DDX39B

gene
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Also known as D6S81EUap56

Summary

DDX39B (DExD-box helicase 39B, HGNC:13917) is a protein-coding gene on chromosome 6p21.33, encoding Spliceosome RNA helicase DDX39B (Q13838). Involved in nuclear export of spliced and unspliced mRNA. It is a selective cancer dependency (DepMap: 63.2% of cell lines).

This gene encodes a member of the DEAD box family of RNA-dependent ATPases that mediate ATP hydrolysis during pre-mRNA splicing. The encoded protein is an essential splicing factor required for association of U2 small nuclear ribonucleoprotein with pre-mRNA, and it also plays an important role in mRNA export from the nucleus to the cytoplasm. This gene belongs to a cluster of genes localized in the vicinity of the genes encoding tumor necrosis factor alpha and tumor necrosis factor beta. These genes are all within the human major histocompatibility complex class III region. Mutations in this gene may be associated with rheumatoid arthritis. Alternative splicing results in multiple transcript variants. Related pseudogenes have been identified on both chromosomes 6 and 11. Read-through transcription also occurs between this gene and the upstream ATP6V1G2 (ATPase, H+ transporting, lysosomal 13kDa, V1 subunit G2) gene.

Source: NCBI Gene 7919 — RefSeq curated summary.

At a glance

  • Gene–disease (curated): neurodevelopmental disorder (Limited, GenCC)
  • GWAS associations: 32
  • Clinical variants (ClinVar): 3 total
  • Druggable target: yes
  • Cancer dependency (DepMap): dependent in 63.2% of screened cell lines
  • MANE Select transcript: NM_004640

Identifiers

Gene identifiers

FieldValue
HGNC IDHGNC:13917
Approved symbolDDX39B
NameDExD-box helicase 39B
Location6p21.33
Locus typegene with protein product
StatusApproved
AliasesD6S81E, Uap56
Ensembl geneENSG00000198563
Ensembl biotypeprotein_coding
OMIM142560
Entrez7919

Gene structure

Transcript identifiers

Ensembl transcripts: 68 — 61 protein_coding, 5 retained_intron, 1 protein_coding_CDS_not_defined, 1 nonsense_mediated_decay

ENST00000376177, ENST00000396172, ENST00000417023, ENST00000418897, ENST00000419020, ENST00000419338, ENST00000427214, ENST00000428098, ENST00000428450, ENST00000431908, ENST00000449757, ENST00000456662, ENST00000456976, ENST00000458640, ENST00000462256, ENST00000462421, ENST00000474961, ENST00000478365, ENST00000481456, ENST00000482195, ENST00000484566, ENST00000866323, ENST00000866324, ENST00000866325, ENST00000866326, ENST00000866327, ENST00000866328, ENST00000866329, ENST00000866330, ENST00000866331, ENST00000866332, ENST00000866333, ENST00000866334, ENST00000866335, ENST00000866336, ENST00000866337, ENST00000866338, ENST00000866339, ENST00000923348, ENST00000923349, ENST00000923350, ENST00000923351, ENST00000923352, ENST00000923353, ENST00000923354, ENST00000923355, ENST00000923356, ENST00000923357, ENST00000923358, ENST00000923359, ENST00000923360, ENST00000923361, ENST00000923362, ENST00000923363, ENST00000923364, ENST00000923365, ENST00000963245, ENST00000963246, ENST00000963247, ENST00000963248, ENST00000963249, ENST00000963250, ENST00000963251, ENST00000963252, ENST00000963253, ENST00000963254, ENST00000963255, ENST00000963256

RefSeq mRNA: 2 — MANE Select: NM_004640 NM_004640, NM_080598

CCDS: CCDS4697

Canonical transcript exons

ENST00000396172 — 11 exons

ExonStartEnd
ENSE000017639073154195031542003
ENSE000034673293153914731539274
ENSE000035204973153876331538855
ENSE000035326133154032231540664
ENSE000036254973153105331531197
ENSE000036371643153536731535485
ENSE000036383633153650031536683
ENSE000036645723153129631531405
ENSE000037858493153077931530926
ENSE000037914423153278031532911
ENSE000038503943153022631530450

Expression profiles

Bgee: expression breadth ubiquitous, 263 present calls, max score 99.55.

FANTOM5 (CAGE): breadth ubiquitous, TPM avg 248.3796 / max 2478.9709, expressed in 1827 samples.

FANTOM5 promoters (9 alternative TSS)

Promoter IDTPM avgSamples expressed
72690244.13811827
726891.56381063
726870.7386289
726910.4571174
2039430.4458200
726860.4131192
726840.2876125
726920.181471
726830.154263

Top tissues by expression

282 total, by Bgee expression score (0-100, higher = more expressed):

TissueAnatomy IDExpression scoreQuality
granulocyteCL:000009499.55gold quality
adenohypophysisUBERON:000219699.48gold quality
ventricular zoneUBERON:000305399.48gold quality
ganglionic eminenceUBERON:000402399.48gold quality
right uterine tubeUBERON:000130299.47gold quality
right hemisphere of cerebellumUBERON:001489099.42gold quality
right lobe of thyroid glandUBERON:000111999.41gold quality
left lobe of thyroid glandUBERON:000112099.41gold quality
left ovaryUBERON:000211999.38gold quality
cerebellar hemisphereUBERON:000224599.38gold quality
body of uterusUBERON:000985399.38gold quality
right ovaryUBERON:000211899.37gold quality
endocervixUBERON:000045899.36gold quality
mucosa of stomachUBERON:000119999.35gold quality
cortical plateUBERON:000534399.34gold quality
cerebellar cortexUBERON:000212999.32gold quality
left uterine tubeUBERON:000130399.31gold quality
metanephros cortexUBERON:001053399.31gold quality
muscle layer of sigmoid colonUBERON:003580599.28gold quality
small intestine Peyer’s patchUBERON:000345499.27gold quality
lower esophagus mucosaUBERON:003583499.26gold quality
esophagogastric junction muscularis propriaUBERON:003584199.26gold quality
tibial nerveUBERON:000132399.25gold quality
skin of abdomenUBERON:000141699.25gold quality
upper lobe of left lungUBERON:000895299.24gold quality
lower esophagusUBERON:001347399.24gold quality
lower esophagus muscularis layerUBERON:003583399.24gold quality
ectocervixUBERON:001224999.23gold quality
skin of legUBERON:000151199.20gold quality
body of pancreasUBERON:000115099.19gold quality

Single-cell (SCXA)

Detected in 3 experiment(s), a significant marker in 2.

