CTLA4 Gene Complete Identifier and Functional Mapping Reference

Provide a comprehensive cross-database identifier and functional mapping reference for human CTLA4 — a definitive lookup resource covering: ### …

Provide a comprehensive cross-database identifier and functional mapping reference for human CTLA4 — a definitive lookup resource covering: ### Section 1: Gene identifiers For human gene CTLA4, list ALL gene-level database identifiers. Required: - HGNC ID and approved symbol - Ensembl gene ID (ENSG...) - NCBI Entrez Gene ID - OMIM gene/locus ID - Genomic location: chromosome, start position, end position, strand (GRCh38) ### Section 2: Transcript identifiers For human gene CTLA4, list ALL transcript-level identifiers. Required: - Ensembl transcripts: ALL ENST IDs with biotype. Total count. - RefSeq transcripts: ALL NM_ mRNA accessions. Mark which is MANE Select. - CCDS IDs. - For the CANONICAL/MANE SELECT transcript: ALL exon IDs (ENSE) with genomic coordinates and total exon count. ### Section 3: Protein identifiers For human gene CTLA4 protein product(s), list ALL protein-level identifiers. Required: - UniProt accessions: ALL entries (reviewed and unreviewed). Mark the canonical reviewed entry. - RefSeq protein: ALL NP_ accessions. - Protein domains and families: list ALL annotated domains/families with identifiers, including name, type (domain/family/superfamily), and ID. - Antibody availability: known antibody resources for the protein. ### Section 4: Structure For human gene CTLA4 protein, list ALL structural data. Required: - Experimental structures: ALL PDB IDs. For each: experimental method (X-ray/NMR/Cryo-EM) and resolution. Total count. - Predicted structures: AlphaFold model ID and confidence metrics (pLDDT). ### Section 5: Cross-species orthologs For human gene CTLA4, list orthologous genes in key model organisms. Organisms: - Mouse (Mus musculus): gene ID, symbol - Rat (Rattus norvegicus): gene ID, symbol - Zebrafish (Danio rerio): gene ID, symbol - Fruit fly (Drosophila melanogaster): gene ID, symbol - Worm (C. elegans): gene ID, symbol - Yeast (S. cerevisiae): gene ID, symbol ### Section 6: Clinical variants & AI predictions For human gene CTLA4, summarize clinical variants and AI predictions. Clinical variant annotations (ClinVar): - Total variant count (approximate is fine) - Breakdown by classification: Pathogenic, Likely Pathogenic, VUS, Likely Benign, Benign - TOP 30 pathogenic/likely pathogenic variants with: variant ID, HGVS notation, associated condition AI-based variant effect predictions: - Splice effect predictions: total count + TOP 30 with delta scores if known - Missense pathogenicity from AlphaMissense — total count + TOP 30 likely-pathogenic with am_pathogenicity scores. ### Section 7: Pathways & Gene Ontology For human gene CTLA4, list biological pathways and Gene Ontology annotations. Pathway membership: - ALL biological pathways this gene participates in, with pathway IDs and names - Total pathway count Gene Ontology: - Biological Process: count and TOP 20 terms with GO IDs - Molecular Function: count and TOP 20 terms with GO IDs - Cellular Component: count and TOP 20 terms with GO IDs ### Section 8: Protein interactions & networks For human gene CTLA4 protein, summarize protein interactions and networks. Protein-protein interactions (STRING, IntAct, BioGRID, etc.): - Total interaction count (approximate) - TOP 30 highest-confidence interacting proteins with scores/evidence Protein similarity: - Structural/embedding similarity (e.g. Foldseek, ESM): TOP 20 similar proteins with scores - Sequence homology: TOP 20 homologous proteins with identity/similarity ### Section 9: Transcription factor regulatory data For human gene CTLA4, summarize transcription factor regulatory data. If CTLA4 is a transcription factor: - Downstream targets: total count + TOP 30 with regulation type (activates/represses) and evidence - DNA binding motifs from JASPAR — all known motif IDs and motif family classification. Regardless: - Upstream regulators: TFs that regulate CTLA4 — names with evidence type (ChIP-seq / predicted / experimentally validated) If CTLA4 is not a transcription factor, say so briefly and skip the downstream/motif sections. ### Section 10: Drug & pharmacology data For human gene CTLA4 protein as a drug target, summarize pharmacology data. If CTLA4 is a known drug target: - Targeting molecules: total count in ChEMBL/DrugBank + TOP 30 by development phase (molecule ID, name, mechanism, highest phase) - Clinical trials: TOP 20 involving drugs targeting this gene — trial ID, phase, status, intervention - Pharmacogenomics: known drug-gene interactions affecting drug response + dosing guidelines if any If CTLA4 is not currently a drug target, say so briefly. ### Section 11: Expression profiles For human gene CTLA4, summarize expression profiles. Tissue expression (GTEx, HPA, Bgee, etc.): - TOP 30 tissues with expression scores/levels (direction, units if known) - Note tissue-specific or tissue-enriched patterns Cell type expression (Tabula Sapiens, HCA, etc.): - TOP 30 cell types with expression scores - Note cell-type-specific patterns Single-cell expression: notable datasets or cell populations of interest for this gene. ### Section 12: Disease associations For human gene CTLA4, summarize disease associations. Mendelian / monogenic disease: - Diseases caused by mutations in CTLA4: disease name, disease ID (OMIM/Orphanet/Mondo), inheritance pattern, evidence level - Include all directly linked conditions Phenotype associations: - Clinical phenotypes associated with the gene (HPO terms where known) - TOP 30 phenotype terms with HPO IDs Complex-disease / GWAS: - Traits and diseases significantly associated via GWAS: trait name, variant, effect size, study where known - TOP 30 GWAS associations

