Aliases: ZFH4, ZHF4
Chromosome No: 8
Chromosome Band: 8q21.13
Genetic Category: Rare single gene variant-Syndromic/Functional-Syndromic
ASD Reports: 5
Recent Reports: 0
Annotated variants: 64
Associated CNVs: 8
Evidence score: null
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Relevance to Autism
Perez Baca et al., 2025 reported 63 individuals (57 probands and 6 affected family members) with protein-truncating variants (n=41), copy number variants (n=21), or an inversion (n=1) affecting the ZFHX4 gene presenting with a variable neurodevelopmental syndrome characterized by developmental delay and intellectual disability, distinctive facial characteristics, morphological abnormalities of the central nervous system, behavioral abnormalities (of which stereotypies (n=7) and autism (n=10) were the most frequently reported), short stature, hypotonia, and occasionally cleft palate and anterior segment dysgenesis; while ZFHX4 deletions showed a mild methylation profile, protein-truncating variants did not. Moreover, the authors of this study implicated ZFHX4 interactors in transcriptional regulation and development and its target gene in neural development using multi-omics data and also observed that zebrafish zfhx4 crispants displayed craniofacial/medulla oblongata defects and reduced movement frequency. Additional de novo variants in ZFHX4, including two de novo loss-of-function variants and several de novo missense variants, have been identified in ASD probands from the Autism Sequencing Consortium, the MSSNG cohort, and the SPARK cohort (Satterstrom et al., 2020; Zhou et al., 2022; Trost et al., 2022).
Molecular Function
Predicted to enable DNA-binding transcription factor activity, RNA polymerase II-specific and RNA polymerase II cis-regulatory region sequence-specific DNA binding activity. Predicted to be involved in regulation of transcription by RNA polymerase II. Predicted to be located in chromatin. Predicted to be active in nucleus