ExperimentMarker?Max mean expression
E-MTAB-7037yes83.10
E-ANND-3yes6.47
E-GEOD-93593no6.33

Regulation

Is transcription factor: no

miRNA regulators (miRDB)

27 targeting DDX39B, top 30 by miRDB confidence (max_score; target_count = how many genes the miRNA targets in total — lower means more specific):

miRNAMax scoreAvg scoremiRNA target_count
HSA-MIR-153-5P99.8973.866317
HSA-MIR-444799.8567.812900
HSA-MIR-6756-5P99.8267.972466
HSA-MIR-548AJ-5P99.7871.123085
HSA-MIR-548F-5P99.7871.023093
HSA-MIR-548G-5P99.7871.123085
HSA-MIR-548X-5P99.7871.123085
HSA-MIR-92A-2-5P99.7567.012164
HSA-MIR-6766-5P99.6867.702325
HSA-MIR-205399.5769.151635
HSA-MIR-6751-5P99.5664.991145
HSA-MIR-671-5P99.5267.111277
HSA-MIR-2115-3P99.3169.682026
HSA-MIR-642A-3P99.2367.671258
HSA-MIR-642B-3P99.2367.671258
HSA-MIR-6803-5P99.1963.901026
HSA-MIR-465199.0667.572002
HSA-MIR-140-3P99.0467.691324
HSA-MIR-60898.9367.832013
HSA-MIR-6846-5P98.8165.861121
HSA-MIR-6848-5P98.8165.491126
HSA-MIR-876-3P98.7668.23945
HSA-MIR-323A-5P98.5965.13651
HSA-MIR-6852-3P98.5467.601468
HSA-MIR-4433A-3P97.7562.821435
HSA-MIR-390997.5566.78887
HSA-MIR-6835-5P95.8164.27500

Functional genomics

DepMap (CRISPR cell-line fitness): dependent in 63.2% of screened cell lines.

Literature-anchored findings (GeneRIF, showing 40)

  • BAT1 transcription on the 7.1 AH (diabetes-resistant ancestral haplotype)is modified by interactions involving DNA flanking positions -22 and -348 in the promotor (PMID:15028669)
  • The structures of UAP56/Sub2(BAT1) reveal a unique spatial arrangement of the two conserved helicase domains, and ADP-binding induces significant conformational changes of key residues in the ATP-binding pocket (PMID:15585580)
  • recruitment of the human TREX complex to spliced mRNA is not directly coupled to transcription, but is instead coupled to transcription indirectly through splicing (PMID:15998806)
  • UAP56 provides a herpesviral regulatory protein with access to a conserved cellular transport system in order to promote nuclear export of unspliced RNA. (PMID:16478985)
  • Reducing the expression of UAP56 and URH49 resulted in a reduction in reporter gene expression as well as cell death within 72 h suggest that both helicases have essential but largely overlapping functions in the processing and export of mammalian mRNAs. (PMID:16949217)
  • Minor homozygous genotypes of polymorphisms in BAT1 were associated with moderately protective effects against myocardial infarction. (PMID:17517687)
  • UAP56 has ATPase and helicase activity and roles in spliceosome assembly and mRNA export (PMID:17562711)
  • The role of BAT1 in the regulation of tumor necrosis factor-a suggests that BAT1 may regulate the inflammatory response observed in patients with rheumatoid arthritis. (PMID:18381799)
  • The equilibrium binding of UAP56 in complexes at speckled domains was directly regulated by ATP binding. (PMID:18411249)
  • hUAP56 first interacts with U2AF(65) in an ATP-dependent manner, and subsequently with U4/U6 snRNAs to facilitate stepwise assembly of the spliceosome. (PMID:18593880)
  • APOE epsilon4 was associated with an independent increase in risk for Alzheimer’s disease (AD) in individuals with TNFA -850*2, while carriage of BAT1 -22*2 reduced the risk for AD, independent of APOE epsilon4 genotype (PMID:18715507)
  • The authors demonstrate that ORF57 recruits several members of hTREX, namely Aly, UAP56 and hTHO-complex proteins, onto the viral mRNAs to assemble an export-competent ribonucleoprotein particle. (PMID:19264631)
  • This report summarizes recent evidence for the role of UAP56 in pre-mRNA splicing and nuclear export. (PMID:19403039)
  • UAP56 is an important regulator of protein synthesis and plays an important role in the regulation of cardiomyocyte growth. (PMID:20116367)
  • Data show that the two closely related RNA helicases UAP56 and URH49 have evolved to form distinct mRNA export machineries, which regulate mitosis at different steps. (PMID:20573985)
  • Using a UL69 viral mutant that is unable to bind UAP56 and URH49, the authors demonstrated that UL69’s interaction with UAP56 or URH49 does not contribute to the growth phenotype associated with the UL69 deletion mutant. (PMID:20610707)
  • UAP56 binding was shown to represent a unique characteristic of members of the genus Cytomegalovirus that is required for efficient replication of HCMV and required for nuclear mRNA export. (PMID:21147923)
  • These findings demonstrate that replication of the inlfuenza virus genome is followed by its encapsidation by NP in collaboration with its chaperone UAP56. (PMID:21507964)
  • In summary, these data demonstrate that UAP56 is utilized by influenza A viruses to prevent the formation of dsRNA and, hence, the activation of the innate immune response. (PMID:21680511)
  • UAP56 and URH49 exhibit an intrinsic CRM1-independent nucleocytoplasmic shuttling (PMID:21799930)
  • Mx proteins exert their antiviral activity against IAV by interfering with the function of the RNA helicases UAP56 and URH49 (PMID:21859714)
  • We unravel the role of unexplored immunologically important genes, BAT1 and BTNL2, and the haplotypes of the significantly associated SNPs therein, to understand susceptibility to the disease, leprosy and its differential severity. (PMID:22071774)
  • these data identify UAP56 as an important binding partner of Bcr and a novel target for inhibiting vascular smooth muscle cell proliferation. (PMID:22446327)
  • The G allele of DDX39B-22C > G was associated with absent or decreased manifestations of vivax malaria and the C allele was a risk factor for disease complications. (PMID:25038626)
  • However, no significant association was observed between the DDX39B -22 G/C polymorphism in the cases and controls. Furthermore, it is clarified that the protective effect of IL-4 -590 is independent from APOE protective genotypes (PMID:26265379)
  • DDX39B and its paralog DDX39A regulate androgen receptor splice variant AR-V7 generation (PMID:28025139)
  • Distinct features of RNA influence and ATPase efficiency between UAP56 and TcSub2 may reflect distinct structures for functional sites of TcSub2. For this reason, ligand-based or structure-based methodologies can be applied to investigate the potential of TcSub2 as a target for new drugs. (PMID:28212935)
  • Study showed that a genetic variant in the 5’ UTR of DDX39B reduces translation of DDX39B mRNAs and increases multiple sclerosis (MS) risk. Importantly, this DDX39B variant showed strong genetic & functional epistasis with allelic variants in IL7R exon 6; study establishes the occurrence of biological epistasis in humans & provides mechanistic insight into the regulation of IL7R exon 6 splicing & its impact on MS risk. (PMID:28340352)
  • DDX39B promotes proliferation and colony forming potential of cells and its levels are significantly elevated in diverse cancer types.DDX39B regulates the pre-ribosomal RNA levels. (PMID:30176153)
  • Cellular mRNA export factor UAP56 recognizes nucleic acid binding site of influenza virus NP protein. (PMID:32085897)
  • THE BRANCHED-CHAIN AMINO ACID TRANSAMINASE 1 -23C/G POLYMORPHISM CONFERS PROTECTION AGAINST ACUTE CORONARY SYNDROME. (PMID:32132739)
  • Cellular UAP56 interacts with the HBx protein of the hepatitis B virus and is involved in viral RNA nuclear export in hepatocytes. (PMID:32169426)
  • DDX39B interacts with the pattern recognition receptor pathway to inhibit NF-kappaB and sensitize to alkylating chemotherapy. (PMID:32209106)
  • UAP56/DDX39B is a major cotranscriptional RNA-DNA helicase that unwinds harmful R loops genome-wide. (PMID:32439635)
  • Suppression of DDX39B sensitizes ovarian cancer cells to DNA-damaging chemotherapeutic agents via destabilizing BRCA1 mRNA. (PMID:32989256)
  • The DDX39B/FUT3/TGFbetaR-I axis promotes tumor metastasis and EMT in colorectal cancer. (PMID:33436563)
  • DDX39B Predicts Poor Survival and Associated with Clinical Benefit of Anti-PD-L1 Therapy in ccRCC. (PMID:34382524)
  • DDX39B drives colorectal cancer progression by promoting the stability and nuclear translocation of PKM2. (PMID:35973989)
  • RETSAT associates with DDX39B to promote fork restarting and resistance to gemcitabine based chemotherapy in pancreatic ductal adenocarcinoma. (PMID:36109793)
  • DDX39B facilitates the malignant progression of hepatocellular carcinoma via activation of SREBP1-mediated de novo lipid synthesis. (PMID:37052853)