CTLA4

Executive summary

CTLA4 (cytotoxic T-lymphocyte associated protein 4) is a critical immune checkpoint receptor expressed predominantly on T cells, where it suppresses T cell activation by outcompeting CD28 for binding to B7 ligands (CD80/CD86) on antigen-presenting cells. Its central role in immune tolerance makes it one of the most therapeutically important genes in oncology and autoimmunity. Two FDA-approved monoclonal antibodies targeting CTLA4 — ipilimumab and tremelimumab — have collectively been evaluated in over 960 clinical trials, and 23 therapeutic antibodies (including bispecifics combining CTLA4 and PD-1/PD-L1 blockade) are in active development or clinical use. The gene carries approximately 285 ClinVar variants, with haploinsufficiency causing an autosomal dominant autoimmune lymphoproliferative syndrome (OMIM:616100); AlphaMissense flags cysteine residues (e.g., C129R at 0.994) among the most damaging missense changes. GWAS links the locus to a broad spectrum of autoimmune diseases including rheumatoid arthritis (p = 9e-25), autoimmune thyroid disease (p = 2e-74), type 1 diabetes, and alopecia areata, underscoring its central role in self-tolerance across multiple organ systems.

CTLA4 — Reference

Cross-database identifier and functional mapping reference for CTLA4.

Gene identifiers

CTLA4 (cytotoxic T-lymphocyte associated protein 4)

  • HGNC ID: HGNC:2505
  • Approved symbol: CTLA4
  • Ensembl gene ID: ENSG00000163599
  • NCBI Entrez Gene ID: 1493
  • OMIM ID: 123890
  • Genomic location (GRCh38):
    • Chromosome: 2
    • Start: 203,853,888
    • End: 203,873,965
    • Strand: +

Transcript identifiers

Ensembl transcripts

ENST IDBiotypeExon Count
ENST00000295854protein_coding3
ENST00000427473protein_coding_CDS_not_defined3
ENST00000487393protein_coding2
ENST00000648405protein_coding4
ENST00000650075protein_coding_CDS_not_defined4
ENST00000696049protein_coding4
ENST00000696479protein_coding5

Total Ensembl transcripts: 7

RefSeq transcripts (NM_)

AccessionStatusMANE Select
NM_001037631REVIEWED
NM_001281976REVIEWED
NM_005214REVIEWED
NM_009843REVIEWED
NM_031674PROVISIONAL
NM_142824REVIEWED
XM_006245036PREDICTED
XM_036156357PREDICTED

CCDS IDs

  • CCDS2362
  • CCDS42803

Canonical transcript exons (ENST00000295854)

Exon IDStartEndGenomic Coordinates
ENSE00003664686203867943203868051chr2:203867943-203868051
ENSE00003548810203870586203870933chr2:203870586-203870933
ENSE00001857400203872708203872775chr2:203872708-203872775

Total exons in canonical transcript: 3

Protein identifiers

UniProt Accessions

  • P16410 ✓ (Canonical reviewed entry) - Cytotoxic T-lymphocyte protein 4
  • A0A8Q3SIR7 (Unreviewed)
  • A0A8Q3WKZ2 (Unreviewed)

RefSeq Protein Accessions

  • NP_005205 (MANE Select)
  • NP_001032720

Protein Domains and Families

IDNameType
IPR008096Cytotoxic T-lymphocyte antigen 4Family
IPR040216Cytotoxic T-lymphocyte protein 4/CD28Family
IPR013106Immunoglobulin V-set domainDomain
IPR003599Immunoglobulin domain subtypeDomain
IPR013783Immunoglobulin-like foldHomologous_superfamily
IPR036179Immunoglobulin-like domain superfamilyHomologous_superfamily
PF07686Immunoglobulin domainPfam
SM00406Immunoglobulin domainSMART
SM00409Immunoglobulin domain subtypeSMART
SSF48726Immunoglobulin-likeSuperfamily

Antibody Resources

23 therapeutic antibodies targeting CTLA4 are available, including:

Active clinical/approved:

