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1
Inheritance
2
Pathophys.
7
Phenotypes
1
Genes
3
Treatments
8
References
2
Deep Research
👪

Inheritance

1
X-linked Dominant
X-linked dominant inheritance. Lethal in most affected males, therefore predominantly affects females. Approximately two-thirds of cases are de novo mutations.
Show evidence (1 reference)
PMID:16397067 SUPPORT
"Oral-facial-digital syndrome type 1 (OFD1) is characterised by an X linked dominant mode of inheritance with lethality in males"
Confirms X-linked dominant inheritance with male lethality.

Pathophysiology

2
Primary Cilia Dysfunction
OFD1 encodes a centrosomal and basal body protein required for primary cilium formation. OFD1 is involved in centriole distal appendage assembly and ciliogenesis. Loss of function disrupts Hedgehog and WNT signaling pathways dependent on primary cilia, leading to defects in craniofacial, limb, brain, and kidney development.
Epithelial Cell link
Cilium Assembly link Hedgehog Signaling link
Primary Cilium link
Show evidence (3 references)
PMID:19876934 SUPPORT
"OFD1 gene that encodes a centrosomal protein localized at the basal bodies at the origin of primary cilia"
Identifies OFD1 as a centrosomal/basal body protein required for primary cilia.
PMID:19876934 SUPPORT
"Ofd1 inactivation is associated to defective sonic hedgehog (Shh) and canonical Wnt signaling pathways"
Demonstrates that OFD1 loss disrupts both Hedgehog and Wnt signaling, explaining pleiotropic developmental defects.
PMID:19876934 SUPPORT
"OFD1 has a crucial role in the biology of primary cilia thus ascribing this pleiotropic disease to the growing number of disorders associated to dysfunction of primary cilia"
Confirms OFD1 as a ciliopathy.
Renal Cystogenesis
Disruption of primary cilia function in renal tubular epithelium leads to polycystic kidney disease, similar to other ciliopathies. Renal involvement is progressive and may lead to renal failure.
Kidney Development link
Kidney link
Show evidence (2 references)
PMID:9482645 SUPPORT
"cystic medullary disease was noted in OFD 1 carriers, leading 1 patient to dialysis by age 35 years and the other to severe renal insufficiency by age 28 years"
Documents progressive renal cystic disease in OFD1 carriers leading to renal failure.
PMID:19876934 SUPPORT
"OFD1 shares phenotypic similarities with this latter group of disorders, such as cystic kidneys, skeletal, and CNS abnormalities"
Confirms cystic kidneys as a shared ciliopathy feature in OFD1.

Phenotypes

7
Genitourinary 1
Polycystic Kidneys Renal cyst (HP:0000107)
Show evidence (3 references)
PMID:16397067 SUPPORT
"polycystic kidney disease, and central nervous system malformations"
Polycystic kidney disease is a recognized feature of OFD1.
PMID:16397067 SUPPORT
"polycystic kidneys and short stature were significantly more frequent in the group with no OFD1 mutation"
Interestingly, polycystic kidneys were more common in clinically diagnosed OFD without confirmed OFD1 mutations, suggesting genetic heterogeneity.
PMID:9482645 SUPPORT
"renal cystic disease is an often overlooked complication specific to OFD 1"
Highlights renal cystic disease as an underappreciated but specific complication of OFD1.
Head and Neck 3
Lobulated Tongue Lobulated tongue (HP:0000180)
Show evidence (2 references)
PMID:16397067 SUPPORT
"lingual hamartomas were significantly more frequent in the group with OFD1 mutation"
Lingual hamartomas (contributing to lobulated tongue) are significantly associated with confirmed OFD1 mutations.
PMID:23033313 SUPPORT
"oral features are the most reliable diagnostic criteria"
Oral features including lobulated tongue are the most diagnostically reliable findings.
Accessory Oral Frenula Accessory oral frenulum (HP:0000191)
Show evidence (1 reference)
PMID:23033313 SUPPORT
"oral features are the most reliable diagnostic criteria"
Accessory oral frenula are among the most reliable diagnostic features of OFD1.
Median Cleft Upper Lip Median cleft upper lip (HP:0000161)
Show evidence (1 reference)
PMID:16397067 SUPPORT
"facial dysmorphism with oral, tooth, and distal abnormalities"
Facial and oral abnormalities including cleft lip are characteristic features.
Limbs 1
Polydactyly Polydactyly (HP:0010442)
Show evidence (2 references)
PMID:16397067 SUPPORT
"facial dysmorphism with oral, tooth, and distal abnormalities"
Distal (digit) abnormalities are part of the OFD1 phenotype.
PMID:19876934 SUPPORT
"OFD1 is characterized by malformation of the oral cavity, face, and digits"
Digit malformations are a cardinal feature of OFD1.
Nervous System 2
Agenesis of Corpus Callosum Agenesis of corpus callosum (HP:0001274)
Show evidence (2 references)
PMID:23033313 SUPPORT
"complete agenesis of the corpus callosum, large single or multiple interhemispheric cysts, striking cortical infolding of gyri, ventriculomegaly, mild molar tooth malformation and moderate to severe cerebellar vermis hypoplasia"
Detailed brain MRI evaluation showing corpus callosum agenesis as part of the complete brain phenotype in OFD1.
PMID:9482645 SUPPORT
"Intracerebral cysts and porencephaly or arachnoid cysts are rarely but are repeatedly reported in orofaciodigital (OFD) syndrome type 1"
CNS malformations including intracranial cysts are recurrently reported.
Intellectual Disability Intellectual disability (HP:0001249)
Show evidence (2 references)
PMID:23033313 SUPPORT
"A first, detailed evaluation of brain MRIs from seven patients with cognitive defects illustrated extensive variability"
Cognitive defects in OFD1 are accompanied by extensive brain structural variability.
PMID:16397067 SUPPORT
"mental retardation and mutations located in exons 3, 8, 9, 13, and 16"
Genotype-phenotype correlation suggests intellectual disability associates with mutations in specific exons.
🧬