Cross-species orthologs

3 orthologs

OrganismSymbolGene ID
danio_rerioddx39bENSDARG00000036069
mus_musculusDdx39bENSMUSG00000019432
rattus_norvegicusDdx39bENSRNOG00000000841

Paralogs (38): DDX20 (ENSG00000064703), DDX3Y (ENSG00000067048), DDX1 (ENSG00000079785), DDX43 (ENSG00000080007), DDX18 (ENSG00000088205), DDX24 (ENSG00000089737), DDX17 (ENSG00000100201), DDX49 (ENSG00000105671), DDX50 (ENSG00000107625), DDX5 (ENSG00000108654), DDX25 (ENSG00000109832), DDX6 (ENSG00000110367), DDX55 (ENSG00000111364), DDX59 (ENSG00000118197), DDX54 (ENSG00000123064), DDX39A (ENSG00000123136), DDX27 (ENSG00000124228), DDX31 (ENSG00000125485), DDX56 (ENSG00000136271), EIF4A3 (ENSG00000141543), DDX46 (ENSG00000145833), DDX4 (ENSG00000152670), EIF4A2 (ENSG00000156976), DDX19B (ENSG00000157349), EIF4A1 (ENSG00000161960), DDX21 (ENSG00000165732), DDX19A (ENSG00000168872), TDRD12 (ENSG00000173809), DDX23 (ENSG00000174243), DDX10 (ENSG00000178105), DDX28 (ENSG00000182810), DDX41 (ENSG00000183258), DDX53 (ENSG00000184735), DDX51 (ENSG00000185163), DDX42 (ENSG00000198231), DDX47 (ENSG00000213782), DDX3X (ENSG00000215301), DDX52 (ENSG00000278053)

Protein

Protein identifiers

Spliceosome RNA helicase DDX39BQ13838 (reviewed: Q13838)

Alternative names: 56 kDa U2AF65-associated protein, ATP-dependent RNA helicase p47, DEAD box protein UAP56, HLA-B-associated transcript 1 protein

All UniProt accessions (15): A0A024RCM3, A0A0A0MT12, Q13838, F6QYI9, F6R6M7, F6S2B7, F6S4E6, F6SXL5, F6TRA5, F6U6E2, F6UJC5, F6WLT2, H0Y400, H0YCC6, Q5STU3