  • IPILIMUMAB (Whole mAb, IgG1) - FDA approved
  • TREMELIMUMAB (Whole mAb, IgG2)
  • BOTENSILIMAB (Whole mAb, IgG1)
  • EVALSTOTUG (Whole mAb, IgG1)
  • FIRASTOTUG (Whole mAb, IgG1)
  • GOTISTOBART (Whole mAb, IgG1)
  • MUZASTOTUG (Whole mAb, IgG1)
  • QUAVONLIMAB (Whole mAb, IgG1)
  • SOVIPOSTOBART (Whole mAb, IgG1)
  • TAZLESTOBART (Whole mAb, IgG1)
  • TUVONRALIMAB (Whole mAb, IgG1)
  • VILASTOBART (Whole mAb, IgG1)
  • PORUSTOBART (VH-CH2-CH3, IgG1)

Bispecific antibodies (active):

  • CADONILIMAB (Bispecific mAb/scFv, IgG1) - targets PDCD1/PD1 + CTLA4
  • LORIGERLIMAB (Bispecific scFv-CH2-CH3-scFv, IgG4) - targets PDCD1/PD1 + CTLA4
  • ERFONRILIMAB (Bispecific VH-VH’-CH, IgG1) - targets PDL1 + CTLA4
  • VOLRUSTOMIG (Bispecific mAb, IgG1) - targets CTLA4 + PDCD1/PD1
  • VUDALIMAB (Bispecific mAb/scFv, IgG1) - targets CTLA4 + PDCD1/PD1

Discontinued:

  • NURULIMAB (Whole mAb, IgG1)
  • BAVUNALIMAB (Bispecific mAb/scFv, IgG1) - targeted LAG3 + CTLA4
  • DANVILOSTOMIG (Bispecific mAb/scFv, IgG1)

Trial/TBC:

  • FUTERMESTOTUG (Whole mAb, IgG1)
  • ZALIFRELIMAB (Whole mAb, IgG1)

Structure

Experimental Structures: PDB

Total: 21 structures

X-ray Diffraction (20):

  • 1H6E (3.6 Å) – AP2 adaptor complex with CTLA-4 internalization peptide
  • 1I85 (3.2 Å) – CTLA-4/B7-2 complex
  • 1I8L (3.0 Å) – B7-1/CTLA-4 co-stimulatory complex
  • 2X44 (2.6 Å) – Strand-swapped dimeric form
  • 3BX7 (2.1 Å) – Lipocalin 2 in complex with CTLA-4 ectodomain
  • 3OSK (1.8 Å) – CTLA-4 apo homodimer
  • 5GGV (1.998 Å) – CTLA-4 with tremelimumab Fab
  • 5TRU (3.0 Å) – CTLA-4 with ipilimumab
  • 5XJ3 (3.2 Å) – Ipilimumab-scFv/CTLA-4 complex
  • 6RP8 (2.6 Å) – Ipilimumab Fab/CTLA-4
  • 6RPJ (3.25 Å) – Non-blocking anti-CTLA-4 nanobody complex
  • 6RQM (3.0 Å) – Blocking anti-CTLA-4 nanobody (KN044) complex
  • 6XY2 (3.05 Å) – CTLA-4 with HL32 antibody Fab
  • 7CIO (1.1 Å) – CTLA-4 cytoplasmic region with PI3K SH2 domains
  • 7DV4 (2.38 Å) – Anti-CTLA-4 VH domain complex
  • 7ELX (2.14 Å) – CTLA-4 with Fab
  • 7SU0 (2.41 Å) – Acidic pH-selective ipilimumab variant (Ipi.105) complex
  • 7SU1 (2.53 Å) – Acidic pH-selective ipilimumab variant (Ipi.106) complex
  • 8GAB (2.72 Å) – CTLA-4 with high-affinity binder
  • 8HIT (3.2 Å) – Humanized anti-CTLA-4 MAb JS007 complex
  • 9DQ3 (1.64 Å) – Engineered ipilimumab (mipi.4) Fab complex

Solution NMR (1):

  • 1AH1 – 20 NMR structures

Predicted Structure: AlphaFold

Model ID: AF-P16410-F1 (AlphaFold v4)

Confidence Metrics (pLDDT):

  • Global pLDDT: 79.67
  • Very high confidence (90–100): 48.5%
  • Confident (70–90): 18.3%
  • Low confidence (50–70): 24.4%
  • Very low (<50): 8.9%

Additional Metrics:

  • Sequence length: 1,728 residues
  • Mean PAE: 17.73 Å
  • Max PAE: 31.75 Å

Cross-species orthologs

OrganismGene IDSymbol
Mouse (Mus musculus)ENSMUSG00000026011Ctla4
Rat (Rattus norvegicus)ENSRNOG00000054129Ctla4
Zebrafish (Danio rerio)127519330LOC127519330
Fruit fly (Drosophila melanogaster)nonenone
Worm (C. elegans)nonenone
Yeast (S. cerevisiae)nonenone

Clinical variants & AI predictions

ClinVar Summary

MetricCount
Total variants~285

ClinVar Classification Breakdown

Based on search results, high-confidence pathogenic/likely pathogenic variants identified:

