PTEN
protein-codingphosphatase and tensin homolog, the group of Phosphoinositide phosphatases|C2 tensin-type domain containing|PTEN protein phosphatases
Gene summary
This gene was identified as a tumor suppressor that is mutated in a large number of cancers at high frequency. The protein encoded by this gene is a phosphatidylinositol-3,4,5-trisphosphate 3-phosphatase. It contains a tensin like domain as well as a catalytic domain similar to that of the dual specificity protein tyrosine phosphatases. Unlike most of the protein tyrosine phosphatases, this protein preferentially dephosphorylates phosphoinositide substrates. It negatively regulates intracellular levels of phosphatidylinositol-3,4,5-trisphosphate in cells and functions as a tumor suppressor by negatively regulating AKT/PKB signaling pathway. The use of a non-canonical (CUG) upstream initiation site produces a longer isoform that initiates translation with a leucine, and is thought to be preferentially associated with the mitochondrial inner membrane. This longer isoform may help regulate energy metabolism in the mitochondria. A pseudogene of this gene is found on chromosome 9. Alternative splicing and the use of multiple translation start codons results in multiple transcript variants encoding different isoforms. [provided by RefSeq, Feb 2015]
- BZS
- MHAM
MANE transcript
Inheritance
ClinVar variants
Top phenotype
gnomAD constraint
Max pathogenic AF
Genomic locus
External References & Databases
Transcript & Mutation Effects
hg38 • Region Span ~109.3 kbGenCC Phenotypes & Disease Associations
Curated gene-disease validity assertions and inheritance patterns
Inheritance Pattern: AD
Disease ID:MONDO:0008021
Submitter: Genomics England PanelApp
Inheritance Pattern: AD
Disease ID:MONDO:0008021
Submitter: Labcorp Genetics (formerly Invitae)
Inheritance Pattern: AD
Disease ID:MONDO:0011537
Submitter: Orphanet
Inheritance Pattern: AD
Disease ID:MONDO:0019002
Submitter: G2P
Inheritance Pattern: AD
Disease ID:MONDO:0017623
Submitter: ClinGen
*PTEN* gene encodes a phosphatidylinositol-3,4,5-trisphosphate 3 (PIP3)-phosphatase, which blocks phosphatidylinositol 3 kinase (PI3K) signaling by inhibiting PIP3 dependent processes such as the membrane recruitment and activation of AKT, therefore inhibiting cell survival, growth, and proliferation. In 1997, Steck et al. (PMID: 9090379) first identified *PTEN* gene and reported the association of germline PTEN variants with multiple cancer types, including breast cancer, kidney carcinoma and glioma. The PTEN hamartoma tumor syndrome (PHTS) includes Cowden syndrome (CS), Bannayan-Riley-Ruvalcaba syndrome (BRRS), PTEN-related Proteus syndrome (PS), and PTEN-related Proteus-like syndrome. The phenotypes include macrocephaly, autism or developmental delay, intestinal hamartomatous polyposis, lipomas, pigmented macules of the glans penis, and a high risk for benign and malignant tumors of the thyroid, breast, kidney, and endometrium. Per criteria outlined by the ClinGen Lumping and Splitting Working Group, we found no difference in molecular mechanism(s) or inheritance pattern. Therefore, these phenotypes have been lumped into this curation. The mechanism of pathogenicity is reported to be loss of function. Eight variants (nonsense, frameshift, and missense) that have been reported in 11 probands in 4 publications (PMIDs: 17526800, 22595938, 22628360, 36082652) are included in this curation. More evidence is available in the literature, but the maximum score for genetic evidence (12 Points) has been reached. This gene-disease relationship is also supported by experimental evidence, including in vitro functional assays and animal models (6 Points, PMIDs: 9356475, 9393738, 9778245, 21194675, 21343951, 21828076, 23066114). This experimental evidence demonstrates that PTEN is a protein phosphatase that exhibits functional and specific growth-suppressing activity. Additionally, heterozygous mutant mice demonstrate noticeable increased cell proliferation and significant macrocephaly as a result of megancephaly. A spectrum of immune phenotypes is associated with PTEN hamartoma tumor syndrome (PHTS), ranging from asymptomatic lymphopenia, to lymphoid hyperplasia, autoimmunity, and immunodeficiency (PMID: 31501268, 28523199, 26246517). While a majority of patients with PHTS do not present with immunodeficiency or immune dysregulation, many show evidence of subclinical immunological abnormalities such as reduced total numbers of CD4+ T cells, inverted CD4:CD8 ratio, or abnormal immunoglobulin subclasses (PMID: 31501268). The B cell phenotype is highly variable, with increased numbers of specific B cell subsets or increased immunoglobulin levels, in contrast to most antibody deficiencies where there is hypogammaglobulinemia and/or B cell deficiency. Autoimmune disorders, including Hashimoto's thyroiditis, celiac disease, autoimmune colitis, and autoimmune hemolytic anemia, have been reported in 29% of 79 PHTS patients in one study (PMID: 27477328). Mouse models of Pten loss-of-function recapitulate the patient immune phenotypes including hypergammaglobulinemia and autoimmunity (10497129) and impaired class-switch recombination and autoantibody production (PMID: 12615906). In summary, there is definitive evidence supporting the relationship between PTEN and autosomal dominant PTEN hamartoma tumor syndrome. This has been repeatedly demonstrated in both the research and clinical diagnostic settings and has been upheld over time. This gene-disease pair was originally evaluated as definitive by the PTEN GCEP on 10/09/2017. Secondary contributor evidence was provided by the PIRD GCEP. In summary, there is Definitive evidence to support this gene-disease relationship. This has been repeatedly demonstrated in both the research and clinical diagnostic settings, and has been upheld over time. This re-curation as definitive was approved by the ClinGen Hereditary Cancer GCEP on 04/05/2024 (SOP Version 10).