Genetic Associations

1
OFD1 Mutations (Causative)
Show evidence (5 references)
PMID:23033313 SUPPORT
"Comprehensive mutation analysis in OFD1 revealed mutations in 37 female patients from 30 families; 22 mutations have not been previously described including two heterozygous deletions spanning OFD1 and neighbouring genes"
Large mutation study identifying 22 novel OFD1 mutations in 30 families, confirming genetic basis.
PMID:23033313 SUPPORT
"Mutations in OFD1 also cause X-linked Joubert syndrome (JBTS10) and Simpson-Golabi-Behmel syndrome type 2 (SGBS2)"
OFD1 mutations can also cause Joubert syndrome and SGBS2, demonstrating allelic heterogeneity.
PMID:16397067 SUPPORT
"11 novel mutations, including nine frameshift, one nonsense, and one missense mutation were identified, which spanned nine different exons"
Frameshift mutations predominate, consistent with loss-of-function mechanism.
+ 2 more references
💊

Treatments

3
Surgical Correction of Oral Anomalies
Surgical removal of accessory frenula, tongue hamartomas, and repair of cleft lip/palate as needed.
Renal Management
Monitoring and management of polycystic kidney disease, including dialysis or transplantation for progressive renal failure.
Show evidence (1 reference)
PMID:9482645 SUPPORT
"Longitudinal follow-up of OFD 1 carriers should be performed, and renal function should be assessed in those with cysts because the functional prognosis of this developmental anomaly may be worse than usually reported in the literature"
Recommends longitudinal renal monitoring due to risk of progressive renal failure.
Neurodevelopmental Support
Early intervention and educational support for intellectual disability and developmental delay.
{ }