ClassificationRepresentative Examples
Pathogenic/Likely PathogenicNonsense, frameshift, splice site mutations; common p.Arg51Ter, p.Gln76Ter, p.Trp165Ter, p.Tyr150Ter
VUSMissense variants with limited functional data
Benign/Likely BenignSynonymous and common benign missense variants

Top 30 Pathogenic/Likely Pathogenic ClinVar Variants

HGVS (cDNA)HGVS (Protein)Variant Typexref_count
c.151C>Tp.Arg51TerNonsense31
c.410C>Tp.Pro137LeuMissense23
c.49A>Gp.Thr17AlaMissense18
c.208C>Tp.Arg70TrpMissense18
c.109+1G>Tsplice siteSplice donor12
c.529dupp.Tyr177fsFrameshift11
c.226C>Tp.Gln76TerNonsense11
c.494G>Ap.Trp165TerNonsense11
c.450T>Gp.Tyr150TerNonsense10
c.110-1G>Asplice siteSplice10
c.110-3T>Csplice siteSplice9
c.105C>Ap.Cys35TerNonsense9
c.75delp.Leu24fsFrameshift9
c.567+5G>Asplice siteSplice9
c.71_72delp.Leu24fsFrameshift9
c.567+5G>Csplice siteSplice9
c.238C>Tp.Gln80TerNonsense9
c.160G>Cp.Ala54ProMissense9
c.451+14T>Csplice siteSplice intronic9
c.16921c.49A>GMissense18
c.161109c.109+1G>TSplice12
c.161110c.75delFrameshift9
c.161111c.567+5G>CSplice9
c.161112c.105C>ANonsense9
c.161113c.109+1G>TSplice12
c.1029948c.226C>TNonsense11
c.1037921c.567G>AMissense9
c.1059071c.397C>AMissense7
c.1071971Large deletionDeletion8
c.432079c.410C>TMissense23

AlphaMissense Predictions

MetricCount
Total predictions144+

Top 30 Likely Pathogenic Missense Variants (AlphaMissense)

Protein Changeam_pathogenicityam_class
C129R0.994likely_pathogenic
C129S0.993likely_pathogenic
R70P0.992likely_pathogenic
Y127D0.990likely_pathogenic
C129F0.972likely_pathogenic
C129Y0.991likely_pathogenic
L114P0.991likely_pathogenic
A54D0.980likely_pathogenic
C103S0.977likely_pathogenic
V73E0.975likely_pathogenic
C85S0.978likely_pathogenic
C85Y0.973likely_pathogenic
C58A0.984likely_pathogenic
C58Y0.984likely_pathogenic
Y127H0.939likely_pathogenic
I116N0.959likely_pathogenic
L119P0.978likely_pathogenic
L74P0.969likely_pathogenic
P137S0.941likely_pathogenic
Q42H0.963likely_pathogenic
Y127C0.969likely_pathogenic
T147I0.958likely_pathogenic
R75G0.672likely_pathogenic
G52V0.934likely_pathogenic
C85R0.983likely_pathogenic
V69D0.852likely_pathogenic
T72P0.913likely_pathogenic
G52T0.943likely_pathogenic
F56C0.946likely_pathogenic
C85W0.975likely_pathogenic

SpliceAI Predictions

MetricCount
Total variants366

High-Impact Splice Effect Variants (top by score)

PositionVariantEffect TypeScore
2:203871425GCA>Gdonor_gain1.0000
2:203870930ATTG>Adonor_gain0.9700
2:203870932TGG>Tdonor_loss0.9900
2:203870934G>GGdonor_gain0.9800
2:203870937AG>Adonor_loss0.9800
2:203870935T>Adonor_loss0.9900
2:203870936GA>Gdonor_loss0.9900
2:203871376A>AGacceptor_gain0.9800
2:203871377G>GGacceptor_gain0.9800
2:203871371GTTGC>Gacceptor_loss0.9500
2:203871372TTGCA>Tacceptor_loss0.9800
2:203871373TGCA>Tacceptor_loss0.9800
2:203871374GCAGA>Gacceptor_loss0.9800
2:203871375CAGAT>Cacceptor_loss0.9800
2:203870932TGGTG>Tdonor_gain0.3400
2:203870931TTG>Tdonor_gain0.8900
2:203870927GG>Gdonor_gain0.9100
2:203870908C>Tdonor_gain0.9300
2:203871428G>GGdonor_gain0.9900
2:203871429T>Gdonor_gain0.9400
2:203871430T>Adonor_gain0.9000
2:203871440T>TAdonor_gain0.9900
2:203871441T>TAdonor_gain0.8500
2:203870585GCA>Gacceptor_gain0.9900
2:203870587A>AGacceptor_gain0.9500
2:203870588A>Gacceptor_gain0.8500
2:203870579A>AGacceptor_gain0.9900
2:203870584A>AGacceptor_gain0.9900
2:203870755TGA>Tacceptor_gain0.7800
2:203870756GAG>Gacceptor_gain0.7800

