. The KRAS gene is also located in the Ras/MAPK pathway, which is associated with the CFC phenotype (Aoki et al., 2016; Rauen, 2013). Of note, KRAS has also been classified as Definitive in association with Noonan syndrome and as Disputed in association with Costello syndrome. The ClinGen RASopathy Expert Panel found no evidence associating KRAS with NS-like disorder with loose anagen hair or NS with multiple lentigines. In summary, the evidence supporting the association between KRAS and CFC is Strong. This curation was approved by the ClinGen RASopathy Gene Curation Expert Panel on 7/24/18 (SOP Version 5).

Noonan syndrome 3STRONG

Inheritance Pattern: AD

Disease ID:MONDO:0012371

Submitter: Genomics England PanelApp

Costello syndromeNO_KNOWN

Inheritance Pattern: AD

Disease ID:MONDO:0009026

Submitter: ClinGen

There have been five studies to date that have identified patients with features consistent with Costello syndrome (CS) and de novo or inherited variants in KRAS (Carta et al., 2006; Nava et al., 2007; Schubbert et al., 2007; Zenker et al., 2007). However, none of the patients possessed features to definitively differentiate their diagnosis from other RASopathies as CS. Variable expressivity, age of ascertainment, and outdated clinical assessments of affected individuals may complicate the clinical diagnosis of CS versus severe forms of cardiofaciocutaneous (CFC) syndrome. Therefore, the evidence for this association is Disputed. Furthermore, the HRAS gene is believed to be the only gene associated with CS (Aoki et al., 2005; Estep, Tidyman, Teitell, Cotter, & Rauen, 2006; Gripp et al., 2006; Kerr et al., 2006; Zampino et al., 2007). Of note, KRAS has also been classified as definitive in association with Noonan syndrome (NS) and as strong in association with CFC syndrome. The ClinGen RASopathy Expert Panel found no evidence associating KRAS with NS-like disorder with loose anagen hair or NS with multiple lentigines. This curation was approved by the ClinGen RASopathy Gene Curation Expert Panel on 7/24/18 (SOP Version 5).

Noonan syndromeDEFINITIVE

Inheritance Pattern: AD

Disease ID:MONDO:0018997

Submitter: ClinGen

There is a definitive association between alteration of the KRAS gene and Noonan syndrome (NS). The maximum amount of scorable genetic evidence has been published showing de novo as well as non-de novo variants occur in KRAS in patients with NS (Carta et al., 2006; Kratz et al., 2009; Nosan, Bertok, Vesel, Yntema, & Paro-Panjan, 2013; Schubbert et al., 2006). The KRAS gene is also located in the Ras/MAPK pathway, which is associated with the NS phenotype and variants found in NS patients in this gene disrupt the RAS pathway function as demonstrated by both mouse and zebrafish models (Aoki et al., 2016; Hernandez-Porras et al., 2014; Rauen, 2013; Razzaque et al., 2012). Of note, KRAS has also been classified as strong in association with cardiofaciocutaneous syndrome and as disputed in association with Costello syndrome. The ClinGen RASopathy Expert Panel found no evidence associating KRAS with NS-like disorder with loose anagen hair or NS with multiple lentigines. This curation was approved by the ClinGen RASopathy Gene Curation Expert Panel on 7/24/18 (SOP Version 5).

Clinical Genomic Database (CGD)

Noonan syndrome; Cardiofaciocutaneous syndrome 2AD

Manifestation: Cardiovascular; Craniofacial; Dermatologic; Hematologic; Musculoskeletal; Neurologic; Oncologic

Intervention: Cardiovascular; Hematologic; Oncologic

Rationale: Surveillance and treatment related to manifestations such as cardiac anomalies (which can include hypertrophic cardiomyopathy and arrhythmias) and short stature can be beneficial; An individual has been reported with a hematologic malignancy, and surveillance may be beneficial; Precautions related to bleeding risk can be beneficial

Refs: 16474405; 16474404; 16474405; 17468812; 17056636; 18456719; 18042262; 19396835; 20301303; 20301365; 20358587; 20602484; 20876176; 21797849; 22211815; 22777296; 22510777; 23885229Source: CGD (NHGRI)

ClinVar Associated Diseases & Phenotypes

Reported disease conditions connected to KRAS variants in ClinVar

67 Conditions Cataloged
RASopathyTotal: 191
not providedTotal: 130
Cardiovascular phenotypeTotal: 100
Prostate cancer, hereditary, 1Total: 72
Noonan syndrome 3Total: 56
not specifiedTotal: 56
Cardiofaciocutaneous syndrome 2Total: 37
Autoimmune lymphoproliferative syndrome type 4Total: 28