Source YAML

click to show
name: Orofaciodigital Syndrome Type I
creation_date: '2026-02-13T00:31:42Z'
updated_date: '2026-02-17T21:53:14Z'
category: Mendelian
description: >
  Orofaciodigital syndrome type I (OFD1) is an X-linked dominant ciliopathy caused
  by mutations in the OFD1 gene (also known as CXORF5). It is characterized by
  malformations of the oral cavity (lobulated tongue, oral frenula, cleft palate),
  face (facial asymmetry, hypertelorism), and digits (brachydactyly, syndactyly,
  polydactyly). CNS malformations including agenesis of the corpus callosum and
  polycystic kidneys are common. The condition is typically lethal in males.
disease_term:
  preferred_term: Orofaciodigital syndrome I
  term:
    id: MONDO:0010702
    label: orofaciodigital syndrome I
parents:
- Ciliopathies
inheritance:
- name: X-linked Dominant
  description: >
    X-linked dominant inheritance. Lethal in most affected males,
    therefore predominantly affects females. Approximately two-thirds
    of cases are de novo mutations.
  evidence:
  - reference: PMID:16397067
    reference_title: "Clinical, molecular, and genotype-phenotype correlation studies from 25 cases of oral-facial-digital syndrome type 1: a French and Belgian collaborative study."
    supports: SUPPORT
    snippet: >-
      Oral-facial-digital syndrome type 1 (OFD1) is characterised by an X linked
      dominant mode of inheritance with lethality in males
    explanation: "Confirms X-linked dominant inheritance with male lethality."
prevalence:
- population: Published clinical estimates
  percentage: 1 in 50,000 to 1 in 250,000
  notes: >-
    Recent clinical literature describes OFD1 as a rare X-linked dominant
    ciliopathy with broad estimated prevalence, likely reflecting underdiagnosis
    and phenotypic heterogeneity.
  evidence:
  - reference: PMID:41064626
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "OFD 1 manifests with skeletal, CNS, and renal abnormalities with prevalence estimated between 1 in 50,000 and 1 in 250,000."
    explanation: Recent clinical case report and review provides an explicit published prevalence range for OFD1.
pathophysiology:
- name: Primary Cilia Dysfunction
  conforms_to: "ciliopathy_dysfunction#Basal Body and Transition Zone Dysfunction"
  description: >
    OFD1 encodes a centrosomal and basal body protein required for
    primary cilium formation. OFD1 is involved in centriole distal
    appendage assembly and ciliogenesis. Loss of function disrupts
    Hedgehog and WNT signaling pathways dependent on primary cilia,
    leading to defects in craniofacial, limb, brain, and kidney
    development.
  biological_processes:
  - preferred_term: Cilium Assembly
    term:
      id: GO:0060271
      label: cilium assembly
  - preferred_term: Hedgehog Signaling
    term:
      id: GO:0007224
      label: smoothened signaling pathway
  cellular_components:
  - preferred_term: Primary Cilium
    term:
      id: GO:0005929
      label: cilium
  cell_types:
  - preferred_term: Epithelial Cell
    term:
      id: CL:0000066
      label: epithelial cell
  evidence:
  - reference: PMID:19876934
    reference_title: "The molecular basis of oral-facial-digital syndrome, type 1."
    supports: SUPPORT
    snippet: >-
      OFD1 gene that encodes a centrosomal protein localized at the basal bodies
      at the origin of primary cilia
    explanation: "Identifies OFD1 as a centrosomal/basal body protein required for
      primary cilia."
  - reference: PMID:19876934
    reference_title: "The molecular basis of oral-facial-digital syndrome, type 1."
    supports: SUPPORT
    snippet: >-
      Ofd1 inactivation is associated to defective sonic hedgehog (Shh) and
      canonical Wnt signaling pathways
    explanation: "Demonstrates that OFD1 loss disrupts both Hedgehog and Wnt signaling,
      explaining pleiotropic developmental defects."
  - reference: PMID:19876934
    reference_title: "The molecular basis of oral-facial-digital syndrome, type 1."
    supports: SUPPORT
    snippet: >-
      OFD1 has a crucial role in the biology of primary cilia thus ascribing this
      pleiotropic disease to the growing number of disorders associated to dysfunction
      of primary cilia
    explanation: "Confirms OFD1 as a ciliopathy."
- name: Renal Cystogenesis
  conforms_to: "ciliopathy_dysfunction#Renal Tubular Cystic and Fibrotic Disease"
  description: >
    Disruption of primary cilia function in renal tubular epithelium
    leads to polycystic kidney disease, similar to other ciliopathies.
    Renal involvement is progressive and may lead to renal failure.
  biological_processes:
  - preferred_term: Kidney Development
    term:
      id: GO:0001822
      label: kidney development
  locations:
  - preferred_term: Kidney
    term:
      id: UBERON:0002113
      label: kidney
  evidence:
  - reference: PMID:9482645
    reference_title: "Central nervous system malformations and early end-stage renal disease in oro-facio-digital syndrome type I: a review."
    supports: SUPPORT
    snippet: >-
      cystic medullary disease was noted in OFD 1 carriers, leading 1 patient to
      dialysis by age 35 years and the other to severe renal insufficiency by age
      28
      years
    explanation: "Documents progressive renal cystic disease in OFD1 carriers leading
      to renal failure."
  - reference: PMID:19876934
    reference_title: "The molecular basis of oral-facial-digital syndrome, type 1."
    supports: SUPPORT
    snippet: >-
      OFD1 shares phenotypic similarities with this latter group of disorders, such
      as cystic kidneys, skeletal, and CNS abnormalities
    explanation: "Confirms cystic kidneys as a shared ciliopathy feature in OFD1."
phenotypes:
- name: Lobulated Tongue
  description: >
    Lobulated or multilobed tongue with hamartomas is a characteristic
    oral finding.
  phenotype_term:
    preferred_term: Lobulated tongue
    term:
      id: HP:0000180
      label: Lobulated tongue
  evidence:
  - reference: PMID:16397067
    reference_title: "Clinical, molecular, and genotype-phenotype correlation studies from 25 cases of oral-facial-digital syndrome type 1: a French and Belgian collaborative study."
    supports: SUPPORT
    snippet: >-
      lingual hamartomas were significantly more frequent in the group with OFD1
      mutation
    explanation: "Lingual hamartomas (contributing to lobulated tongue) are significantly
      associated with confirmed OFD1 mutations."
  - reference: PMID:23033313
    reference_title: "Novel mutations including deletions of the entire OFD1 gene in 30 families with type 1 orofaciodigital syndrome: a study of the extensive clinical variability."