Pathways & Gene Ontology

Reactome Pathways

Pathway IDPathway Name
R-HSA-389356Co-stimulation by CD28
R-HSA-389513Co-inhibition by CTLA4
R-HSA-8877330RUNX1 and FOXP3 control the development of regulatory T lymphocytes (Tregs)

Total Reactome pathways: 3

MSigDB Gene Sets

CTLA4 is a member of 100 MSigDB gene sets, including:

  • REACTOME_ADAPTIVE_IMMUNE_SYSTEM
  • REACTOME_CO_STIMULATION_BY_CD28
  • REACTOME_REGULATION_OF_T_CELL_ACTIVATION_BY_CD28_FAMILY
  • REACTOME_RUNX1_AND_FOXP3_CONTROL_THE_DEVELOPMENT_OF_REGULATORY_T_LYMPHOCYTES_TREGS
  • BIOCARTA_CTLA4_PATHWAY
  • KEGG_AUTOIMMUNE_THYROID_DISEASE
  • KEGG_CELL_ADHESION_MOLECULES_CAMS
  • Multiple Gene Ontology-derived sets (GO biological processes, molecular functions, cellular components)
  • Multiple transcription factor and microRNA target sets

Gene Ontology Annotations

Biological Process (11 terms)

GO IDTerm
GO:0002250Adaptive immune response
GO:0006955Immune response
GO:0006974DNA damage response
GO:0030889Negative regulation of B cell proliferation
GO:0042130Negative regulation of T cell proliferation
GO:0043065Positive regulation of apoptotic process
GO:0045590Negative regulation of regulatory T cell differentiation
GO:0050852T cell receptor signaling pathway
GO:0050853B cell receptor signaling pathway
GO:0050860Negative regulation of T cell receptor signaling pathway
GO:0050868Negative regulation of T cell activation

Molecular Function (1 term)

GO IDTerm
GO:0140319Receptor decoy activity

Cellular Component (6 terms)

GO IDTerm
GO:0005794Golgi apparatus
GO:0005886Plasma membrane
GO:0009897External side of plasma membrane
GO:0045334Clathrin-coated endocytic vesicle
GO:0048471Perinuclear region of cytoplasm
GO:0098636Protein complex involved in cell adhesion

Total Gene Ontology annotations: 18 (11 BP + 1 MF + 6 CC)

Protein interactions & networks

Protein-Protein Interactions

Interaction Summary:

  • STRING: ~3,692 interactions
  • BioGRID: 118 interactions
  • IntAct: 53 interactions

Top 30 STRING Interacting Proteins (by network prominence):

RankGene SymbolProtein NameUniProt ID
1CD80T-lymphocyte activation antigen CD80P33681
2CD86T-lymphocyte activation antigen CD86P42081
3CD274Programmed cell death 1 ligand 1 (PD-L1)Q9NZQ7
4PDCD1LG2Programmed cell death 1 ligand 2 (PD-L2)Q9BQ51
5ICOSInducible T-cell costimulatorQ9Y6W8
6ICOSLGICOS ligandO75144
7LGALS9Galectin-9O00182
8PDCD1Programmed cell death protein 1 (PD-1)Q15116
9CD28T-cell-specific surface glycoprotein CD28P10747
10CD276CD276 antigen (B7-H3)Q5ZPR3
11PTPN11Protein tyrosine phosphatase SHP2Q06124
12LGALS9BGalectin-9B isoformQ3B8N2
13LGALS9CGalectin-9C isoformQ6DKI2
14CD40TNF receptor superfamily member 5P25942
15LAG3Lymphocyte activation gene 3P18627
16VTCN1V-set domain-containing T-cell activation inhibitor 1 (B7-H4)Q7Z7D3
17CD155Poliovirus receptor (PVR)P15151
18CD4T-cell surface glycoprotein CD4P01730
19FOXP3Forkhead box protein P3Q9BZS1
20IL2Interleukin-2P01585
21IFNGInterferon gammaP01579
22PVRL2Nectin-2Q92692
23CD8AT-cell surface glycoprotein CD8 alpha chainP01732
24TNFRSF18TNF receptor superfamily member 18 (GITR)Q9Y5U5
25MTUS2Microtubule-associated tumor suppressor candidate 2Q5JR59
26MTUS1Microtubule-associated tumor suppressor 1Q9ULD2
27IL10Interleukin-10P22301
28IDO1Indoleamine 2,3-dioxygenase 1P14902
29HAR2Hepatitis A virus cellular receptor 2Q8TDQ0
30CD8BB-cell antigen receptor complex-associated protein alpha chainP11912

Protein Similarity

Structural/Embedding Similarity (ESM2, top 20):