UniProt curated annotations — full annotation on UniProt →

Function. Involved in nuclear export of spliced and unspliced mRNA. Component of the TREX complex which is thought to couple mRNA transcription, processing and nuclear export, and specifically associates with spliced mRNA and not with unspliced pre-mRNA. The TREX complex is recruited to spliced mRNAs by a transcription-independent mechanism, binds to mRNA upstream of the exon-junction complex (EJC) and is recruited in a splicing- and cap-dependent manner to a region near the 5’ end of the mRNA where it functions in mRNA export to the cytoplasm via the TAP/NXF1 pathway. The THOC1-THOC2-THOC3 core complex alone is sufficient to promote ATPase activity of DDX39B; in the complex THOC2 is the only component that directly interacts with DDX39B. Associates with SARNP/CIP29, which facilitates RNA binding of DDX39B and likely plays a role in mRNA export. May undergo several rounds of ATP hydrolysis during assembly of TREX to drive subsequent loading of components such as ALYREF/THOC4 and CHTOP onto mRNA. Also associates with pre-mRNA independent of ALYREF/THOC4. Involved in the nuclear export of intronless mRNA; the ATP-bound form is proposed to recruit export adapter ALYREF/THOC4 to intronless mRNA; its ATPase activity is cooperatively stimulated by RNA and ALYREF/THOC4 and ATP hydrolysis is thought to trigger the dissociation from RNA to allow the association of ALYREF/THOC4 and the NXF1-NXT1 heterodimer. Involved in transcription elongation and genome stability. Splice factor that is required for the first ATP-dependent step in spliceosome assembly and for the interaction of U2 snRNP with the branchpoint. Has both RNA-stimulated ATP binding/hydrolysis activity and ATP-dependent RNA unwinding activity. Even with the stimulation of RNA, the ATPase activity is weak. Can only hydrolyze ATP but not other NTPs. The RNA stimulation of ATPase activity does not have a strong preference for the sequence and length of the RNA. However, ssRNA stimulates the ATPase activity much more strongly than dsRNA. Can unwind 5’ or 3’ overhangs or blunt end RNA duplexes in vitro. The ATPase and helicase activities are not influenced by U2AF2; the effect of ALYREF/THOC4 is reported conflictingly with [PubMed:23299939] reporting a stimulatory effect. (Microbial infection) The TREX complex is essential for the export of Kaposi’s sarcoma-associated herpesvirus (KSHV) intronless mRNAs and infectious virus production.

Subunit / interactions. Homodimer, and heterodimer with DDX39A. DDX39B interacts with the THO subcomplex to form the THO-DDX39B complex which multimerizes into a 28-subunit tetrameric assembly. Component of the transcription/export (TREX) complex at least composed of ALYREF/THOC4, DDX39B, SARNP/CIP29, CHTOP and the THO subcomplex; in the complex interacts with THOC2. THOC1-THOC2-THOC3-DDX39B subcomplex is sufficient for the interaction with export factor NXF1-NXT1. TREX seems to have a dynamic structure involving ATP-dependent remodeling. Within the TREX complex bridges ALYREF/THOC4 and the THO subcomplex, and, in a ATP-dependent manner, ALYREF/THOC4 and SARNP/CIP29. Component of the spliceosome. Interacts directly with U2AF2. Interacts with RBM8A, RNPS1 and SRRM1, FYTTD1/UIF, THOC1, MX1 and POLDIP3. Interacts with LUZP4. Interacts with SARNP/CIP29 (via the C-terminal domain); the interaction is direct and facilitates RNA binding of DDX39B. (Microbial infection) Interacts with human cytomegalovirus/HHV-5 protein UL69.

Subcellular location. Nucleus. Nucleus speckle. Cytoplasm.

Domain organisation. The helicase C-terminal domain mediates interaction with ALYREF/THOC4.

Similarity. Belongs to the DEAD box helicase family. DECD subfamily.

Isoforms (2)

UniProt IDNamesCanonical?
Q13838-11yes
Q13838-22

RefSeq proteins (2): NP_004631, NP_542165 (=MANE)

Domains & families (InterPro)

IDNameType
IPR001650Helicase_C-likeDomain
IPR011545DEAD/DEAH_box_helicase_domDomain
IPR014001Helicase_ATP-bdDomain
IPR014014RNA_helicase_DEAD_Q_motifDomain
IPR027417P-loop_NTPaseHomologous_superfamily

Pfam: PF00270, PF00271

Catalyzed reactions (Rhea), 1 shown:

  • ATP + H2O = ADP + phosphate + H(+) (RHEA:13065)

UniProt features (65 total): helix 20, strand 19, mutagenesis site 7, modified residue 5, domain 2, turn 2, short sequence motif 2, initiator methionine 1, chain 1, cross-link 1, splice variant 1, sequence conflict 1, region of interest 1, compositionally biased region 1, binding site 1

Structure

Experimental structures (PDB)

17 structures.

PDBMethodResolution (Å)
1T5IX-RAY DIFFRACTION1.9
1T6NX-RAY DIFFRACTION1.94
1XTIX-RAY DIFFRACTION1.95
1XTKX-RAY DIFFRACTION2.4
8ENKX-RAY DIFFRACTION2.5
1XTJX-RAY DIFFRACTION2.7
9DLPELECTRON MICROSCOPY2.79
9T6LELECTRON MICROSCOPY2.9
9DLVELECTRON MICROSCOPY2.97
9T6NELECTRON MICROSCOPY3
9DLRELECTRON MICROSCOPY3.08
7APKELECTRON MICROSCOPY3.3
9UPBELECTRON MICROSCOPY3.41
7ZNLELECTRON MICROSCOPY3.45
8R7KELECTRON MICROSCOPY3.5
7ZNKELECTRON MICROSCOPY3.9
8R7LELECTRON MICROSCOPY4.12

Predicted structure (AlphaFold)

ModelpLDDTFraction very-high
AF-Q13838-F185.340.64

Functional residue map

Curated UniProt residues grouped by drug-discovery relevance — catalytic, ligand-binding, modification, and mutation-validated positions. Source: UniProtKB sequence features.

Ligand- & substrate-binding residues (1): 89–96

Post-translational modifications (6): 36, 38, 41, 172, 36, 2

Mutagenesis-validated functional residues (7):

PositionPhenotype
94–96loss of atpase and helicase activity.
95loss of atpase and helicase activity.
197loss of atpase and helicase activity.
198no effect on atpase activity.
199increased atpase activity and loss of helicase activity.
228–230decreased atpase activity and loss of helicase activity.
283abolishes interaction with sarnp; when associated with 2-a–t-258 del.

Function

Pathways and Gene Ontology

Reactome pathways

5 pathways

IDPathway
R-HSA-159236Transport of Mature mRNA derived from an Intron-Containing Transcript
R-HSA-72163mRNA Splicing - Major Pathway
R-HSA-72187mRNA 3’-end processing
R-HSA-9013418RHOBTB2 GTPase cycle
R-HSA-73856RNA Polymerase II Transcription Termination

MSigDB gene sets: 252 (showing top): HORIUCHI_WTAP_TARGETS_DN, MORF_SMC1L1, MORF_SNRP70, MORF_UBE2I, MATTIOLI_MGUS_VS_PCL, GRAESSMANN_APOPTOSIS_BY_DOXORUBICIN_DN, MORF_HDAC1, MORF_UBE2N, HSIAO_HOUSEKEEPING_GENES, MORF_HDAC2, PUJANA_CHEK2_PCC_NETWORK, GOBP_NUCLEAR_TRANSPORT, MORF_TERF1, RHEIN_ALL_GLUCOCORTICOID_THERAPY_UP, MORF_CTBP1