    supports: SUPPORT
    snippet: >-
      oral features are the most reliable diagnostic criteria
    explanation: "Oral features including lobulated tongue are the most diagnostically
      reliable findings."
- name: Accessory Oral Frenula
  description: >
    Multiple accessory oral frenula (bands of tissue between lips,
    gums, and tongue) are a hallmark oral feature.
  phenotype_term:
    preferred_term: Accessory oral frenulum
    term:
      id: HP:0000191
      label: Accessory oral frenulum
  evidence:
  - reference: PMID:23033313
    reference_title: "Novel mutations including deletions of the entire OFD1 gene in 30 families with type 1 orofaciodigital syndrome: a study of the extensive clinical variability."
    supports: SUPPORT
    snippet: >-
      oral features are the most reliable diagnostic criteria
    explanation: "Accessory oral frenula are among the most reliable diagnostic features
      of OFD1."
- name: Median Cleft Upper Lip
  description: >
    Median (midline) cleft of the upper lip, distinct from the more
    common lateral cleft lip.
  phenotype_term:
    preferred_term: Median cleft upper lip
    term:
      id: HP:0000161
      label: Median cleft upper lip
  evidence:
  - reference: PMID:16397067
    reference_title: "Clinical, molecular, and genotype-phenotype correlation studies from 25 cases of oral-facial-digital syndrome type 1: a French and Belgian collaborative study."
    supports: SUPPORT
    snippet: >-
      facial dysmorphism with oral, tooth, and distal abnormalities
    explanation: "Facial and oral abnormalities including cleft lip are characteristic
      features."
- name: Polydactyly
  description: >
    Digital anomalies including brachydactyly, clinodactyly, syndactyly,
    and polydactyly affecting hands and/or feet.
  phenotype_term:
    preferred_term: Polydactyly
    term:
      id: HP:0010442
      label: Polydactyly
  evidence:
  - reference: PMID:16397067
    reference_title: "Clinical, molecular, and genotype-phenotype correlation studies from 25 cases of oral-facial-digital syndrome type 1: a French and Belgian collaborative study."
    supports: SUPPORT
    snippet: >-
      facial dysmorphism with oral, tooth, and distal abnormalities
    explanation: "Distal (digit) abnormalities are part of the OFD1 phenotype."
  - reference: PMID:19876934
    reference_title: "The molecular basis of oral-facial-digital syndrome, type 1."
    supports: SUPPORT
    snippet: >-
      OFD1 is characterized by malformation of the oral cavity, face, and digits
    explanation: "Digit malformations are a cardinal feature of OFD1."
- name: Polycystic Kidneys
  description: >
    Polycystic kidney disease develops in a significant proportion of
    patients, potentially leading to renal failure.
  phenotype_term:
    preferred_term: Renal cyst
    term:
      id: HP:0000107
      label: Renal cyst
  evidence:
  - reference: PMID:16397067
    reference_title: "Clinical, molecular, and genotype-phenotype correlation studies from 25 cases of oral-facial-digital syndrome type 1: a French and Belgian collaborative study."
    supports: SUPPORT
    snippet: >-
      polycystic kidney disease, and central nervous system malformations
    explanation: "Polycystic kidney disease is a recognized feature of OFD1."
  - reference: PMID:16397067
    reference_title: "Clinical, molecular, and genotype-phenotype correlation studies from 25 cases of oral-facial-digital syndrome type 1: a French and Belgian collaborative study."
    supports: SUPPORT
    snippet: >-
      polycystic kidneys and short stature were significantly more frequent in the
      group with no OFD1 mutation
    explanation: "Interestingly, polycystic kidneys were more common in clinically
      diagnosed OFD without confirmed OFD1 mutations, suggesting genetic heterogeneity."
  - reference: PMID:9482645
    reference_title: "Central nervous system malformations and early end-stage renal disease in oro-facio-digital syndrome type I: a review."
    supports: SUPPORT
    snippet: >-
      renal cystic disease is an often overlooked complication specific to OFD 1
    explanation: "Highlights renal cystic disease as an underappreciated but specific
      complication of OFD1."
- name: Agenesis of Corpus Callosum
  description: >
    Agenesis or dysgenesis of the corpus callosum is a common CNS
    malformation.
  phenotype_term:
    preferred_term: Agenesis of corpus callosum
    term:
      id: HP:0001274
      label: Agenesis of corpus callosum
  evidence:
  - reference: PMID:23033313
    reference_title: "Novel mutations including deletions of the entire OFD1 gene in 30 families with type 1 orofaciodigital syndrome: a study of the extensive clinical variability."
    supports: SUPPORT
    snippet: >-
      complete agenesis of the corpus callosum, large single or multiple
      interhemispheric cysts, striking cortical infolding of gyri, ventriculomegaly,
      mild molar tooth malformation and moderate to severe cerebellar vermis
      hypoplasia
    explanation: "Detailed brain MRI evaluation showing corpus callosum agenesis as
      part of the complete brain phenotype in OFD1."
  - reference: PMID:9482645
    reference_title: "Central nervous system malformations and early end-stage renal disease in oro-facio-digital syndrome type I: a review."
    supports: SUPPORT
    snippet: >-
      Intracerebral cysts and porencephaly or arachnoid cysts are rarely but are
      repeatedly reported in orofaciodigital (OFD) syndrome type 1
    explanation: "CNS malformations including intracranial cysts are recurrently reported."
- name: Intellectual Disability
  description: >
    Intellectual disability of variable severity occurs in approximately
    50% of affected individuals.
  phenotype_term:
    preferred_term: Intellectual disability
    term:
      id: HP:0001249
      label: Intellectual disability
  evidence:
  - reference: PMID:23033313
    reference_title: "Novel mutations including deletions of the entire OFD1 gene in 30 families with type 1 orofaciodigital syndrome: a study of the extensive clinical variability."
    supports: SUPPORT
    snippet: >-
      A first, detailed evaluation of brain MRIs from seven patients with cognitive
      defects illustrated extensive variability
    explanation: "Cognitive defects in OFD1 are accompanied by extensive brain structural
      variability."
  - reference: PMID:16397067
    reference_title: "Clinical, molecular, and genotype-phenotype correlation studies from 25 cases of oral-facial-digital syndrome type 1: a French and Belgian collaborative study."