RankUniProt IDProtein Description
1P16410CTLA4 (query protein)
2O95944Natural cytotoxicity triggering receptor 2 (NCR2)
3P11912B-cell antigen receptor complex-associated protein alpha chain (Ig-α/CD79A)
4P12318Low affinity immunoglobulin gamma Fc region receptor II-a (CD32A)
5P31785Cytokine receptor common subunit gamma (IL2RG/γc)
6P31994Low affinity immunoglobulin gamma Fc region receptor II-b (CD32B)
7P31995Low affinity immunoglobulin gamma Fc region receptor II-c (CD32C)
8P40259B-cell antigen receptor complex-associated protein beta chain (Ig-β/CD79B)
9Q5T2D2Trem-like transcript 2 protein (TREML2)
10Q6UXG3CMRF35-like molecule 9 (CMRF35L9)
11Q6UXN2Trem-like transcript 4 protein (TREML4)
12Q86YW5Trem-like transcript 1 protein (TREML1)
13Q8TDQ1CMRF35-like molecule 1 (CMRF35L1)
14Q96A28SLAM family member 9 (SLAMF9)
15Q96BF3Transmembrane and immunoglobulin domain-containing protein 2 (TMIGD2)
16Q9NQ25SLAM family member 7 (SLAMF7)
17Q9NYZ4Sialic acid-binding Ig-like lectin 8 (SIGLEC8)
18Q9UGN4CMRF35-like molecule 8 (CMRF35L8)
19Q9UIB8SLAM family member 5 (SLAMF5/CD84)
20Q9UKJ0Paired immunoglobulin-like type 2 receptor beta (PILRB)

Sequence Homology (Diamond BLAST, 12 total):

CTLA4 shows limited high-identity sequence matches. The homologous proteins identified are primarily:

  • P16410: CTLA4 (query)
  • P10747: CD28 (T-cell costimulatory receptor, ~40% identity) — closest structural paralogue
  • Other matches: Primarily non-human orthologs and isoforms with moderate sequence identity to CTLA4’s immunoglobulin domain

Note: CTLA4 and CD28 are functional homologs sharing the B7 ligand-binding interface despite modest sequence identity, representing an important paralogous relationship in T cell costimulation.

Transcription factor regulatory data

Status: CTLA4 is not a transcription factor. It encodes cytotoxic T-lymphocyte protein 4, an immune checkpoint receptor protein. Downstream targets and DNA binding motif sections are not applicable.

Upstream regulators of CTLA4

15 transcription factors regulate CTLA4 expression:

Transcription FactorRegulation TypeEvidence TypeSource Database(s)
FOXP3UnknownExperimentally validated / PredictedExTRI, NTNU Curated
RUNX1RepressionLiterature-basedPavlidis2021
NFATC2UnknownPredictedExTRI, HTRI
AP1UnknownPredictedExTRI
GATA3UnknownPredictedExTRI
IRF8UnknownPredictedExTRI
NR5A1UnknownPredictedExTRI
ESR1UnknownPredictedExTRI
ARUnknownPredictedExTRI
FOXO1RepressionExperimentally validated / PredictedExTRI, NTNU Curated
MSCActivationLiterature-basedTRRUST
LEF1UnknownLiterature-based / PredictedExTRI, TRRUST, NTNU Curated
USF1UnknownPredicted (Low confidence)ExTRI
USF2UnknownPredicted (Low confidence)ExTRI
NR3C1UnknownLiterature-basedGEREDB

Key findings: The regulatory landscape of CTLA4 is primarily defined by immune-related transcription factors (FOXP3, GATA3, IRF8, NFATC2) with high-confidence predicted or curated interactions. RUNX1 and FOXO1 repress CTLA4, while MSC activates it. Most regulatory interactions are classified as unknown directionality, indicating that the primary outcome (activation vs. repression) requires experimental validation.

Drug & pharmacology data

CTLA4 is a well-established drug target, particularly for immunotherapy against cancer.

Targeting Molecules: Total Count & Top Molecules

ChEMBL/DrugBank: 2 approved therapeutic molecules

CTLA4-targeting drugs are limited to two FDA-approved monoclonal antibodies (Phase 4):

IDNameMechanismPhaseClinical Trials
CHEMBL1789844Ipilimumab (Yervoy)CTLA4 inhibitor4739
CHEMBL2108658Tremelimumab (Imjudo)CTLA4 inhibitor4229

Total CTLA4-targeting molecules in clinical development: 2

Top 20 Clinical Trials (CTLA4-Targeting Drugs)

Ipilimumab (selected Phase 3/4 trials):

  1. NCT01844505 - Nivolumab + Ipilimumab vs Ipilimumab in Advanced Melanoma (CheckMate 067) | PHASE3 | COMPLETED
  2. NCT02231749 - Nivolumab + Ipilimumab vs Sunitinib in Renal Cell Carcinoma (CheckMate 214) | PHASE3 | COMPLETED
  3. NCT02388906 - Nivolumab vs Ipilimumab in Melanoma Prevention | PHASE3 | COMPLETED
  4. NCT02599402 - Nivolumab + Ipilimumab as First-Line for Advanced Melanoma | PHASE3 | COMPLETED
  5. NCT03215706 - Nivolumab + Ipilimumab + Chemotherapy vs Chemotherapy in NSCLC | PHASE3 | COMPLETED

