PAX6
protein-codingpaired box 6, the group of PRD class homeoboxes and pseudogenes|Paired boxes
Gene summary
This gene encodes paired box protein Pax-6, one of many human homologs of the Drosophila melanogaster gene prd. In addition to a conserved paired box domain, a hallmark feature of this gene family, the encoded protein also contains a homeobox domain. Both domains are known to bind DNA and function as regulators of gene transcription. Activity of this protein is key in the development of neural tissues, particularly the eye. This gene is regulated by multiple enhancers located up to hundreds of kilobases distant from this locus. Mutations in this gene or in the enhancer regions can cause ocular disorders such as aniridia and Peter's anomaly. Use of alternate promoters and alternative splicing results in multiple transcript variants encoding different isoforms. Interestingly, inclusion of a particular alternate coding exon has been shown to increase the length of the paired box domain and alter its DNA binding specificity. Consequently, isoforms that carry the shorter paired box domain regulate a different set of genes compared to the isoforms carrying the longer paired box domain. [provided by RefSeq, Mar 2019]
- AN1
- AN2
MANE transcript
Inheritance
ClinVar variants
Top phenotype
gnomAD constraint
Max pathogenic AF
Genomic locus
External References & Databases
Transcript & Mutation Effects
hg38 • Region Span ~33.2 kbGenCC Phenotypes & Disease Associations
Curated gene-disease validity assertions and inheritance patterns
Inheritance Pattern: Unknown
Disease ID:MONDO:0007848
Submitter: Labcorp Genetics (formerly Invitae)
Inheritance Pattern: AD
Disease ID:MONDO:0024507
Submitter: Genomics England PanelApp
Inheritance Pattern: AD
Disease ID:MONDO:0011414
Submitter: G2P
Inheritance Pattern: AD
Disease ID:MONDO:0024507
Submitter: Labcorp Genetics (formerly Invitae)
Inheritance Pattern: AD
Disease ID:MONDO:0800183
Submitter: ClinGen
PAX6 was first reported in 1990s in relation to autosomal dominant aniridia (OMIM:10620, PMID: 1684738; 1302030), anterior segment malformations including Peters' anomaly (OMIM:604229, PMID: 8162071), and autosomal dominant keratitis (OMIM: 148190, PMID: 7668281). Per criteria outlined by the ClinGen Lumping and Splitting Working Group, we found no difference in molecular mechanism(s) AND inheritance pattern of these disorders and therefore they have been lumped into one disease entities as autosomal dominant anterior segment dysgenesis. Over 200 unique variants, including frameshift, nonsense, splice site, C-terminal extension (run-on), in-frame deletion, missense variants, that have been reported in over 300 probands in numerous publications (PMID: PMID: 1302030 (2), 8111379 (6), 7909985 (5), 17595013 (1), 28321846 (91), 10477494 (1), 12552561 (7), 12721955 ((8), 33514497 (254), are included in this curation. The mechanism of pathogenicity is known to be loss-of-function as predicted by haploinsufficiency. This gene-disease association is also supported by experimental evidence including biochemical function studies (PMID: 12183364), protein interaction (PMID: 14744876, 15020705), animal model/rescue (PMID: 1684639, 7914031, 8689689). More evidence is available in the literature, but the maximum score for genetic (12 points) and experimental (6 points) evidence have been reached. In summary, PAX6 is definitively associated with autosomal dominant anterior segment dysgenesis. This has been repeatedly demonstrated in both the research and clinical diagnostic settings and has been upheld over time.
Inheritance Pattern: AD
Disease ID:MONDO:0800183
Submitter: PanelApp Australia
Inheritance Pattern: AD
Disease ID:MONDO:0011414
Submitter: Orphanet
Inheritance Pattern: AD
Disease ID:MONDO:0007119
Submitter: Orphanet
Inheritance Pattern: AD
Disease ID:MONDO:0008795
Submitter: Orphanet
Inheritance Pattern: AD
Disease ID:MONDO:0024507
Submitter: G2P
Inheritance Pattern: AD
Disease ID:MONDO:0007848
Submitter: Orphanet
Inheritance Pattern: AD
Disease ID:MONDO:0011414
Submitter: Labcorp Genetics (formerly Invitae)
Inheritance Pattern: AD
Disease ID:MONDO:0005015
Submitter: Genomics England PanelApp
Inheritance Pattern: AD
Disease ID:MONDO:0016395
Submitter: Orphanet
Clinical Genomic Database (CGD)
Manifestation: Neurologic; Ophthalmologic
Intervention: Ophthalmologic; Pharmacogenomic
Rationale: Individuals with PAX6 related eye anomalies may be recognizable, but some may also be at high risk of developing glaucoma; Agents that may contribute to glaucoma should be avoided
Comments: Severe and difficult to treat glaucoma has been reported in many individuals with Anterior segment dysgenesis; Homozygous/compound heterozygous variants may cause severe disease, including neuroanatomic anomalies
ClinVar Associated Diseases & Phenotypes
Reported disease conditions connected to PAX6 variants in ClinVar
ClinVar Variants & Pathogenicity by Type
Statistics based on transcript NM_001368894.2. 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.
