STK11
protein-codingserine/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
Inheritance
ClinVar variants
Top phenotype
gnomAD constraint
Max pathogenic AF
Genomic locus
External References & Databases
Transcript & Mutation Effects
hg38 • Region Span ~50.9 kbGenCC Phenotypes & Disease Associations
Curated gene-disease validity assertions and inheritance patterns
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).
Inheritance Pattern: AD
Disease ID:MONDO:0008280
Submitter: G2P
Inheritance Pattern: AD
Disease ID:MONDO:0008280
Submitter: Genomics England PanelApp
Inheritance Pattern: AD
Disease ID:MONDO:0008280
Submitter: Labcorp Genetics (formerly Invitae)
Inheritance Pattern: AD
Disease ID:MONDO:0008280
Submitter: Orphanet
Inheritance Pattern: Unknown
Disease ID:MONDO:0016248
Submitter: ClinGen
Inheritance Pattern: AD
Disease ID:MONDO:0015278
Submitter: G2P
Clinical Genomic Database (CGD)
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
ClinVar Associated Diseases & Phenotypes
Reported disease conditions connected to STK11 variants in ClinVar
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.
| Effect | PathogenicP | Likely pathogenicLP | VUS | Likely benignLB | BenignB | Sum |
|---|---|---|---|---|---|---|
| synonymous | 7 | 565 | 60 | 632 | ||
| missense | 17 | 56 | 995 | 121 | 4 | 1193 |
| nonsense | 67 | 7 | 4 | 78 | ||
| start loss | 2 | 1 | 3 | 6 | ||
| frameshift | 175 | 32 | 20 | 227 | ||
| splice donor/acceptor (+/-2bp) | 33 | 34 | 16 | 2 | 85 | |
| Total | 294 | 130 | 1045 | 688 | 64 | 2221 |
Highest pathogenic variant AF is 0.0000065693525
Transcript Catalog
Annotated transcript isoforms across RefSeq and Ensembl databases
| Transcript ID | Source | Protein ID | Coding Exons | MANE Status |
|---|---|---|---|---|
| RefSeq | NP_000446.1 | 9 | MANE Select | |
| Ensembl | ENSP00000324856.6 | 9 | MANE Select | |
| RefSeq | NP_001394184.1 | 9 | Standard | |
| Ensembl | ENSP00000490268.2 | 9 | Standard |
Model Organisms & Knockout Phenotypes
Observed phenotypic effects in mouse and zebrafish models
| Gene / Model | Organism | Observed Phenotype |
|---|---|---|
| stk11 | Danio 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:
- 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-Score | Observed | Expected | Observed/Expected | Mutation Rate | Total Possible | |
|---|---|---|---|---|---|---|
| Missense | 1.60 | 203 | 278 | 0.730 | 0.0000176 | 2817 |
| Missense (PolyPhen) | 36 | 109.45 | 0.32892 | 1226 | ||
| Synonymous | -2.90 | 167 | 126 | 1.33 | 0.00000921 | 822 |
| Loss of Function | 3.87 | 1 | 19.4 | 0.0516 | 8.21e-7 | 231 |
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) | 0.0000092 | 0.0000092 | rare |
| South Asian | 0 | 0.0 | absent |
| Other | 0 | 0.0 | absent |
dbNSFP Gene Annotations
Source:
- 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
| All | Recessive | Dominant | |
|---|---|---|---|
| Mendelian | Medium | Medium | Medium |
| Primary Immunodeficiency | Medium | Medium | Medium |
| Cancer | Medium | Medium | Medium |