GO Biological Process (7): spliceosomal complex assembly (GO:0000245), mRNA splicing, via spliceosome (GO:0000398), RNA export from nucleus (GO:0006405), mRNA export from nucleus (GO:0006406), RNA splicing (GO:0008380), mRNA processing (GO:0006397), mRNA transport (GO:0051028)

GO Molecular Function (15): RNA binding (GO:0003723), RNA helicase activity (GO:0003724), mRNA binding (GO:0003729), ATP binding (GO:0005524), ATP-dependent activity, acting on RNA (GO:0008186), ATP hydrolysis activity (GO:0016887), U6 snRNA binding (GO:0017070), U4 snRNA binding (GO:0030621), identical protein binding (GO:0042802), ATP-dependent protein binding (GO:0043008), nucleotide binding (GO:0000166), nucleic acid binding (GO:0003676), helicase activity (GO:0004386), protein binding (GO:0005515), hydrolase activity (GO:0016787)

GO Cellular Component (8): transcription export complex (GO:0000346), nucleus (GO:0005634), nucleoplasm (GO:0005654), spliceosomal complex (GO:0005681), U4 snRNP (GO:0005687), U6 snRNP (GO:0005688), cytoplasm (GO:0005737), nuclear speck (GO:0016607)

Reactome top-level categories

Rollup of top-5 pathways:

CategoryPathways
Transport of Mature Transcript to Cytoplasm1
mRNA Splicing1
Processing of Capped Intron-Containing Pre-mRNA1
RHOBTB GTPase Cycle1
RNA Polymerase II Transcription1

GO top-level categories

Rollup of top GO terms by namespace:

CategoryTerms
ATP-dependent activity3
RNA transport2
RNA processing2
snRNA binding2
protein binding2
binding2
nuclear protein-containing complex2
cellular anatomical structure2
spliceosomal snRNP complex2
mRNA splicing, via spliceosome1
protein-RNA complex assembly1
RNA splicing, via transesterification reactions with bulged adenosine as nucleophile1
mRNA processing1
nuclear export1
RNA export from nucleus1
gene expression1
mRNA transport1
mRNA metabolic process1
nucleic acid binding1
helicase activity1
ATP-dependent activity, acting on RNA1
catalytic activity, acting on RNA1
RNA binding1
adenyl ribonucleotide binding1
purine ribonucleoside triphosphate binding1
ribonucleoside triphosphate phosphatase activity1
nucleoside phosphate binding1
heterocyclic compound binding1
nucleic acid conformation isomerase activity1
catalytic activity, acting on a nucleic acid1
catalytic activity1
intracellular membrane-bounded organelle1
nuclear lumen1
ribonucleoprotein complex1
Lsm2-8 complex1
intracellular anatomical structure1
nuclear ribonucleoprotein granule1

Protein interactions and networks

STRING

4353 interactions, top by confidence (×1000):

Protein AProtein BPartner UniProtScore
DDX39BALYREFQ86V81999
DDX39BTHOC2Q8NI27998
DDX39BTHOC3Q96J01998
DDX39BTHOC1Q96FV9995
DDX39BSARNPP82979995
DDX39BCHTOPQ9Y3Y2982
DDX39BU2AF2P26368974
DDX39BFYTTD1Q96QD9972
DDX39BPOLDIP3Q9BY77964
DDX39BTHOC5Q13769927
DDX39BRAE1P78406914
DDX39BNXF1Q9UBU9881
DDX39BTHOC7Q6I9Y2876
DDX39BTHOC6Q86W42873
DDX39BHNRNPA1P09651842

IntAct

227 interactions, top by confidence:

ABTypeScore
THOC1THOC5psi-mi:“MI:0914”(association)0.930
DDX39BCHTOPpsi-mi:“MI:0915”(physical association)0.870
SARNPDDX39Bpsi-mi:“MI:0915”(physical association)0.800
DDX39BTHOC5psi-mi:“MI:0915”(physical association)0.800
DDX39ADDX39Bpsi-mi:“MI:0915”(physical association)0.770
DDX39BALYREFpsi-mi:“MI:0914”(association)0.770
DDX39ADDX39Bpsi-mi:“MI:0914”(association)0.770
SARNPDDX39Apsi-mi:“MI:0914”(association)0.740
MED19MED19psi-mi:“MI:0914”(association)0.730
DDX39BFYTTD1psi-mi:“MI:0915”(physical association)0.720
CFTRESYT2psi-mi:“MI:2364”(proximity)0.710
DDX39BDDX39Bpsi-mi:“MI:0915”(physical association)0.670
SNRPADDX39Bpsi-mi:“MI:0915”(physical association)0.670
THOC1EIF4A3psi-mi:“MI:0914”(association)0.660
NCBP1KPNA3psi-mi:“MI:0914”(association)0.640
NCBP2KPNA3psi-mi:“MI:0914”(association)0.640
SF3B1SAP18psi-mi:“MI:0914”(association)0.640
THOC1DDX39Apsi-mi:“MI:0914”(association)0.640
DDX39Bpsi-mi:“MI:0915”(physical association)0.560

BioGRID (1020): DDX39B (Affinity Capture-MS), DDX39B (Affinity Capture-MS), DDX39B (Affinity Capture-MS), DDX39B (Affinity Capture-MS), DDX39B (Affinity Capture-MS), DDX39B (Affinity Capture-MS), DDX39B (Affinity Capture-MS), DDX39B (Affinity Capture-Western), LUZP4 (Reconstituted Complex), DDOST (Co-fractionation), DDX39B (Co-fractionation), DDX39B (Co-fractionation), DDX39B (Co-fractionation), DDX39B (Co-fractionation), DDX39B (Co-fractionation)

ESM2 similar proteins: A1CMQ7, A1DL85, A2R0B5, A3LST5, A4RBS3, A5DDN0, A5E3W5, A6R603, A6ZXP4, A7EIX7, A7TJT7, A7TLA0, O00148, O13792, P0CQ96, P0CQ97, P54823, P60024, Q07478, Q0CGJ9, Q0JM17, Q0TXZ2, Q13838, Q18212, Q1DI07, Q27268, Q29024, Q29S22, Q2H4D0, Q2U6P7, Q3T147, Q4WCW2, Q56XG6, Q5ASK8, Q5JK84, Q5RE47, Q5TM17, Q5U216, Q5WR10, Q5ZHZ0

Diamond homologs: A1C595, A1CJT5, A1CMQ7, A1D071, A1D7N3, A1DL85, A2QEN5, A2R0B5, A3GFI4, A3GFV3, A3LST5, A4QU31, A4QVP2, A4RBS3, A5AAE5, A5DB98, A5DDN0, A5DE68, A5DVM3, A5E3W5, A6QSQ0, A6R603, A6RJ45, A6ZQJ1, A6ZXP4, A7EGL7, A7EIX7, A7EM88, A7TJT7, A7TK55, A7TLA0, O00148, O02494, O13792, P0CQ70, P0CQ71, P0CQ96, P0CQ97, P10081, P10630

SIGNOR signaling

1 interactions.