Inheritance Pattern: AD
Disease ID:MONDO:0007924
Submitter: Orphanet
Inheritance Pattern: AD
Disease ID:MONDO:0008021
Submitter: Genomics England PanelApp
Inheritance Pattern: AD
Disease ID:MONDO:0008021
Submitter: Ambry Genetics
Inheritance Pattern: AD
Disease ID:MONDO:0005086
Submitter: Genomics England PanelApp
Inheritance Pattern: AR
Disease ID:MONDO:0005058
Submitter: Genomics England PanelApp
Inheritance Pattern: AD
Disease ID:MONDO:0016063
Submitter: Orphanet
Inheritance Pattern: AD
Disease ID:MONDO:0019002
Submitter: Orphanet
Inheritance Pattern: AD
Disease ID:MONDO:0017571
Submitter: Orphanet
Inheritance Pattern: AD
Disease ID:MONDO:0013092
Submitter: Ambry Genetics
Inheritance Pattern: AD
Disease ID:MONDO:0011537
Submitter: Ambry Genetics
Inheritance Pattern: AD
Disease ID:MONDO:0008021
Submitter: Ambry Genetics
Inheritance Pattern: AD
Disease ID:MONDO:0011537
Submitter: Genomics England PanelApp
Inheritance Pattern: AD
Disease ID:MONDO:0018338
Submitter: Orphanet
Inheritance Pattern: AD
Disease ID:MONDO:0008021
Submitter: G2P
Clinical Genomic Database (CGD)
Manifestation: Craniofacial; Dermatologic; Neurologic; Oncologic
Intervention: Oncologic
Rationale: Surveillance is indicated to screen for the presence of neoplasms (including regular thyroid ultrasound, dermatologic examinations, breast screening including mammogram and/or MRI, transvaginal ultrasound and/or endometrial biopsy, colonoscopy, renal imaging, and other screening as specifically indicated by family or personal medical history), which may allow early diagnosis and treatment, which may be beneficial related to morbidity and mortality
Comments: Evidence for association with some cancerous processes is unclear,and the division into many separate disorders is likely specious
ClinVar Associated Diseases & Phenotypes
Reported disease conditions connected to PTEN variants in ClinVar
ClinVar Variants & Pathogenicity by Type
Statistics based on transcript NM_000314.8. 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 | 5 | 3 | 16 | 359 | 35 | 418 |
| missense | 103 | 262 | 838 | 35 | 1 | 1239 |
| nonsense | 155 | 25 | 7 | 187 | ||
| start loss | 5 | 4 | 9 | |||
| frameshift | 605 | 100 | 83 | 788 | ||
| splice donor/acceptor (+/-2bp) | 62 | 79 | 15 | 8 | 164 | |
| Total | 935 | 473 | 959 | 402 | 36 | 2805 |
Highest pathogenic variant AF is 0.00010350587
Transcript Catalog
Annotated transcript isoforms across RefSeq and Ensembl databases
| Transcript ID | Source | Protein ID | Coding Exons | MANE Status |
|---|---|---|---|---|
| RefSeq | NP_000305.3 | 9 | MANE Select | |
| Ensembl | ENSP00000361021.3 | 9 | MANE Select | |
| RefSeq | NP_001291646.4 | 10 | Standard | |
| RefSeq | NP_001291647.1 | 4 | Standard |
Model Organisms & Knockout Phenotypes
Observed phenotypic effects in mouse and zebrafish models
| Gene / Model | Organism | Observed Phenotype |
|---|---|---|
| ptenb | Danio rerio | Structure: myeloid lineage restricted progenitor cell 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)
- Focal adhesion - Homo sapiens (human)
- mTOR signaling pathway - Homo sapiens (human)
- Inositol phosphate metabolism - Homo sapiens (human)
- Central carbon metabolism in cancer - Homo sapiens (human)
Biological Process
- regulation of cyclin-dependent protein serine/threonine kinase activity
- angiogenesis
- negative regulation of protein phosphorylation
- regulation of B cell apoptotic process
- transcription initiation from RNA polymerase II promoter
Molecular Function
- phosphatidylinositol-3-phosphatase activity
- phosphoprotein phosphatase activity
- protein serine/threonine phosphatase activity
- protein tyrosine phosphatase activity
- platelet-derived growth factor receptor binding
Cellular Component
- extracellular region
- nucleus
- nucleoplasm
- cytoplasm
- mitochondrion
gnomAD Constraint
Source:
- Gene type
- protein_coding
- Transcript type
- protein_coding
- Transcript
- ENST00000371953
- Coding exons
- 9
- Length
- 108818