| Effect | PathogenicP | Likely pathogenicLP | VUS | Likely benignLB | BenignB | Sum |
|---|---|---|---|---|---|---|
| synonymous | 1 | 5 | 8 | 94 | 6 | 114 |
| missense | 35 | 73 | 163 | 6 | 2 | 279 |
| nonsense | 60 | 10 | 2 | 72 | ||
| start loss | 5 | 5 | ||||
| frameshift | 165 | 26 | 2 | 193 | ||
| splice donor/acceptor (+/-2bp) | 58 | 11 | 3 | 72 | ||
| Total | 324 | 125 | 178 | 100 | 8 | 735 |
Highest pathogenic variant AF is 0.0002485622
Transcript Catalog
Annotated transcript isoforms across RefSeq and Ensembl databases
| Transcript ID | Source | Protein ID | Coding Exons | MANE Status |
|---|---|---|---|---|
| RefSeq | NP_001355823.1 | 11 | MANE Select | |
| Ensembl | ENSP00000492024.1 | 11 | MANE Select | |
| RefSeq | NP_000271.1 | 10 | Standard | |
| RefSeq | NP_001121084.1 | 10 | Standard |
Model Organisms & Knockout Phenotypes
Observed phenotypic effects in mouse and zebrafish models
| Gene / Model | Organism | Observed Phenotype |
|---|---|---|
| pax6a | Danio rerio | Structure: rhombomere Quality: condensed abnormal |
Gene Ontology (GO) Annotations & Pathways
Biological processes, molecular functions, cellular components and pathways
Pathways ConsensusPathDB
- Maturity onset diabetes of the young - Homo sapiens (human)
- Signaling pathways regulating pluripotency of stem cells - Homo sapiens (human)
- Cardiac Progenitor Differentiation
- Mesodermal Commitment Pathway
- Ectoderm Differentiation
Biological Process
- negative regulation of transcription by RNA polymerase II
- establishment of mitotic spindle orientation
- blood vessel development
- eye development
- cell fate determination
Molecular Function
- RNA polymerase II proximal promoter sequence-specific DNA binding
- RNA polymerase II core promoter sequence-specific DNA binding
- DNA-binding transcription factor activity, RNA polymerase II-specific
- DNA-binding transcription repressor activity, RNA polymerase II-specific
- DNA-binding transcription activator activity, RNA polymerase II-specific
Cellular Component
- nuclear chromatin
- nucleus
- nucleoplasm
- cytoplasm
- cytosol
gnomAD Constraint
Source:
- Gene type
- protein_coding
- Transcript type
- protein_coding
- Transcript
- ENST00000419022
- Coding exons
- 11
- Length
- 33170
- Individuals with no LoFs
- 125741
- Homozygous LoFs
- 0
- Heterozygous LoFs
- 2
- Defined
- 125743
- p
- 0.00000795
| Z-Score | Observed | Expected | Observed/Expected | Mutation Rate | Total Possible | |
|---|---|---|---|---|---|---|
| Missense | 2.82 | 120 | 244 | 0.492 | 0.0000127 | 2843 |
| Missense (PolyPhen) | 19 | 88.318 | 0.21513 | 1035 | ||
| Synonymous | -0.850 | 100 | 89.8 | 1.11 | 0.00000513 | 855 |
| Loss of Function | 4.74 | 1 | 28.1 | 0.0356 | 0.00000171 | 269 |
Population LoF Frequency
| Population | CAF | p-value | Status |
|---|---|---|---|
| African | 0 | 0.0 | absent |
| Latino/Admixed American | 0 | 0.0 | absent |
| Ashkenazi Jewish | 0 | 0.0 | absent |
| East Asian | 0 | 0.0 | absent |
| Finnish | 0 | 0.0 | absent |
| European (Non-Finnish) | 0.0000088 | 0.0000088 | rare |
| South Asian | 0.000033 | 0.000033 | rare |
| Other | 0 | 0.0 | absent |
dbNSFP Gene Annotations
Source:
- Function
- FUNCTION: Transcription factor with important functions in the development of the eye, nose, central nervous system and pancreas. Required for the differentiation of pancreatic islet alpha cells (By similarity). Competes with PAX4 in binding to a common element in the glucagon, insulin and somatostatin promoters. Regulates specification of the ventral neuron subtypes by establishing the correct progenitor domains (By similarity). Isoform 5a appears to function as a molecular switch that specifies target genes. {ECO:0000250}.;
- Disease
- DISEASE: Aniridia 1 (AN1) [MIM:106210]: A congenital, bilateral, panocular disorder characterized by complete absence of the iris or extreme iris hypoplasia. Aniridia is not just an isolated defect in iris development but it is associated with macular and optic nerve hypoplasia, cataract, corneal changes, nystagmus. Visual acuity is generally low but is unrelated to the degree of iris hypoplasia. Glaucoma is a secondary problem causing additional visual loss over time. {ECO:0000269|PubMed:10234503, ECO:0000269|PubMed:10737978, ECO:0000269|PubMed:11309364, ECO:0000269|PubMed:11553050, ECO:0000269|PubMed:11826019, ECO:0000269|PubMed:12552561, ECO:0000269|PubMed:12634864, ECO:0000269|PubMed:16493447, ECO:0000269|PubMed:17595013, ECO:0000269|PubMed:21850189, ECO:0000269|PubMed:24033328, ECO:0000269|PubMed:8364574, ECO:0000269|PubMed:9147640, ECO:0000269|PubMed:9281415, ECO:0000269|PubMed:9792406, ECO:0000269|PubMed:9856761, ECO:0000269|PubMed:9931324, ECO:0000269|Ref.27, ECO:0000269|Ref.28}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Anterior