AEffectBMechanism
DDX39B“form complex”“TREX complex”binding

Enriched among interaction partners

Reactome pathways and GO biological processes over-represented among this gene’s 167 IntAct physical interaction partners (hypergeometric vs the genome-wide background, BH-FDR, gene-set size 15–500, ranked by fold). A functional readout of the neighbourhood — distinct from this gene’s own memberships above, and biased toward well-studied / hub proteins, so read it as themes rather than proof.

Reactome pathways:

PathwayPartnersFoldFDR
Transport of Mature Transcript to Cytoplasm1032.0×3e-11
mRNA 3’-end processing1931.4×3e-21
Metabolism of non-coding RNA526.7×6e-05
RNA Polymerase II Transcription Termination1425.8×2e-14
Transport of Mature mRNA derived from an Intron-Containing Transcript1721.8×3e-16
Processing of Capped Intron-Containing Pre-mRNA2114.5×2e-16
HIV Transcription Elongation514.1×1e-03
Nuclear RNA decay513.0×1e-03

GO biological processes:

GO termPartnersFoldFDR
mRNA export from nucleus1632.2×3e-17
U2-type prespliceosome assembly521.2×7e-04
spliceosomal snRNP assembly519.8×8e-04
nuclear-transcribed mRNA catabolic process, nonsense-mediated decay515.9×2e-03
mRNA splicing, via spliceosome2012.5×9e-14
RNA splicing1710.2×4e-10
mRNA processing147.5×2e-06
response to ethanol77.0×6e-03

Disease & clinical

Clinical variants and AI predictions

ClinVar

3 variants total. Per-class counts are floors (≥ shown; pagination cap):

ClassificationCount (floor)
Pathogenic0
Likely pathogenic0
Uncertain significance1
Likely benign0
Benign0

Top pathogenic / likely-pathogenic (0)

SpliceAI

2519 predictions. Top by Δscore:

VariantEffectΔscore
6:31530773:A:ACdonor_gain1.0000
6:31530774:C:CCdonor_gain1.0000
6:31530774:CTCA:Cdonor_gain1.0000
6:31530775:TCA:Tdonor_loss1.0000
6:31530776:CA:Cdonor_loss1.0000
6:31530777:A:ACdonor_gain1.0000
6:31530777:AC:Adonor_loss1.0000
6:31530778:C:CAdonor_gain1.0000
6:31530778:C:CTdonor_gain1.0000
6:31530778:CT:Cdonor_gain1.0000
6:31530778:CTG:Cdonor_gain1.0000
6:31530778:CTGT:Cdonor_gain1.0000
6:31530778:CTGTA:Cdonor_gain1.0000
6:31530926:CCT:Cacceptor_loss1.0000
6:31530927:C:CGacceptor_loss1.0000
6:31530927:CT:Cacceptor_loss1.0000
6:31531047:GTTTA:Gdonor_loss1.0000
6:31531048:TTTA:Tdonor_loss1.0000
6:31531048:TTTAC:Tdonor_loss1.0000
6:31531049:TTA:Tdonor_loss1.0000
6:31531049:TTAC:Tdonor_loss1.0000
6:31531050:TACC:Tdonor_loss1.0000
6:31531050:TACCC:Tdonor_loss1.0000
6:31531051:A:ACdonor_gain1.0000
6:31531051:A:AGdonor_loss1.0000
6:31531051:A:ATdonor_loss1.0000
6:31531051:AC:Adonor_gain1.0000
6:31531052:C:CCdonor_gain1.0000
6:31531052:CC:Cdonor_gain1.0000
6:31531197:CC:Cacceptor_loss1.0000

AlphaMissense

2862 scored. Top likely-pathogenic:

VariantProtein changeam_pathogenicity
6:31530828:A:CF407L1.000
6:31530828:A:TF407L1.000
6:31530830:A:GF407L1.000
6:31530906:A:CF381L1.000
6:31530906:A:TF381L1.000
6:31530908:A:GF381L1.000
6:31531373:G:CC300W1.000
6:31538835:A:CC120W1.000
6:31539206:C:GG94R1.000
6:31539206:C:TG94R1.000
6:31540338:A:CF65L1.000
6:31540338:A:TF65L1.000
6:31540340:A:GF65L1.000
6:31530832:C:GR406P0.999
6:31530850:A:GL400P0.999
6:31530883:G:TT389K0.999
6:31530889:G:TA387D0.999
6:31530895:C:TG385D0.999
6:31530896:C:GG385R0.999
6:31530913:C:TG379D0.999
6:31531054:C:GR374P0.999
6:31531058:G:CH373D0.999
6:31531092:A:CN361K0.999
6:31531092:A:TN361K0.999
6:31531127:C:GG350R0.999
6:31531150:A:TV342E0.999
6:31531153:A:GL341P0.999
6:31531374:C:TC300Y0.999
6:31531394:A:CF293L0.999
6:31531394:A:TF293L0.999

dbSNP variants (sampled 300 via entrez): RS1000206682 (6:31543039 C>G,T), RS1000501115 (6:31537902 A>G), RS1000639768 (6:31530616 T>A), RS1000684336 (6:31530463 C>T), RS1000783743 (6:31537688 A>G), RS1001010377 (6:31531062 G>A), RS1001076799 (6:31543436 C>G,T), RS1001148780 (6:31537720 G>A,C), RS1001362107 (6:31533826 C>A), RS1001426600 (6:31531965 A>G), RS1001624394 (6:31538593 G>A,C), RS1002055197 (6:31538266 C>G), RS1002358117 (6:31537280 A>G,T), RS1002767048 (6:31532316 G>A), RS1003081366 (6:31535838 T>C)