- Individuals with no LoFs
- 125737
- Homozygous LoFs
- 0
- Heterozygous LoFs
- 11
- Defined
- 125748
- p
- 0.0000437
| Z-Score | Observed | Expected | Observed/Expected | Mutation Rate | Total Possible | |
|---|---|---|---|---|---|---|
| Missense | 3.49 | 72 | 216 | 0.333 | 0.0000106 | 2705 |
| Missense (PolyPhen) | 5 | 50.786 | 0.098453 | 669 | ||
| Synonymous | -0.123 | 74 | 72.7 | 1.02 | 0.00000360 | 691 |
| Loss of Function | 3.20 | 5 | 20.8 | 0.241 | 0.00000115 | 271 |
Population LoF Frequency
| Population | CAF | p-value | Status |
|---|---|---|---|
| African | 0.000062 | 0.000062 | rare |
| Latino/Admixed American | 0.000058 | 0.000058 | rare |
| Ashkenazi Jewish | 0.000099 | 0.000099 | rare |
| East Asian | 0 | 0.0 | absent |
| Finnish | 0 | 0.0 | absent |
| European (Non-Finnish) | 0.000035 | 0.000035 | rare |
| South Asian | 0.000098 | 0.000098 | rare |
| Other | 0 | 0.0 | absent |
dbNSFP Gene Annotations
Source:
- Function
- FUNCTION: Tumor suppressor. Acts as a dual-specificity protein phosphatase, dephosphorylating tyrosine-, serine- and threonine- phosphorylated proteins. Also acts as a lipid phosphatase, removing the phosphate in the D3 position of the inositol ring from phosphatidylinositol 3,4,5-trisphosphate, phosphatidylinositol 3,4-diphosphate, phosphatidylinositol 3- phosphate and inositol 1,3,4,5-tetrakisphosphate with order of substrate preference in vitro PtdIns(3,4,5)P3 > PtdIns(3,4)P2 > PtdIns3P > Ins(1,3,4,5)P4 (PubMed:26504226). The lipid phosphatase activity is critical for its tumor suppressor function. Antagonizes the PI3K-AKT/PKB signaling pathway by dephosphorylating phosphoinositides and thereby modulating cell cycle progression and cell survival. The unphosphorylated form cooperates with AIP1 to suppress AKT1 activation. Dephosphorylates tyrosine-phosphorylated focal adhesion kinase and inhibits cell migration and integrin-mediated cell spreading and focal adhesion formation. Plays a role as a key modulator of the AKT-mTOR signaling pathway controlling the tempo of the process of newborn neurons integration during adult neurogenesis, including correct neuron positioning, dendritic development and synapse formation. May be a negative regulator of insulin signaling and glucose metabolism in adipose tissue. The nuclear monoubiquitinated form possesses greater apoptotic potential, whereas the cytoplasmic nonubiquitinated form induces less tumor suppressive ability. In motile cells, suppresses the formation of lateral pseudopods and thereby promotes cell polarization and directed movement. {ECO:0000269|PubMed:26504226}.;
- Disease
- DISEASE: Cowden syndrome 1 (CWS1) [MIM:158350]: An autosomal dominant hamartomatous polyposis syndrome with age-related penetrance. Cowden syndrome is characterized by hamartomatous lesions affecting derivatives of ectodermal, mesodermal and endodermal layers, macrocephaly, facial trichilemmomas (benign tumors of the hair follicle infundibulum), acral keratoses, papillomatous papules, and elevated risk for development of several types of malignancy, particularly breast carcinoma in women and thyroid carcinoma in both men and women. Colon cancer and renal cell carcinoma have also been reported. Hamartomas can be found in virtually every organ, but most commonly in the skin, gastrointestinal tract, breast and thyroid. {ECO:0000269|PubMed:10051160, ECO:0000269|PubMed:10234502, ECO:0000269|PubMed:10400993, ECO:0000269|PubMed:10866302, ECO:0000269|PubMed:11230179, ECO:0000269|PubMed:11494117, ECO:0000269|PubMed:15355975, ECO:0000269|PubMed:18716620, ECO:0000269|PubMed:9140396, ECO:0000269|PubMed:9241266, ECO:0000269|PubMed:9259288, ECO:0000269|PubMed:9345101, ECO:0000269|PubMed:9399897, ECO:0000269|PubMed:9425889, ECO:0000269|PubMed:9467011, ECO:0000269|PubMed:9600246, ECO:0000269|PubMed:9735393, ECO:0000269|PubMed:9797362, ECO:0000269|PubMed:9811831, ECO:0000269|PubMed:9832031, ECO:0000269|PubMed:9915974}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Lhermitte-Duclos