    supports: SUPPORT
    snippet: >-
      mental retardation and mutations located in exons 3, 8, 9, 13, and 16
    explanation: "Genotype-phenotype correlation suggests intellectual disability
      associates with mutations in specific exons."
genetic:
- name: OFD1 Mutations
  association: Causative
  notes: >
    Mutations in OFD1 (Xp22.2), encoding a centrosomal/basal body
    protein essential for ciliogenesis. Most mutations are truncating
    (nonsense, frameshift, splice-site). The condition is typically
    lethal in hemizygous males.
  evidence:
  - reference: PMID:23033313
    reference_title: "Novel mutations including deletions of the entire OFD1 gene in 30 families with type 1 orofaciodigital syndrome: a study of the extensive clinical variability."
    supports: SUPPORT
    snippet: >-
      Comprehensive mutation analysis in OFD1 revealed mutations in 37 female
      patients from 30 families; 22 mutations have not been previously described
      including two heterozygous deletions spanning OFD1 and neighbouring genes
    explanation: "Large mutation study identifying 22 novel OFD1 mutations in 30 families,
      confirming genetic basis."
  - reference: PMID:23033313
    reference_title: "Novel mutations including deletions of the entire OFD1 gene in 30 families with type 1 orofaciodigital syndrome: a study of the extensive clinical variability."
    supports: SUPPORT
    snippet: >-
      Mutations in OFD1 also cause X-linked Joubert syndrome (JBTS10) and
      Simpson-Golabi-Behmel syndrome type 2 (SGBS2)
    explanation: "OFD1 mutations can also cause Joubert syndrome and SGBS2, demonstrating
      allelic heterogeneity."
  - reference: PMID:16397067
    reference_title: "Clinical, molecular, and genotype-phenotype correlation studies from 25 cases of oral-facial-digital syndrome type 1: a French and Belgian collaborative study."
    supports: SUPPORT
    snippet: >-
      11 novel mutations, including nine frameshift, one nonsense, and one missense
      mutation were identified, which spanned nine different exons
    explanation: "Frameshift mutations predominate, consistent with loss-of-function
      mechanism."
  - reference: PMID:16397067
    reference_title: "Clinical, molecular, and genotype-phenotype correlation studies from 25 cases of oral-facial-digital syndrome type 1: a French and Belgian collaborative study."
    supports: SUPPORT
    snippet: >-
      majority of mutations (65.5%) was located in exons 3, 8, 9, 13, and 16
    explanation: "Mutation hotspot exons identified, useful for diagnostic screening."
  - reference: PMID:23033313
    reference_title: "Novel mutations including deletions of the entire OFD1 gene in 30 families with type 1 orofaciodigital syndrome: a study of the extensive clinical variability."
    supports: SUPPORT
    snippet: >-
      Although the OFD1 gene apparently escapes X-inactivation, skewed inactivation
      was observed in seven of 14 patients. The direction of skewing did not correlate
      with disease severity
    explanation: "X-inactivation patterns do not explain clinical variability despite
      OFD1 escaping X-inactivation."
diagnosis:
- name: Clinical and Molecular Diagnosis
  description: >-
    Oral-facial-digital syndrome type I is diagnosed in a female proband from
    the characteristic oral (lingual hamartomas, clefting, frenula), facial,
    and digital findings, frequently with polycystic kidney disease and CNS
    malformations, and is confirmed by identification of a heterozygous OFD1
    pathogenic variant. X-linked dominant OFD1 is typically lethal in males.
  diagnosis_term:
    preferred_term: molecular genetic testing
    term:
      id: MAXO:0000533
      label: molecular genetic testing
  evidence:
  - reference: PMID:20301367
    reference_title: "Oral-Facial-Digital Syndrome Type I."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "The diagnosis of OFD1 is established in a female proband with suggestive findings and a heterozygous OFD1 pathogenic variant identified by molecular genetic testing."
    explanation: >-
      GeneReviews defines the clinical-plus-molecular diagnostic criteria for
      OFD1 in female probands.
treatments:
- name: Surgical Correction of Oral Anomalies
  description: >
    Surgical removal of accessory frenula, tongue hamartomas, and
    repair of cleft lip/palate as needed.
- name: Renal Management
  description: >
    Monitoring and management of polycystic kidney disease, including
    dialysis or transplantation for progressive renal failure.
  evidence:
  - reference: PMID:9482645
    reference_title: "Central nervous system malformations and early end-stage renal disease in oro-facio-digital syndrome type I: a review."
    supports: SUPPORT
    snippet: >-
      Longitudinal follow-up of OFD 1 carriers should be performed, and renal
      function should be assessed in those with cysts because the functional prognosis
      of this developmental anomaly may be worse than usually reported in the
      literature
    explanation: "Recommends longitudinal renal monitoring due to risk of progressive
      renal failure."
- name: Neurodevelopmental Support
  description: >
    Early intervention and educational support for intellectual
    disability and developmental delay.
datasets: []
references:
- reference: PMID:20301367
  title: "Oral-Facial-Digital Syndrome Type I."
  tags:
  - GeneReviews
  findings: []
- reference: DOI:10.1038/s41467-023-37340-z
  title: An actin filament branching surveillance system regulates cell cycle
    progression, cytokinesis and primary ciliogenesis
  findings: []
- reference: DOI:10.1080/15548627.2022.2067383
  title: 'Crosstalk between cilia and autophagy: implication for human diseases'
  findings: []
- reference: DOI:10.1093/hmg/ddaa029
  title: The HOPS complex subunit VPS39 controls ciliogenesis through autophagy
  findings: []
- reference: DOI:10.1186/s12887-024-05304-x
  title: Case series of kidney transplantation in two pediatric recipients with
    rare genetic diseases and intellectual disability
  findings: []
- reference: DOI:10.15252/embj.2020106503
  title: The TBC1D31/praja2 complex controls primary ciliogenesis through
    PKA‐directed OFD1 ubiquitylation
  findings: []
- reference: DOI:10.15252/embr.202154160
  title: Myosin VI regulates ciliogenesis by promoting the turnover of the
    centrosomal/satellite protein OFD1
  findings: []
- reference: DOI:10.3390/genes14020327
  title: Autistic Behavior as Novel Clinical Finding in OFD1 Syndrome
  findings: []
📚