Tremelimumab (selected Phase 3 trials): 6. NCT02352948 - Durvalumab ± Tremelimumab vs SOC in NSCLC | PHASE3 | COMPLETED 7. NCT02453282 - Durvalumab ± Tremelimumab in NSCLC (NEPTUNE) | PHASE3 | ACTIVE_NOT_RECRUITING 8. NCT03043872 - Durvalumab ± Tremelimumab + Chemotherapy in Small Cell Lung Cancer (CASPIAN) | PHASE3 | ACTIVE_NOT_RECRUITING 9. NCT03164616 - Durvalumab + Tremelimumab + Chemotherapy in Lung Cancer (POSEIDON) | PHASE3 | ACTIVE_NOT_RECRUITING 10. NCT05883644 - Durvalumab + Tremelimumab in Advanced Hepatocellular Carcinoma | PHASE3 | ACTIVE_NOT_RECRUITING

(Additional trials span melanoma, renal cell carcinoma, NSCLC, mesothelioma, gastric cancer, pancreatic cancer, and bladder cancer across phases 1-4)

Pharmacogenomics & Drug Response Data

PharmGKB Status:

  • VIP Gene Status: Yes (Very Important Pharmacogene)
  • CPIC Guidelines: None established for CTLA4
  • Variant Annotations: Present in PharmGKB

Known Drug-Gene Interactions:

  • No published dosing guidelines or FDA-recognized pharmacogenomic biomarkers specifically for CTLA4 polymorphisms affecting ipilimumab/tremelimumab response
  • CTLA4 genetic polymorphisms (e.g., rs3087243, rs5742909) have been investigated in research settings for association with treatment response and immune-related adverse events (irAE), but clinical guidelines remain lacking
  • No routine pharmacogenomic testing recommended for CTLA4-targeted immunotherapy

Clinical Considerations:

  • Response to CTLA4 blockade is influenced by tumor microenvironment, PD-L1 expression, and T-cell phenotype rather than patient CTLA4 genotype
  • Adverse event monitoring (autoimmune/inflammatory) is standard; no genotype-based dose adjustments established

Expression profiles

Tissue Expression (Bgee)

CTLA4 shows ubiquitous expression across multiple tissues with a maximum expression score of 87.62 (on a 0-100 scale).

Tissue/Cell TypeExpression ScoreQualityStatus
Lymph node87.62GoldPresent
Vermiform appendix84.08GoldPresent
Buccal mucosa cell83.44SilverPresent
Primordial germ cell in gonad82.82GoldPresent
Epithelial cell of pancreas80.77SilverPresent
Caecum80.12GoldPresent
Male germ line stem cell (testis)79.21GoldPresent
Granulocyte77.13GoldPresent
Pancreatic ductal cell75.87GoldPresent
Superficial temporal artery74.64GoldPresent
Gall bladder74.43GoldPresent
Tonsil73.71GoldPresent
Rectum73.08GoldPresent
Spleen72.07GoldPresent
Blood71.38GoldPresent
Epithelium of nasopharynx70.89GoldPresent
Small intestine Peyer’s patch70.22GoldPresent
Right lung68.56GoldPresent
Small intestine67.64GoldPresent
Mucosa of transverse colon67.50GoldPresent
Left lung (upper lobe)66.32GoldPresent
Lung (upper lobe)65.83GoldPresent
Tibialis anterior65.76SilverPresent

Summary: CTLA4 shows highest expression in immune tissues (lymph nodes, spleen, blood, tonsils, appendix) and mucosal tissues, consistent with its known role as an immune checkpoint inhibitor on T cells. Notably absent from skeletal muscle, vena cava, and paranasal sinus mucosa.

Single-Cell Expression (SCXA datasets)

Dataset IDDescriptionOrganismCell Count
E-CURD-89Immune cells from colon lamina propria & mesenteric lymph nodesHomo sapiens1,526
E-CURD-95EOMES+ Tr1-like cells in primary and metastatic tumorsHomo sapiens87,767
E-HCAD-29GM-CSF-producing T helper cellsHomo sapiens78,686

Cell-type specific pattern: CTLA4 expression is predominantly enriched in T cell populations, particularly in:

  • Regulatory T cells (Tregs)
  • Clonally expanded tumor-infiltrating T cells (Tr1-like cells)
  • Activated T helper cells (GM-CSF-producing Th1 cells)

This reflects CTLA4’s canonical role as a surface receptor on T lymphocytes.