Disease associations

OMIM: gene MIM:142560 | disease phenotypes:

GenCC curated gene-disease

DiseaseClassificationInheritance
neurodevelopmental disorderLimitedAutosomal dominant

Mondo (1): neurodevelopmental disorder (MONDO:0700092)

Orphanet (0):

HPO phenotypes

0 total (0 of 0 shown, HPO-id order):

GWAS associations

32 associations (top):

StudyTraitp-value
GCST000308_1AIDS progression3.000000e-19
GCST001239_1Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS-TEN)2.000000e-08
GCST001363_6Atopic dermatitis2.000000e-06
GCST003092_22Myositis3.000000e-49
GCST003092_23Myositis6.000000e-49
GCST004131_25Inflammatory bowel disease2.000000e-31
GCST004133_79Ulcerative colitis5.000000e-65
GCST004521_114Autism spectrum disorder or schizophrenia3.000000e-17
GCST004521_117Autism spectrum disorder or schizophrenia3.000000e-15
GCST004521_126Autism spectrum disorder or schizophrenia2.000000e-10
GCST004521_209Autism spectrum disorder or schizophrenia5.000000e-16
GCST004521_211Autism spectrum disorder or schizophrenia5.000000e-15
GCST004521_213Autism spectrum disorder or schizophrenia5.000000e-13
GCST004521_265Autism spectrum disorder or schizophrenia7.000000e-14
GCST004521_27Autism spectrum disorder or schizophrenia1.000000e-09
GCST004521_3Autism spectrum disorder or schizophrenia2.000000e-15
GCST004521_70Autism spectrum disorder or schizophrenia8.000000e-20
GCST004521_81Autism spectrum disorder or schizophrenia1.000000e-14
GCST004599_42Mean platelet volume2.000000e-24
GCST004609_64Monocyte percentage of white cells4.000000e-13
GCST004863_114Mosquito bite size2.000000e-17
GCST008916_111Asthma2.000000e-14
GCST008916_114Asthma1.000000e-09
GCST008916_30Asthma1.000000e-09
GCST008917_2Asthma (childhood onset)4.000000e-07
GCST008921_1Asthma and major depressive disorder2.000000e-16
GCST010725_43Malaria5.000000e-07
GCST010725_62Malaria3.000000e-06
GCST90002385_552High light scatter reticulocyte count5.000000e-24
GCST90002397_119Mean spheric corpuscular volume2.000000e-27

EFO canonical traits (3, from GWAS)

EFO IDTrait name
EFO:0007989monocyte percentage of leukocytes
EFO:0008378mosquito bite reaction size measurement
EFO:0007986reticulocyte count

MeSH disease descriptors (1)

DescriptorNameTree numbers
D065886Neurodevelopmental DisordersF03.625

Drugs & pharmacology

Drug and pharmacology data

Is drug target: yes

ChEMBL targets (1): CHEMBL6066325 (SINGLE PROTEIN)

PharmGKB: 1 entry (VIP=true, CPIC=false)

PharmGKB variants

1 variants.

VariantGenesLevelScore#Clin annotsDrugs
rs2734583DDX39B, SNORD11733.751allopurinol

ChEMBL bioactivities

2 potent at pChembl≥5 of 4 total, top 2 by pChembl (potency: 10 = 0.1 nM, 6 = 1 µM).

pChemblTypeValueUnitMolecule
6.02Kd956.8nMCHEMBL5653589
6.02ED50956.8nMCHEMBL5653589

PubChem BioAssay actives

1 with measured affinity, of 4 total; 1 most potent distinct compounds. Largely complementary to BindingDB; screening values are coarse (µM, 4 dp), so sub-nM hits tie at the floor.

CompoundAssayTypeValueUnit
4-methyl-3-[(2-methyl-6-pyridin-3-ylpyrazolo[3,4-d]pyrimidin-4-yl)amino]-N-[3-(trifluoromethyl)phenyl]benzamide2148222: Binding affinity to human DDX39B incubated for 45 mins by Kinobead based pull down assaykd0.9568uM

CTD chemical–gene interactions

42 total (human), top 30 by PubMed support.

ChemicalActions (top 5)PubMed papers
bisphenol Adecreases expression2
Valproic Aciddecreases expression, affects expression2
bisphenol Fincreases expression1
TAK-243decreases sumoylation1
triphenyl phosphateaffects expression1
trichostatin Aaffects cotreatment, decreases expression1
beta-lapachonedecreases expression, increases expression1
2,3-bis(3’-hydroxybenzyl)butyrolactoneaffects cotreatment, increases expression1
vanadyl sulfatedecreases expression1
di-n-butylphosphoric acidaffects expression1
4-(5-benzo(1,3)dioxol-5-yl-4-pyridin-2-yl-1H-imidazol-2-yl)benzamideaffects cotreatment, decreases expression1
nutlin 3affects cotreatment, increases secretion1
ICG 001decreases expression1
2-amino-14,16-dimethyloctadecan-3-oldecreases expression1
bromovaninincreases expression1
dorsomorphinaffects cotreatment, decreases expression1
bisphenol AFincreases expression1
4-(4-((5-(4,5-dimethyl-2-nitrophenyl)-2-furanyl)methylene)-4,5-dihydro-3-methyl-5-oxo-1H-pyrazol-1-yl)benzoic aciddecreases expression1
Temozolomideincreases expression1
Arsenic Trioxideincreases expression1
Vorinostatdecreases expression1
Acetaminophendecreases expression1
Arsenicaffects methylation1
Vehicle Emissionsincreases expression1
Caffeinedecreases phosphorylation1
Calcium Chlorideincreases expression1
Carcinogensdecreases expression1
Coumestrolaffects cotreatment, increases expression1
Dactinomycinaffects cotreatment, increases secretion1
Doxorubicindecreases expression1

ChEMBL screening assays

1 unique, capped per target: 1 binding

Representative assays (with source publication via chembl_document):

Assay IDTypeDescriptionSource paper
CHEMBL5651264BindingBinding affinity to human DDX39B incubated for 45 mins by Kinobead based pull down assayNVP-BHG712: Effects of Regioisomers on the Affinity and Selectivity toward the EPHrin Family. — ChemMedChem

Cellosaurus cell lines

475 cell lines: 475 cancer cell line

First 10 cell lines (id-ordered, not curated):

CellosaurusNameCategorySex
CVCL_0006THP-1Cancer cell lineMale
CVCL_0R21THP-1/DC-SIGNCancer cell lineMale
CVCL_0R25THP-1(NCI)Cancer cell lineMale
CVCL_0R26THP-1(NCI)/DC-SIGNCancer cell lineMale
CVCL_3426THP-1hCancer cell lineMale
CVCL_3427THP-1lCancer cell lineMale
CVCL_4V22THP-1/ara-CCancer cell lineMale
CVCL_5115A-THP-1Cancer cell lineMale
CVCL_5I76THP1-defCASP1Cancer cell lineMale
CVCL_5I77THP1-NLRC4Cancer cell lineMale

Clinical trials (associated diseases)

202 trials via MONDO — disease-level, not drug-specific.