References & Deep Research

References

8
Oral-Facial-Digital Syndrome Type I.
No top-level findings curated for this source.
An actin filament branching surveillance system regulates cell cycle progression, cytokinesis and primary ciliogenesis
No top-level findings curated for this source.
Crosstalk between cilia and autophagy: implication for human diseases
No top-level findings curated for this source.
The HOPS complex subunit VPS39 controls ciliogenesis through autophagy
No top-level findings curated for this source.
Case series of kidney transplantation in two pediatric recipients with rare genetic diseases and intellectual disability
No top-level findings curated for this source.
The TBC1D31/praja2 complex controls primary ciliogenesis through PKA‐directed OFD1 ubiquitylation
No top-level findings curated for this source.
Myosin VI regulates ciliogenesis by promoting the turnover of the centrosomal/satellite protein OFD1
No top-level findings curated for this source.
Autistic Behavior as Novel Clinical Finding in OFD1 Syndrome
No top-level findings curated for this source.

Deep Research

2
Disorder

Disorder

  • Name: Orofaciodigital Syndrome Type I
  • Category: Mendelian
  • Existing deep-research providers: falcon
  • Existing evidence reference count in YAML: 32

Key Pathophysiology Nodes

  • Primary Cilia Dysfunction
  • Renal Cystogenesis
  • Deep research literature mapping

Citation Inventory (for evidence mapping)

  • DOI:10.1038/s41467-023-37340-z
  • DOI:10.1080/15548627.2022.2067383
  • DOI:10.1093/hmg/ddaa029
  • DOI:10.1186/s12887-024-05304-x
  • DOI:10.15252/embj.2020106503
  • DOI:10.15252/embr.202154160
  • DOI:10.3390/genes14020327
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Disease Pathophysiology Research Report
Edison Scientific Literature 27 citations 2026-02-10T08:12:54.087867

Disease Pathophysiology Research Report

Target Disease - Disease Name: Orofaciodigital syndrome type I (OFD1 syndrome) - MONDO ID: - Category: Mendelian (X‑linked dominant ciliopathy)

Pathophysiology overview OFD1 syndrome is a primary ciliopathy caused by pathogenic variants in OFD1, a centriolar and centriolar‑satellite protein essential for biogenesis of the primary cilium and for the integrity of distal appendages at the mother centriole. OFD1 localizes to the distal end of centrioles/basal bodies and to pericentriolar satellites, where its precise abundance and turnover control the initiation of ciliogenesis, distal appendage assembly, and downstream cilia‑dependent signaling in development. Failure of these processes produces a characteristic spectrum of craniofacial/oral, digital, brain, and renal phenotypes. Mechanistically, OFD1 is regulated by selective autophagy and by the ubiquitin–proteasome system (UPS), and it interfaces with actin nucleation (Arp2/3) to couple centrosomal actin dynamics to ciliogenesis. Disruption of OFD1 leads to defects in distal appendages (e.g., altered CEP164 homeostasis), impaired removal of CP110 from the mother centriole, and abnormal Hedgehog/Wnt signaling, which together explain key malformations and kidney disease in OFD1 patients (iaconis2020thehopscomplex pages 10-10, morleo2023crosstalkbetweencilia pages 9-10, senatore2021thetbc1d31praja2complex pages 1-2, magistrati2022myosinviregulates pages 9-10, magistrati2022myosinviregulates pages 3-5, cao2023anactinfilament pages 3-4, papuc2023autisticbehavioras pages 5-7).