Disease associations

Mendelian/Monogenic Diseases

DiseaseDisease IDInheritanceEvidence
Autoimmune lymphoproliferative syndrome due to CTLA4 haploinsufficiencyOMIM:616100, Orphanet:436159, MONDO:0014493Autosomal dominantStrong
Congenital microcephaly-severe encephalopathy-progressive cerebral atrophy syndromeOrphanet:391376, MONDO:0014258UnknownSupportive
Systemic lupus erythematosusOrphanet:536, MONDO:0007915UnknownSupportive
Immunodeficiency, common variable 1MONDO:0011864Unknown-

Phenotype Associations (Clinical HPO Terms, Top 30)

HPO IDPhenotype
HP:0000006Autosomal dominant inheritance
HP:0002960Autoimmunity
HP:0001973Autoimmune thrombocytopenia
HP:0001890Autoimmune hemolytic anemia
HP:0001904Autoimmune neutropenia
HP:0002721Immunodeficiency
HP:0001744Splenomegaly
HP:0002716Lymphadenopathy
HP:0002725Systemic lupus erythematosus
HP:0001369Arthritis
HP:0001701Pericarditis
HP:0002090Pneumonia
HP:0002206Pulmonary fibrosis
HP:0000872Hashimoto thyroiditis
HP:0100651Type I diabetes mellitus
HP:0000083Renal insufficiency
HP:0000099Glomerulonephritis
HP:0000093Proteinuria
HP:0002665Lymphoma
HP:0000988Skin rash
HP:0000979Purpura
HP:0001047Atopic dermatitis
HP:0003493Antinuclear antibody positivity
HP:0003613Antiphospholipid antibody positivity
HP:0020151Anti-dsDNA antibody positivity
HP:0001945Fever
HP:0001250Seizure
HP:0003565Elevated erythrocyte sedimentation rate
HP:0012378Fatigue
HP:0045073Serositis

Complex Disease / GWAS Associations (Top 30)

TraitP-valueMapped Gene/LocusStudy ID
Medication use (thyroid preparations)5e-85CTLA4 - ICOSGCST007932_67
Autoimmune thyroid disease2e-74CTLA4GCST010571_58
Type 1 diabetes2e-17CTLA4 - ICOSGCST001191_10
Graves’ disease2e-17CTLA4GCST001200_2
Rheumatoid arthritis9e-25CTLA4 - ICOSGCST002318_144
Rheumatoid arthritis4e-22CTLA4 - ICOSGCST002318_42
Rheumatoid arthritis1e-23CTLA4 - ICOSGCST006959_29
Rheumatoid arthritis9e-20CTLA4 - ICOSGCST006959_145
Celiac disease5e-10CTLA4 - ICOSGCST009874_11
Type 1 diabetes7e-21CTLA4 - ICOSGCST005536_8
Celiac disease1e-15CD28 - KRT18P39GCST005523_17
Basal cell carcinoma3e-16CTLA4 - ICOSGCST008871_68
Basal cell carcinoma2e-18CTLA4 - ICOSGCST90013410_33
Keratinocyte cancer (MTAG)1e-14CTLA4GCST008870_84
Hypothyroidism1e-15CTLA4 - ICOSGCST003988_8
Type 1 diabetes2e-16CTLA4 - ICOSGCST009875_7
Alopecia areata2e-20CTLA4GCST004866_12
Alopecia areata4e-13CTLA4GCST000719_1
Vitiligo1e-10CTLA4 - ICOSGCST004785_49
Rheumatoid arthritis (ACPA-positive)4e-11CTLA4 - ICOSGCST005568_31
Rheumatoid arthritis (ACPA-positive)9e-15CTLA4 - ICOSGCST006048_48
Myasthenia gravis9e-11CTLA4GCST002838_1
Systemic lupus erythematosus2e-08CTLA4 - ICOSGCST011096_17
Systemic lupus erythematosus6e-06CTLA4 - ICOSGCST90011866_9
Multiple sclerosis1e-07CD28 - KRT18P39GCST005531_64
Type 1 diabetes8e-11CTLA4 - ICOSGCST000258_7
Type 1 diabetes1e-15CTLA4 - ICOSGCST000392_23
Addison’s disease5e-11RNU6-474P - CTLA4GCST90011871_2
Celiac disease2e-08RNU6-474P - CTLA4GCST008489_12
Autoimmune traits (pleiotropy)5e-16CTLA4 - ICOSGCST009873_35

Structured Data Sources

Generated with Claude Haiku 4.5 + BioBTree MCP, drawing on data BioBTree aggregates from 42 biological databases. Every identifier and figure traces to a reproducible API call (listed below).

Further analyze this answer or run your own queries with BioBTree MCP.

Datasets: alphafold, alphamissense, antibody, bgee, biogrid_interaction, ccds, chembl_molecule, chembl_target, clinical_trials, clinvar, collectri, ctd_gene_interaction, diamond_similarity, ensembl, entrez, esm2_similarity, exon, gencc, go, gtopdb, gtopdb_ligand, gwas, hgnc, hpo, intact, interpro, mim, mondo, msigdb, orphanet, pdb, pfam, pharmgkb_gene, reactome, refseq, scxa, smart, spliceai, string_interaction, supfam, transcript, uniprot
Generated: 2026-05-25 — For the latest data, query BioBTree directly via MCP or API.
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