STK11

protein-coding

serine/threonine kinase 11

Gene summary

The protein encoded by this gene is a serine/threonine kinase that regulates cell polarity and energy metabolism and functions as a tumor suppressor. Mutations in this gene have been associated with the autosomal dominant Peutz-Jeghers syndrome, as well as with skin, pancreatic, and testicular cancers. [provided by RefSeq, May 2022]

MANE transcript

NM_000455.5

Inheritance

AD

ClinVar variants

P:424U:1045B:752

Top phenotype

Peutz-Jeghers syndrome

gnomAD constraint

pLI —, LoF o/e 0.05

Max pathogenic AF

—

Genomic locus

chr19:1,177,558-1,228,431

External References & Databases

Transcript & Mutation Effects

hg38 • Region Span ~50.9 kb
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GenCC Phenotypes & Disease Associations

Curated gene-disease validity assertions and inheritance patterns

Peutz-Jeghers syndromeDEFINITIVE

Inheritance Pattern: AD

Disease ID:MONDO:0008280

Submitter: ClinGen

*STK11* was first reported in relation to autosomal dominant Peutz-Jeghers syndrome (PJS) in 1998 (Jenne et al. and Hemmiki et al., PMIDs 9425897 and 9428765). PJS is characterized by the development of gastrointestinal (GI) PJS-type hamartomatous polyps and mucocutaneous hyperpigmentation, which most often presents in childhood and fades by puberty. GI polyps present a significant clinical burden and can cause chronic bleeding and intussusception in individuals with PJS. Individuals with PJS have been reported to have an increased cumulative lifetime risk for various cancers, including female breast cancer, colorectal cancer, stomach cancer, small bowel cancer, pancreatic cancer, lung cancer, endometrial cancer, cervical cancer, non-epithelial sex cord tumors of the ovary, and Sertoli cell testicular tumors. Per criteria outlined by the ClinGen Lumping and Splitting Working Group, we found no difference in molecular mechanism or inheritance pattern and phenotypic variability. Therefore, the described phenotypic manifestations and tumor spectrum has been lumped into one disease entity: Peutz-Jeghers syndrome (OMIM: 175200). Fourteen variants (missense, in-frame deletions/insertions, nonsense, frameshift, large deletion, complex rearrangements) that have been reported in 14 probands in 5 publications (PMIDs: 9425897, 9428765, 12865922, 15121768, 30689838) were included in this curation. Variants reported are largely truncations and gross deletions, and additional evidence of familial co-segregation supports their association with PJS. Furthermore, large-scale meta analyses and case control analyses show the association of cancer susceptibility in individuals with PJS (PMIDs: 23415580, 11113065, 16707622). Data from these studies is largely from highly-ascertained cohorts and may overestimate cancer risks. At least one large-scale population-based study contradicts the high risk of breast cancer reported in the literature (PMID: 33471991). More evidence is available in the literature, but the maximum score for genetic evidence (12 pts.) has been reached. The mechanism of pathogenicity is known to be loss-of-function. This gene-disease association is also supported by experimental evidence (6 points, PMIDs: 15800014, 10441497, 15261145, 19681070, 12226664, 15987703, 9425897). In non-patient cells (mouse embryonic fibroblasts), deleterious effects such as hyperactivated mTOR signaling was observed when *Stk11* was lost. Mouse models of loss of *Stk11* replicating the human phenotype including mammary tumors and small intestine hamartomatous polyps. In summary, *STK11* is definitively associated with autosomal dominant Peutz-Jeghers 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 on 2/22/2017 by Colon Cancer GCEP. This re-curation was approved by the ClinGen Hereditary Cancer GCEP on 5/26/2023 (SOP Version 9).

Peutz-Jeghers syndromeDEFINITIVE

Inheritance Pattern: AD

Disease ID:MONDO:0008280

Submitter: G2P

Peutz-Jeghers syndromeSTRONG

Inheritance Pattern: AD

Disease ID:MONDO:0008280

Submitter: Genomics England PanelApp

Peutz-Jeghers syndromeSTRONG

Inheritance Pattern: AD

Disease ID:MONDO:0008280

Submitter: Labcorp Genetics (formerly Invitae)

Peutz-Jeghers syndromeSUPPORTIVE

Inheritance Pattern: AD

Disease ID:MONDO:0008280

Submitter: Orphanet

familial ovarian cancerNO_KNOWN

Inheritance Pattern: Unknown

Disease ID:MONDO:0016248

Submitter: ClinGen

familial pancreatic carcinomaDEFINITIVE

Inheritance Pattern: AD

Disease ID:MONDO:0015278

Submitter: G2P

Clinical Genomic Database (CGD)