segment dysgenesis 5 (ASGD5) [MIM:604229]: A form of anterior segment dysgenesis, a group of defects affecting anterior structures of the eye including cornea, iris, lens, trabecular meshwork, and Schlemm canal. Anterior segment dysgeneses result from abnormal migration or differentiation of the neural crest derived mesenchymal cells that give rise to components of the anterior chamber during eye development. Different anterior segment anomalies may exist alone or in combination, including iris hypoplasia, enlarged or reduced corneal diameter, corneal vascularization and opacity, posterior embryotoxon, corectopia, polycoria, abnormal iridocorneal angle, ectopia lentis, and anterior synechiae between the iris and posterior corneal surface. Clinical conditions falling within the phenotypic spectrum of anterior segment dysgeneses include aniridia, Axenfeld anomaly, Reiger anomaly/syndrome, Peters anomaly, and iridogoniodysgenesis. {ECO:0000269|PubMed:10441571, ECO:0000269|PubMed:12721955, ECO:0000269|PubMed:8162071}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Foveal hypoplasia 1 (FVH1) [MIM:136520]: An isolated form of foveal hypoplasia, a developmental defect of the eye defined as the lack of foveal depression with continuity of all neurosensory retinal layers in the presumed foveal area. Clinical features include absence of foveal pit on optical coherence tomography, absence of foveal hyperpigmentation, absence of foveal avascularity, absence of foveal and macular reflexes, decreased visual acuity, and nystagmus. Anterior segment anomalies and cataract are observed in some FVH1 patients. {ECO:0000269|PubMed:8640214, ECO:0000269|PubMed:9931324}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Keratitis hereditary (KERH) [MIM:148190]: An ocular disorder characterized by corneal opacification, recurrent stromal keratitis and vascularization. {ECO:0000269|PubMed:7668281}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Coloboma, ocular, autosomal dominant (COAD) [MIM:120200]: A set of malformations resulting from abnormal morphogenesis of the optic cup and stalk, and the fusion of the fetal fissure (optic fissure). The clinical presentation is variable. Some individuals may present with minimal defects in the anterior iris leaf without other ocular defects. More complex malformations create a combination of iris, uveoretinal and/or optic nerve defects without or with microphthalmia or even anophthalmia. {ECO:0000269|PubMed:12721955}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Coloboma of optic nerve (COLON) [MIM:120430]: An ocular defect that is due to malclosure of the fetal intraocular fissure affecting the optic nerve head. In some affected individuals, it appears as enlargement of the physiologic cup with severely affected eyes showing huge cavities at the site of the disk. {ECO:0000269|PubMed:12721955}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Bilateral optic nerve hypoplasia (BONH) [MIM:165550]: A congenital anomaly in which the optic disk appears abnormally small. It may be an isolated finding or part of a spectrum of anatomic and functional abnormalities that includes partial or complete agenesis of the septum pellucidum, other midline brain defects, cerebral anomalies, pituitary dysfunction, and structural abnormalities of the pituitary. {ECO:0000269|PubMed:12721955}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Aniridia 2 (AN2) [MIM:617141]: A form of aniridia, a congenital, bilateral, panocular disorder characterized by complete absence of the iris or extreme iris hypoplasia. Aniridia is not just an isolated defect in iris development but it is associated with macular and optic nerve hypoplasia, cataract, corneal changes, nystagmus. Visual acuity is generally low but is unrelated to the degree of iris hypoplasia. Glaucoma is a secondary problem causing additional visual loss over time. {ECO:0000269|PubMed:24290376}. Note=The gene represented in this entry is involved in disease pathogenesis. A mutation in a PAX6 long-range cis-regulatory element, known as SIMO, affects PAX6 expression in the developing eye and has pathological consequences. The mutation is located in ELP4 intron 9, 150 kb downstream of PAX6. {ECO:0000269|PubMed:24290376}.;
Recessive Scores
- pRec
- 0.829
Intolerance Scores
- LoFtool
- 0.0409
- RVIS EVS
- -0.36
- RVIS percentile EVS
- 28.63
Essentials
- Essential (CRISPR)
- N
- Essential (CRISPR2)
- N
- Essential (gene trap)
- N
- Indispensability pred.
- E
- Indispensability score
- 0.654
Gene Damage Prediction
| All | Recessive | Dominant | |
|---|---|---|---|
| Mendelian | Medium | Low | Medium |
| Primary Immunodeficiency | Medium | Low | Medium |
| Cancer | Medium | Medium | Medium |