ClinVar Variants & Pathogenicity by Type

Statistics based on transcript NM_004985.5. 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
1
clinvar
12
clinvar
98
clinvar
1
clinvar
112
missense
34
clinvar
57
clinvar
116
clinvar
207
nonsense
1
clinvar
5
clinvar
1
clinvar
7
start loss
1
clinvar
1
frameshift
12
clinvar
12
splice donor/acceptor (+/-2bp)
7
clinvar
7
Total3459153991346

Highest pathogenic variant AF is 0.000007446959

Loading ClinVar variants...

Transcript Catalog

Annotated transcript isoforms across RefSeq and Ensembl databases

Showing 4 of 43 transcripts
Transcript IDSourceProtein IDCoding ExonsMANE Status
NM_004985.5RefSeqNP_004976.24MANE Select
ENST00000311936.8EnsemblENSP00000308495.34MANE Select
NM_001369786.1RefSeqNP_001356715.14Standard
NM_001369787.1RefSeqNP_001356716.14Standard

Model Organisms & Knockout Phenotypes

Observed phenotypic effects in mouse and zebrafish models

Gene / ModelOrganismObserved Phenotype
krasDanio rerio

Structure: nucleate erythrocyte

Quality: mislocalised

abnormal

Gene Ontology (GO) Annotations & Pathways

Biological processes, molecular functions, cellular components and pathways

Pathways ConsensusPathDB

  • PI3K-Akt signaling pathway - Homo sapiens (human)
  • Non-small cell lung cancer - Homo sapiens (human)
  • Chronic myeloid leukemia - Homo sapiens (human)
  • Gastric cancer - Homo sapiens (human)
  • mTOR signaling pathway - Homo sapiens (human)

Biological Process

  • MAPK cascade
  • liver development
  • positive regulation of protein phosphorylation
  • stimulatory C-type lectin receptor signaling pathway
  • Ras protein signal transduction

Molecular Function

  • GTPase activity
  • protein binding
  • GTP binding
  • GMP binding
  • GDP binding

Cellular Component

  • cytoplasm
  • mitochondrion
  • cytosol
  • plasma membrane
  • focal adhesion

gnomAD Constraint

Source: gnomAD

Gene type
protein_coding
Transcript type
protein_coding
Transcript
ENST00000256078
Coding exons
4
Length
46148
Individuals with no LoFs
125688
Homozygous LoFs
0
Heterozygous LoFs
37
Defined
125725
p
0.000147
Z-ScoreObservedExpectedObserved/ExpectedMutation RateTotal Possible
Missense2.323397.40.3390.000004431244
Missense (PolyPhen)434.9740.11437462
Synonymous0.3363234.50.9270.00000180340
Loss of Function1.0669.530.6294.84e-7123

Population LoF Frequency

PopulationCAFp-valueStatus
African00.0absent
Latino/Admixed American0.0000870.000087rare
Ashkenazi Jewish0.000200.00020rare
East Asian0.000220.00022rare
Finnish00.0absent
European (Non-Finnish)0.000240.00024rare
South Asian0.0000330.000033rare
Other00.0absent