Peutz-Jeghers syndromeAD

Manifestation: Dermatologic; Gastrointestinal; Oncologic

Intervention: Gastrointestinal; Oncologic

Rationale: Routine surgical/endoscopic procedures can decrease the need of emergent procedures for sudden and severe sequelae (eg, intussusception); Surveillance for and early treatment of a variety of common malignancies (individuals may be at increased risk of a number of types of epithelial malignancies, including breast, cervical adenoma malignum, colorectal, gastric, ovarian, pancreatic cancers, sex cord tumors with annular tubules, and testicular Sertoli cell tumors) can be beneficial

Refs: 15399020; 14214503; 14279723; 5466889; 990720; 7436458; 3943856; 3697923; 3587280; 3181678; 2599445; 1986290; 7776109; 7802138; 9850045; 9428765; 9425897; 10408777; 10689645; 10874301; 11389158; 12044140; 15121768; 15200509; 15863673; 15617552; 20581245; 20301443Source: CGD (NHGRI)

ClinVar Associated Diseases & Phenotypes

Reported disease conditions connected to STK11 variants in ClinVar

44 Conditions Cataloged
Peutz-Jeghers syndromeTotal: 2216
Hereditary cancer-predisposing syndromeTotal: 1782
not providedTotal: 500
not specifiedTotal: 391
Melanoma, cutaneous malignant, susceptibility to, 1Total: 150
STK11-related disorderTotal: 76
Germ cell tumor of testisTotal: 55
Familial pancreatic carcinomaTotal: 51

ClinVar Variants & Pathogenicity by Type

Statistics based on transcript NM_000455.5. 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
7
clinvar
565
clinvar
60
clinvar
632
missense
17
clinvar
56
clinvar
995
clinvar
121
clinvar
4
clinvar
1193
nonsense
67
clinvar
7
clinvar
4
clinvar
78
start loss
2
clinvar
1
clinvar
3
clinvar
6
frameshift
175
clinvar
32
clinvar
20
clinvar
227
splice donor/acceptor (+/-2bp)
33
clinvar
34
clinvar
16
clinvar
2
clinvar
85
Total2941301045688642221

Highest pathogenic variant AF is 0.0000065693525

Loading ClinVar variants...

Transcript Catalog

Annotated transcript isoforms across RefSeq and Ensembl databases

Showing 4 of 40 transcripts
Transcript IDSourceProtein IDCoding ExonsMANE Status
NM_000455.5RefSeqNP_000446.19MANE Select
ENST00000326873.12EnsemblENSP00000324856.69MANE Select
NM_001407255.1RefSeqNP_001394184.19Standard
ENST00000585465.3EnsemblENSP00000490268.29Standard

Model Organisms & Knockout Phenotypes

Observed phenotypic effects in mouse and zebrafish models

Gene / ModelOrganismObserved Phenotype
stk11Danio rerio

Structure: intestinal epithelium

Quality: flattened

abnormal

Gene Ontology (GO) Annotations & Pathways

Biological processes, molecular functions, cellular components and pathways

Pathways ConsensusPathDB

  • PI3K-Akt signaling pathway - Homo sapiens (human)
  • mTOR signaling pathway - Homo sapiens (human)
  • Adipocytokine signaling pathway - Homo sapiens (human)
  • Tight junction - Homo sapiens (human)
  • Autophagy - animal - Homo sapiens (human)

Biological Process

  • regulation of cell growth
  • tissue homeostasis
  • vasculature development
  • protein phosphorylation
  • protein dephosphorylation

Molecular Function

  • magnesium ion binding
  • p53 binding
  • protein serine/threonine kinase activity
  • protein binding
  • ATP binding

Cellular Component

  • nucleus
  • nucleoplasm
  • cytoplasm
  • mitochondrion
  • cytosol

gnomAD Constraint

Source: gnomAD

Gene type
protein_coding
Transcript type
protein_coding
Transcript
ENST00000326873
Coding exons
9
Length
39023
Individuals with no LoFs
120835
Homozygous LoFs
0
Heterozygous LoFs
1
Defined
120836
p
0.00000414
Z-ScoreObservedExpectedObserved/ExpectedMutation RateTotal Possible
Missense1.602032780.7300.00001762817
Missense (PolyPhen)36109.450.328921226
Synonymous-2.901671261.330.00000921822
Loss of Function3.87119.40.05168.21e-7231