disease (LDD) [MIM:158350]: A rare disease characterized by the occurrence of a slowly enlarging mass within the cerebellar cortex corresponding histologically to a cerebellar hamartoma. It manifests, most commonly in the third and fourth decades of life, with increased intracranial pressure, headache, nausea, cerebellar dysfunction, occlusive hydrocephalus, ataxia, visual disturbances and other cranial nerve palsies. Various associated abnormalities may be present such as megalencephaly, microgyria, hydromyelia, polydactyly, partial gigantism, macroglossia. LDD is part of the PTEN hamartoma tumor syndromes spectrum that also includes Cowden syndrome. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Squamous cell carcinoma of the head and neck (HNSCC) [MIM:275355]: A non-melanoma skin cancer affecting the head and neck. The hallmark of cutaneous SCC is malignant transformation of normal epidermal keratinocytes. {ECO:0000269|PubMed:11801303}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Endometrial cancer (ENDMC) [MIM:608089]: A malignancy of endometrium, the mucous lining of the uterus. Most endometrial cancers are adenocarcinomas, cancers that begin in cells that make and release mucus and other fluids. Note=Disease susceptibility is associated with variations affecting the gene represented in this entry.; DISEASE: Note=PTEN mutations are found in a subset of patients with Proteus syndrome, a genetically heterogeneous condition. The molecular diagnosis of PTEN mutation positive cases classifies Proteus syndrome patients as part of the PTEN hamartoma syndrome spectrum. As such, patients surviving the early years of Proteus syndrome are likely at a greater risk of developing malignancies.; DISEASE: Glioma 2 (GLM2) [MIM:613028]: Gliomas are benign or malignant central nervous system neoplasms derived from glial cells. They comprise astrocytomas and glioblastoma multiforme that are derived from astrocytes, oligodendrogliomas derived from oligodendrocytes and ependymomas derived from ependymocytes. {ECO:0000269|PubMed:12085208}. Note=Disease susceptibility is associated with variations affecting the gene represented in this entry.; DISEASE: Prostate cancer (PC) [MIM:176807]: A malignancy originating in tissues of the prostate. Most prostate cancers are adenocarcinomas that develop in the acini of the prostatic ducts. Other rare histopathologic types of prostate cancer that occur in approximately 5% of patients include small cell carcinoma, mucinous carcinoma, prostatic ductal carcinoma, transitional cell carcinoma, squamous cell carcinoma, basal cell carcinoma, adenoid cystic carcinoma (basaloid), signet-ring cell carcinoma and neuroendocrine carcinoma. {ECO:0000269|PubMed:26504226, ECO:0000269|PubMed:9072974}. Note=Disease susceptibility is associated with variations affecting the gene represented in this entry.; DISEASE: Macrocephaly/autism syndrome (MCEPHAS) [MIM:605309]: Patients have autism spectrum disorders and macrocephaly, with head circumferences ranging from +2.5 to +8 SD for age and sex (average head circumference +4.0 SD). {ECO:0000269|PubMed:15805158, ECO:0000269|PubMed:23160955, ECO:0000269|PubMed:26637798}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Note=A microdeletion of chromosome 10q23 involving BMPR1A and PTEN is a cause of chromosome 10q23 deletion syndrome, which shows overlapping features of the following three disorders: Bannayan-Zonana syndrome, Cowden disease and juvenile polyposis syndrome.;
Recessive Scores
- pRec
- 0.946
Intolerance Scores
- LoFtool
- 0.0929
- RVIS EVS
- -0.23
- RVIS percentile EVS
- 36.86
Essentials
- Essential (CRISPR)
- N
- Essential (gene trap)
- N
- Indispensability pred.
- E
- Indispensability score
- 0.999
Gene Damage Prediction
| All | Recessive | Dominant | |
|---|---|---|---|
| Mendelian | Medium | Low | Low |
| Primary Immunodeficiency | Medium | Low | Medium |
| Cancer | Medium | Low | Medium |