1) Core pathophysiology: mechanisms, dysregulated pathways, affected processes - Centriole/satellite roles and ciliogenesis: OFD1 is a centrosome/basal‑body and centriolar‑satellite protein “required for primary cilia formation” and for axoneme/ distal assembly; its removal from the satellite pool is a gatekeeping step to commence ciliogenesis (Autophagy review, Morleo et al., 2023, URL: https://doi.org/10.1080/15548627.2022.2067383; Human Molecular Genetics, Iaconis et al., 2020, URL: https://doi.org/10.1093/hmg/ddaa029) (morleo2023crosstalkbetweencilia pages 9-10, iaconis2020thehopscomplex pages 10-10). - Autophagy–cilia axis: Selective autophagy of satellite OFD1 initiates ciliogenesis (“removal of OFD1 from centriolar satellites through the autophagy machinery is required to initiate ciliogenesis”). OFD1 also participates in autophagosome biogenesis, indicating bidirectional crosstalk (EMBO J., 2021, URL: https://doi.org/10.15252/embj.2020106503; Autophagy, 2023, URL above) (senatore2021thetbc1d31praja2complex pages 1-2, morleo2023crosstalkbetweencilia pages 9-10). - UPS control via PKA–Praja2: GPCR–cAMP–PKA phosphorylates OFD1 at Ser735 to promote Praja2 (E3)-mediated ubiquitylation and proteasomal degradation, a pathway essential for ciliogenesis and cilium morphology/dynamics in vivo (Medaka) (EMBO J., 2021, URL: https://doi.org/10.15252/embj.2020106503) (senatore2021thetbc1d31praja2complex pages 1-2). - Distal appendage homeostasis and actomyosin: Myosin VI binds OFD1 and “regulates the localisation of OFD1 at the centrioles and, as a consequence, the recruitment of the distal appendage protein CEP164.” Loss of myosin VI causes accumulation of OFD1 along centriole walls, increases CEP164 at centrioles, and “triggers a severe defect in ciliogenesis,” consistent with a role in OFD1 turnover possibly via short‑range transport on centrosomal actin (EMBO reports, 2022, URL: https://doi.org/10.15252/embr.202154160) (magistrati2022myosinviregulates pages 3-5, magistrati2022myosinviregulates pages 9-10). - Endolysosomal/autophagy machinery: VPS39 (HOPS) controls ciliogenesis through autophagy in renal cells and in vivo, linking lysosomal tethering machinery to the distribution of OFD1 at centriolar satellites and cilium assembly (Human Molecular Genetics, 2020, URL: https://doi.org/10.1093/hmg/ddaa029) (iaconis2020thehopscomplex pages 10-10, iaconis2020thehopscomplex pages 9-10). - Actin/Arp2/3 coupling: OFD1 directly binds the seven‑subunit Arp2/3 complex (“OFD1‑Flag pulled down the purified 7‑subunit Arp2/3 complex”) and “functions as a class II nucleation promoting factor to promote centrosomal actin branching.” OFD1 loss reduces centrosomal F‑actin, revealing a cytoskeletal mechanism that impacts ciliogenesis and cell‑cycle states (Nature Communications, 2023, URL: https://doi.org/10.1038/s41467-023-37340-z) (cao2023anactinfilament pages 1-2, cao2023anactinfilament pages 3-4). - Signaling consequences: OFD1 deficiency perturbs cilia‑dependent Hedgehog (Shh) and Wnt signaling in development, underpinning neurodevelopmental and craniofacial patterning phenotypes (Genes, 2023, URL: https://doi.org/10.3390/genes14020327; additional summaries) (ekumi2020biochemicalandcellular pages 24-26, papuc2023autisticbehavioras pages 5-7).

2) Key molecular players - Genes/proteins (HGNC gene symbols): OFD1; distal appendage components CEP164, CEP83, SCLT1, FBF1; transition‑onset kinases TTBK2 and MARK4; CP110; centriolar satellite scaffold PCM1; motor MYO6 (myosin VI); HOPS subunit VPS39; PKA (PRKACA/PRKACB), E3 ligase PRAJA2; Arp2/3 subunits (ACTR2/ARP2, ACTR3/ARP3, ARPCs) (iaconis2020thehopscomplex pages 10-10, magistrati2022myosinviregulates pages 3-5, ekumi2020biochemicalandcellular pages 24-26, senatore2021thetbc1d31praja2complex pages 1-2, cao2023anactinfilament pages 1-2). - Chemical entities (CHEBI/biochemical): cAMP (PKA activation); autophagy modulators (general ATG/LC3 pathway); actin monomers/polymers (cytoskeletal branching). Where tested, Arp2/3 inhibitors (e.g., CK‑666) were used experimentally to probe pathways (Nature Communications, 2023) (cao2023anactinfilament pages 1-2). - Cell types (CL terms, narrative): renal tubular epithelial cells; neural progenitors/neurons; craniofacial mesenchyme/epithelia; multiciliated and primary ciliated epithelia (iaconis2020thehopscomplex pages 10-10, papuc2023autisticbehavioras pages 5-7). - Anatomical locations (UBERON terms, narrative): basal body/centrioles (distal end), centriolar satellites (pericentriolar cytoplasm), transition zone; affected organs: kidney, brain, craniofacial/oral tissues, digits (iaconis2020thehopscomplex pages 10-10, papuc2023autisticbehavioras pages 5-7).

3) Biological processes (GO-aligned, narrative) - Cilium assembly and organization; basal body docking; distal appendage assembly and maintenance (CEP164/CEP83/SCLT1/FBF1); CP110 removal and axoneme initiation (TTBK2/MARK4 recruitment via CEP164); centriolar satellite organization and proteostasis; selective macroautophagy; ubiquitin‑dependent protein catabolic process; GPCR–cAMP–PKA signaling; actin filament branching (Arp2/3), centrosomal actin dynamics; Hedgehog and Wnt signal transduction (ekumi2020biochemicalandcellular pages 24-26, morleo2023crosstalkbetweencilia pages 9-10, senatore2021thetbc1d31praja2complex pages 1-2, cao2023anactinfilament pages 1-2, magistrati2022myosinviregulates pages 3-5).