Population LoF Frequency

PopulationCAFp-valueStatus
African00.0absent
Latino/Admixed American00.0absent
Ashkenazi Jewish00.0absent
East Asian00.0absent
Finnish00.0absent
European (Non-Finnish)0.00000920.0000092rare
South Asian00.0absent
Other00.0absent

dbNSFP Gene Annotations

Source: dbNSFP

Function
FUNCTION: Tumor suppressor serine/threonine-protein kinase that controls the activity of AMP-activated protein kinase (AMPK) family members, thereby playing a role in various processes such as cell metabolism, cell polarity, apoptosis and DNA damage response. Acts by phosphorylating the T-loop of AMPK family proteins, thus promoting their activity: phosphorylates PRKAA1, PRKAA2, BRSK1, BRSK2, MARK1, MARK2, MARK3, MARK4, NUAK1, NUAK2, SIK1, SIK2, SIK3 and SNRK but not MELK. Also phosphorylates non- AMPK family proteins such as STRADA, PTEN and possibly p53/TP53. Acts as a key upstream regulator of AMPK by mediating phosphorylation and activation of AMPK catalytic subunits PRKAA1 and PRKAA2 and thereby regulates processes including: inhibition of signaling pathways that promote cell growth and proliferation when energy levels are low, glucose homeostasis in liver, activation of autophagy when cells undergo nutrient deprivation, and B-cell differentiation in the germinal center in response to DNA damage. Also acts as a regulator of cellular polarity by remodeling the actin cytoskeleton. Required for cortical neuron polarization by mediating phosphorylation and activation of BRSK1 and BRSK2, leading to axon initiation and specification. Involved in DNA damage response: interacts with p53/TP53 and recruited to the CDKN1A/WAF1 promoter to participate in transcription activation. Able to phosphorylate p53/TP53; the relevance of such result in vivo is however unclear and phosphorylation may be indirect and mediated by downstream STK11/LKB1 kinase NUAK1. Also acts as a mediator of p53/TP53-dependent apoptosis via interaction with p53/TP53: translocates to the mitochondrion during apoptosis and regulates p53/TP53-dependent apoptosis pathways. In vein endothelial cells, inhibits PI3K/Akt signaling activity and thus induces apoptosis in response to the oxidant peroxynitrite (in vitro). Regulates UV radiation-induced DNA damage response mediated by CDKN1A. In association with NUAK1, phosphorylates CDKN1A in response to UV radiation and contributes to its degradation which is necessary for optimal DNA repair (PubMed:25329316). {ECO:0000269|PubMed:11430832, ECO:0000269|PubMed:12805220, ECO:0000269|PubMed:14517248, ECO:0000269|PubMed:14976552, ECO:0000269|PubMed:15016379, ECO:0000269|PubMed:15733851, ECO:0000269|PubMed:15987703, ECO:0000269|PubMed:17108107, ECO:0000269|PubMed:18321849, ECO:0000269|PubMed:21317932, ECO:0000269|PubMed:25329316}.;
Disease
DISEASE: Peutz-Jeghers syndrome (PJS) [MIM:175200]: An autosomal dominant disorder characterized by melanocytic macules of the lips, multiple gastrointestinal hamartomatous polyps and an increased risk for various neoplasms, including gastrointestinal cancer. {ECO:0000269|PubMed:10408777, ECO:0000269|PubMed:12372054, ECO:0000269|PubMed:15987703, ECO:0000269|PubMed:21411391, ECO:0000269|PubMed:9425897, ECO:0000269|PubMed:9428765, ECO:0000269|PubMed:9760200, ECO:0000269|PubMed:9837816}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Testicular germ cell tumor (TGCT) [MIM:273300]: A common malignancy in males representing 95% of all testicular neoplasms. TGCTs have various pathologic subtypes including: unclassified intratubular germ cell neoplasia, seminoma (including cases with syncytiotrophoblastic cells), spermatocytic seminoma, embryonal carcinoma, yolk sac tumor, choriocarcinoma, and teratoma. {ECO:0000269|PubMed:9605748, ECO:0000269|PubMed:9887330}. Note=The gene represented in this entry may be involved in disease pathogenesis.; DISEASE: Note=Defects in STK11 are associated with some sporadic cancers, especially lung cancers. Frequently mutated and inactivated in non-small cell lung cancer (NSCLC). Defects promote lung cancerigenesis process, especially lung cancer progression and metastasis. Confers lung adenocarcinoma the ability to trans- differentiate into squamous cell carcinoma. Also able to promotes lung cancer metastasis, via both cancer-cell autonomous and non- cancer-cell autonomous mechanisms.;

Recessive Scores

pRec
0.307

Intolerance Scores

LoFtool
0.112
RVIS EVS
-0.54
RVIS percentile EVS
20.54

Essentials

Essential (CRISPR)
E
Essential (CRISPR2)
S
Essential (gene trap)
K
Indispensability pred.
E
Indispensability score
0.998

Gene Damage Prediction

AllRecessiveDominant
MendelianMediumMediumMedium
Primary ImmunodeficiencyMediumMediumMedium
CancerMediumMediumMedium
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