PTEN

protein-coding

phosphatase 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]

Previous symbols:
  • BZS
  • MHAM

MANE transcript

NM_000314.8

Inheritance

AD, AR

ClinVar variants

P:1408U:959B:438

Top phenotype

PTEN hamartoma tumor syndrome; Cowden syndrome 1; Bannayan-Riley-Ruvalcaba syndrome; Lhermitte-Duclos syndrome; Glioma susceptibility 2; Meningioma, familial; Endometrial cancer

gnomAD constraint

pLI —, LoF o/e 0.24

Max pathogenic AF

—

Genomic locus

chr10:87,862,638-87,971,930

External References & Databases

Transcript & Mutation Effects

hg38 • Region Span ~109.3 kb
Loading mutation effect viewer...

GenCC Phenotypes & Disease Associations

Curated gene-disease validity assertions and inheritance patterns

Cowden syndrome 1MODERATE

Inheritance Pattern: AD

Disease ID:MONDO:0008021

Submitter: Genomics England PanelApp

Cowden syndrome 1STRONG

Inheritance Pattern: AD

Disease ID:MONDO:0008021

Submitter: Labcorp Genetics (formerly Invitae)

macrocephaly-autism syndromeSUPPORTIVE

Inheritance Pattern: AD

Disease ID:MONDO:0011537

Submitter: Orphanet

Lhermitte-Duclos diseaseDEFINITIVE

Inheritance Pattern: AD

Disease ID:MONDO:0019002

Submitter: G2P

PTEN hamartoma tumor syndromeDEFINITIVE

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).

Bannayan-Riley-Ruvalcaba syndromeSUPPORTIVE

Inheritance Pattern: AD

Disease ID:MONDO:0007924

Submitter: Orphanet

Cowden syndrome 1STRONG

Inheritance Pattern: AD

Disease ID:MONDO:0008021

Submitter: Genomics England PanelApp

Cowden syndrome 1MODERATE

Inheritance Pattern: AD

Disease ID:MONDO:0008021

Submitter: Ambry Genetics

renal cell carcinomaMODERATE

Inheritance Pattern: AD

Disease ID:MONDO:0005086

Submitter: Genomics England PanelApp

leiomyosarcomaMODERATE

Inheritance Pattern: AR

Disease ID:MONDO:0005058

Submitter: Genomics England PanelApp

Cowden diseaseSUPPORTIVE

Inheritance Pattern: AD

Disease ID:MONDO:0016063

Submitter: Orphanet

Lhermitte-Duclos diseaseSUPPORTIVE

Inheritance Pattern: AD

Disease ID:MONDO:0019002

Submitter: Orphanet

Proteus-like syndromeSUPPORTIVE

Inheritance Pattern: AD

Disease ID:MONDO:0017571

Submitter: Orphanet

glioma susceptibility 2LIMITED

Inheritance Pattern: AD

Disease ID:MONDO:0013092

Submitter: Ambry Genetics

macrocephaly-autism syndromeSTRONG

Inheritance Pattern: AD

Disease ID:MONDO:0011537

Submitter: Ambry Genetics

Cowden syndrome 1DEFINITIVE

Inheritance Pattern: AD

Disease ID:MONDO:0008021

Submitter: Ambry Genetics

macrocephaly-autism syndromeSTRONG

Inheritance Pattern: AD

Disease ID:MONDO:0011537

Submitter: Genomics England PanelApp

activated PI3K-delta syndromeSUPPORTIVE

Inheritance Pattern: AD

Disease ID:MONDO:0018338

Submitter: Orphanet

Cowden syndrome 1DEFINITIVE

Inheritance Pattern: AD

Disease ID:MONDO:0008021

Submitter: G2P

Clinical Genomic Database (CGD)

PTEN hamartoma tumor syndrome; Cowden syndrome 1; Bannayan-Riley-Ruvalcaba syndrome; Lhermitte-Duclos syndrome; Glioma susceptibility 2; Meningioma, familial; Endometrial cancerAD

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

Refs: 5345120; 5091590; 957004; 7449178; 7079022; 6881215; 6507473; 3707175; 3698331; 3340479; 1336932; 1350505; 8207516; 9140396; 9286463; 9399897; 9241266; 9259288; 9545417; 9662392; 9832032; 9832031; 9425889; 9445133; 9856571; 10353779; 10400993; 10234502; 11238682; 11748304; 12085208; 11875759; 12938083; 14518069; 12833416; 14566704; 15805158; 16704655; 16752378; 17286265; 17526800; 17526801; 17847000; 18781191; 21659347; 21633361; 20301661; 21956414; 22595938; 22970944; 23335809; 23344409Source: CGD (NHGRI)

ClinVar Associated Diseases & Phenotypes

Reported disease conditions connected to PTEN variants in ClinVar

80 Conditions Cataloged
PTEN hamartoma tumor syndromeTotal: 1930
Hereditary cancer-predisposing syndromeTotal: 1599
Cowden syndrome 1Total: 1033
not providedTotal: 689
not specifiedTotal: 210
Prostate cancer, hereditary, 1Total: 141
Macrocephaly-autism syndromeTotal: 140
Glioma susceptibility 2Total: 111

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.

EffectPLPVUSLBBSum
synonymous
5
clinvar
3
clinvar
16
clinvar
359
clinvar
35
clinvar
418
missense
103
clinvar
262
clinvar
838
clinvar
35
clinvar
1
clinvar
1239
nonsense
155
clinvar
25
clinvar
7
clinvar
187
start loss
5
clinvar
4
clinvar
9
frameshift
605
clinvar
100
clinvar
83
clinvar
788
splice donor/acceptor (+/-2bp)
62
clinvar
79
clinvar
15
clinvar
8
clinvar
164
Total935473959402362805

Highest pathogenic variant AF is 0.00010350587

Loading ClinVar variants...

Transcript Catalog

Annotated transcript isoforms across RefSeq and Ensembl databases

Showing 4 of 20 transcripts
Transcript IDSourceProtein IDCoding ExonsMANE Status
NM_000314.8RefSeqNP_000305.39MANE Select
ENST00000371953.8EnsemblENSP00000361021.39MANE Select
NM_001304717.5RefSeqNP_001291646.410Standard
NM_001304718.2RefSeqNP_001291647.14Standard

Model Organisms & Knockout Phenotypes

Observed phenotypic effects in mouse and zebrafish models

Gene / ModelOrganismObserved Phenotype
ptenbDanio 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: gnomAD

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-ScoreObservedExpectedObserved/ExpectedMutation RateTotal Possible
Missense3.49722160.3330.00001062705
Missense (PolyPhen)550.7860.098453669
Synonymous-0.1237472.71.020.00000360691
Loss of Function3.20520.80.2410.00000115271

Population LoF Frequency

PopulationCAFp-valueStatus
African0.0000620.000062rare
Latino/Admixed American0.0000580.000058rare
Ashkenazi Jewish0.0000990.000099rare
East Asian00.0absent
Finnish00.0absent
European (Non-Finnish)0.0000350.000035rare
South Asian0.0000980.000098rare
Other00.0absent

dbNSFP Gene Annotations

Source: dbNSFP

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

AllRecessiveDominant
MendelianMediumLowLow
Primary ImmunodeficiencyMediumLowMedium
CancerMediumLowMedium
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