TrialPhaseStatusTitle
NCT04586348PHASE4UNKNOWNPrenatal Iodine Supplementation and Early Childhood Neurodevelopment
NCT04873115PHASE4UNKNOWNDouble-blind, Placebo-controlled, Randomized Clinical Trial Comparing the Efficacy and Safety of Sialanar Plus orAl rehabiLitation Against Placebo Plus Oral Rehabilitation for chIldren and Adolescents With seVere Sialorrhoea and Neurodisabilties,
NCT02559102PHASE3COMPLETEDDexmedetomidine Sedation Versus General Anaesthesia for Inguinal Hernia Surgery in Infants
NCT02757079PHASE3COMPLETEDStudy of the Efficacy and Safety of NPC-15 for Sleep Disorders of Children With Neurodevelopmental Disorders
NCT06915480PHASE3RECRUITINGReducing Missed Appointments
NCT07377032PHASE3RECRUITINGTAP-GRIN: Interventional Study on Patients With GRIN-related Neurodevelopmental Disorders
NCT02909959PHASE2COMPLETEDSulforaphane for the Treatment of Young Men With Autism Spectrum Disorder
NCT06081348PHASE2RECRUITINGSertraline vs. Placebo in the Treatment of Anxiety in Children and AdoLescents With NeurodevelopMental Disorders
NCT06352372PHASE2COMPLETEDSafety and Efficacy of tPBM for Epileptiform Activity in Autism
NCT00503191PHASE1COMPLETEDNeuroModulation Technique Treatment of Autism
NCT04475848PHASE1COMPLETEDA Study to Investigate the Safety, Tolerability, Pharmacokinetics, Pharmacodynamics and Food Effect of RO6953958 in Healthy Participants
NCT06300398PHASE1COMPLETEDIAMA-6 Oral Dose Study in Healthy Adults
NCT01783041PHASE2/PHASE3COMPLETEDEffect of Early L-Carnitine Supplementation on Neurodevelopmental Outcomes in Very Preterm Infants
NCT05767385PHASE2/PHASE3RECRUITINGFetal Cerebrovascular Autoregulation in Congenital Heart Disease and Association With Neonatal Neurobehavior
NCT05675098EARLY_PHASE1NOT_YET_RECRUITINGCentral Nervous System Stimulants and Physical Function in Children With Cerebral Palsy
NCT00783783Not specifiedCOMPLETEDCYP2D6 Pharmacogenetics in Risperidone-Treated Children
NCT01778504Not specifiedRECRUITINGStudying Childhood-onset Behavioral, Psychiatric, and Developmental Disorders
NCT01850784Not specifiedUNKNOWNHigh Energy Formula Feeding in Infants With Congenital Heart Disease
NCT01922791Not specifiedCOMPLETEDNutrition and Pregnancy Intervention Study
NCT01942525Not specifiedUNKNOWNInfluence of Intrauterine Growth Restriction on Amplitude-integrated EEG in Preterm Infants
NCT02003170Not specifiedCOMPLETEDEtiology and Early Diagnosis of Neurodevelopmental Disorders
NCT02118649Not specifiedACTIVE_NOT_RECRUITINGEnhancing Behavior and Brain Response to Visual Targets Using a Computer Game
NCT02557191Not specifiedTERMINATEDBiomarkers, Neurodevelopment and Preterm Infants
NCT02690675Not specifiedCOMPLETEDIron Supplement Effect on Child Development
NCT02694003Not specifiedCOMPLETEDBetter Nights, Better Days for Children With Neurodevelopment Disorders
NCT02792894Not specifiedCOMPLETEDFamily Networks (FaNs) for Children With Developmental Disorders and Delays
NCT02871674Not specifiedUNKNOWNGood Night Project: Behavioural Sleep Interventions for Children With ADHD: A Randomised Controlled Trial
NCT02887157Not specifiedCOMPLETEDAnalyzing Retinal Microanatomy in ROP
NCT02898298Not specifiedCOMPLETEDPositive Emotion Regulation Training in Children, Adolescents and Young Adults With and Without Developmental Disorder
NCT02912780Not specifiedUNKNOWNIntroduction of Microsystems in a Level 3 Neonatal Intensive Care Unit
NCT03023293Not specifiedCOMPLETEDn-3 PUFAs, Irisin and Maternal Glucose Metabolism From Pregnancy to Postpartum
NCT03023644Not specifiedCOMPLETEDImproving Neurodevelopmental Outcomes in Children With Congenital Heart Disease: An Intervention Study
NCT03032991Not specifiedUNKNOWNEarly Biomarkers of Neurodevelopment in Offspring of Diabetic Mothers
NCT03088189Not specifiedTERMINATEDEffect of Parental Peri-conceptional Vitamin B12 Supplementation on Infant Neurocognitive Development in Offspring
NCT03096028Not specifiedCOMPLETEDDevelopmental Origins of Mental Health Disorders
NCT03148782Not specifiedCOMPLETEDBrain Plasticity Underlying Acquisition of New Organizational Skills in Children-R61 Phase
NCT03172104Not specifiedCOMPLETEDNeurobehavioural Development of Infants Born <30 Weeks Gestational Age Between Birth and Five Years of Age
NCT03222375Not specifiedRECRUITINGSQUED™ Series 28.1 Home-use and Treatment of Autowave Reverberator of Autism
NCT03229928Not specifiedCOMPLETEDClinical Testing of a Real-Time Behavior Measurement Tool: Measuring Outcomes for CHAnge
NCT03232489Not specifiedUNKNOWNStudy for the Evaluation of the Feasibility of Applying Advanced MRI Scanning in Pediatric Clinical Practice