dbNSFP Gene Annotations

Source: dbNSFP

Function
FUNCTION: Ras proteins bind GDP/GTP and possess intrinsic GTPase activity. Plays an important role in the regulation of cell proliferation (PubMed:23698361, PubMed:22711838). Plays a role in promoting oncogenic events by inducing transcriptional silencing of tumor suppressor genes (TSGs) in colorectal cancer (CRC) cells in a ZNF304-dependent manner (PubMed:24623306). {ECO:0000269|PubMed:22711838, ECO:0000269|PubMed:23698361, ECO:0000269|PubMed:24623306, ECO:0000305}.;
Disease
DISEASE: Leukemia, acute myelogenous (AML) [MIM:601626]: A subtype of acute leukemia, a cancer of the white blood cells. AML is a malignant disease of bone marrow characterized by maturational arrest of hematopoietic precursors at an early stage of development. Clonal expansion of myeloid blasts occurs in bone marrow, blood, and other tissue. Myelogenous leukemias develop from changes in cells that normally produce neutrophils, basophils, eosinophils and monocytes. {ECO:0000269|PubMed:8955068}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Leukemia, juvenile myelomonocytic (JMML) [MIM:607785]: An aggressive pediatric myelodysplastic syndrome/myeloproliferative disorder characterized by malignant transformation in the hematopoietic stem cell compartment with proliferation of differentiated progeny. Patients have splenomegaly, enlarged lymph nodes, rashes, and hemorrhages. {ECO:0000269|PubMed:17332249}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Noonan syndrome 3 (NS3) [MIM:609942]: A form of Noonan syndrome, a disease characterized by short stature, facial dysmorphic features such as hypertelorism, a downward eyeslant and low-set posteriorly rotated ears, and a high incidence of congenital heart defects and hypertrophic cardiomyopathy. Other features can include a short neck with webbing or redundancy of skin, deafness, motor delay, variable intellectual deficits, multiple skeletal defects, cryptorchidism, and bleeding diathesis. Individuals with Noonan syndrome are at risk of juvenile myelomonocytic leukemia, a myeloproliferative disorder characterized by excessive production of myelomonocytic cells. {ECO:0000269|PubMed:16474405, ECO:0000269|PubMed:16773572, ECO:0000269|PubMed:17056636, ECO:0000269|PubMed:17468812, ECO:0000269|PubMed:19396835, ECO:0000269|PubMed:20949621}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Gastric cancer (GASC) [MIM:613659]: A malignant disease which starts in the stomach, can spread to the esophagus or the small intestine, and can extend through the stomach wall to nearby lymph nodes and organs. It also can metastasize to other parts of the body. The term gastric cancer or gastric carcinoma refers to adenocarcinoma of the stomach that accounts for most of all gastric malignant tumors. Two main histologic types are recognized, diffuse type and intestinal type carcinomas. Diffuse tumors are poorly differentiated infiltrating lesions, resulting in thickening of the stomach. In contrast, intestinal tumors are usually exophytic, often ulcerating, and associated with intestinal metaplasia of the stomach, most often observed in sporadic disease. {ECO:0000269|PubMed:14534542, ECO:0000269|PubMed:3034404, ECO:0000269|PubMed:7773929}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Note=Defects in KRAS are a cause of pylocytic astrocytoma (PA). Pylocytic astrocytomas are neoplasms of the brain and spinal cord derived from glial cells which vary from histologically benign forms to highly anaplastic and malignant tumors. {ECO:0000269|PubMed:16247081}.; DISEASE: Cardiofaciocutaneous syndrome 2 (CFC2) [MIM:615278]: A form of cardiofaciocutaneous syndrome, a multiple congenital anomaly disorder characterized by a distinctive facial appearance, heart defects and mental retardation. Heart defects include pulmonic stenosis, atrial septal defects and hypertrophic cardiomyopathy. Some affected individuals present with ectodermal abnormalities such as sparse, friable hair, hyperkeratotic skin lesions and a generalized ichthyosis-like condition. Typical facial features are similar to Noonan syndrome. They include high forehead with bitemporal constriction, hypoplastic supraorbital ridges, downslanting palpebral fissures, a depressed nasal bridge, and posteriorly angulated ears with prominent helices. CFC2 patients often do not have the skin abnormalities, such as ichthyosis, hyperkeratosis, and hemangioma observed in CFC1. {ECO:0000269|PubMed:16474404, ECO:0000269|PubMed:16474405, ECO:0000269|PubMed:17056636, ECO:0000269|PubMed:20949621, ECO:0000269|PubMed:21797849}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Note=KRAS mutations are involved in cancer development. {ECO:0000269|PubMed:14534542, ECO:0000269|PubMed:1553789, ECO:0000269|PubMed:16533793, ECO:0000269|PubMed:24623306, ECO:0000269|PubMed:3034404, ECO:0000269|PubMed:3627975, ECO:0000269|PubMed:6092920, ECO:0000269|PubMed:6695174, ECO:0000269|PubMed:7773929}.;

Recessive Scores

pRec
0.533

Intolerance Scores

LoFtool
0.190
RVIS EVS
-0.14
RVIS percentile EVS
42.88

Essentials

Essential (CRISPR)
E
Essential (CRISPR2)
N
Essential (gene trap)
K
Indispensability pred.
E
Indispensability score
0.990

Gene Damage Prediction

AllRecessiveDominant
MendelianMediumLowLow
Primary ImmunodeficiencyMediumLowMedium
CancerMediumLowMedium
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