4) Cellular components (GO-aligned, narrative) - Centriole/basal body distal end and distal appendages (CEP164‑positive); centriolar satellites (PCM1‑positive); transition zone; primary cilium axoneme; pericentriolar material; endolysosomal compartments and autophagosomes; actin cytoskeleton at the centrosome (magistrati2022myosinviregulates pages 3-5, iaconis2020thehopscomplex pages 10-10, cao2023anactinfilament pages 1-2).

5) Disease progression: sequence of events - Initiation: Pathogenic OFD1 variants impair OFD1 dosage/localization at centrioles and satellites. Dysregulated clearance by autophagy and/or heightened degradation via UPS (PKA/Praja2) disturb the timing and level of OFD1 needed for ciliogenesis (morleo2023crosstalkbetweencilia pages 9-10, senatore2021thetbc1d31praja2complex pages 1-2). - Ciliogenesis block: Excess satellite OFD1 or mislocalized centriolar OFD1 impairs distal appendage homeostasis, CEP164 recruitment balance, and prevents CP110 removal, arresting axoneme elongation (EMBO reports, 2022; Ekumi synopsis) (magistrati2022myosinviregulates pages 3-5, ekumi2020biochemicalandcellular pages 24-26). - Signaling derangement: Absent/defective primary cilia lead to reduced or misregulated Shh/Wnt pathways in development, affecting brain patterning and craniofacial morphogenesis; renal tubular mechanosensation and signaling are perturbed, predisposing to cystogenesis (iaconis2020thehopscomplex pages 10-10, papuc2023autisticbehavioras pages 5-7, ekumi2020biochemicalandcellular pages 24-26). - Tissue outcomes: Craniofacial/oral anomalies, digital malformations, neurodevelopmental defects (including periventricular nodular heterotopia and reported autistic behavior), and cystic kidney disease with risk of CKD progression (Genes, 2023; HMG, 2020) (papuc2023autisticbehavioras pages 5-7, iaconis2020thehopscomplex pages 10-10).

6) Phenotypic manifestations and mechanistic links - Craniofacial/oral: Oral malformations (lobulated tongue, clefting), facial dysmorphism; linked to disrupted Shh/Wnt and ciliary morphogen signaling (Genes, 2023, URL: https://doi.org/10.3390/genes14020327) (papuc2023autisticbehavioras pages 5-7). - Digits: Brachydactyly/polydactyly, reflecting ciliopathy‑related limb bud patterning defects (Genes, 2023) (papuc2023autisticbehavioras pages 5-7). - Brain/CNS: Malformations (e.g., periventricular nodular heterotopia), developmental delay; a 2023 case highlighted autistic behavior as a novel feature in a female with de novo OFD1 variant (Genes, 2023, URL above) (papuc2023autisticbehavioras pages 9-11, papuc2023autisticbehavioras pages 5-7). - Kidney: Cystic kidney disease and progression to renal dysfunction; mechanistically tied to defective primary cilia and autophagy‑ciliogenesis control (HMG, 2020, URL: https://doi.org/10.1093/hmg/ddaa029) (iaconis2020thehopscomplex pages 10-10).

Direct mechanistic details and recent developments (2023–2024 prioritized) - Autophagy–ciliogenesis crosstalk (2023 review): OFD1 resides at centrioles and satellites, and “selective autophagic degradation of ciliary proteins has been shown to control ciliogenesis,” with OFD1 among satellite cargos whose removal licenses cilium assembly (Autophagy, 2023, URL: https://doi.org/10.1080/15548627.2022.2067383) (morleo2023crosstalkbetweencilia pages 9-10). - PKA–Praja2–OFD1 UPS pathway (EMBO J., 2021): “Upon GPCR‑cAMP stimulation, PKA phosphorylates OFD1 at ser735, thus promoting OFD1 proteolysis through the praja2‑UPS circuitry,” a pathway “essential for ciliogenesis,” and a non‑phosphorylatable OFD1 mutant “dramatically affects cilium morphology and dynamics” (URL: https://doi.org/10.15252/embj.2020106503) (senatore2021thetbc1d31praja2complex pages 1-2). - Myosin VI control of OFD1 and CEP164 (EMBO reports, 2022): “Myosin VI regulates the localisation of OFD1 at the centrioles and, as a consequence, the recruitment of the distal appendage protein CEP164… loss of myosin VI triggers a severe defect in ciliogenesis that could be causally linked to an impairment in the autophagic removal of OFD1 from satellites” (URL: https://doi.org/10.15252/embr.202154160) (magistrati2022myosinviregulates pages 9-10, magistrati2022myosinviregulates pages 3-5). - Arp2/3—OFD1 link (Nature Communications, 2023): “OFD1‑Flag pulled down the purified 7‑subunit Arp2/3 complex,” and “OFD1 functions as a class II Nucleation promoting factor to promote Arp2/3 complex‑mediated actin branching,” providing a cytoskeletal mechanism that integrates actin branching status with ciliogenesis and cell‑cycle control (URL: https://doi.org/10.1038/s41467-023-37340-z) (cao2023anactinfilament pages 1-2, cao2023anactinfilament pages 3-4). - Distal appendage/CP110 program (synthesis of experimental literature): Distal appendage proteins (CEP83/CEP164/SCLT1/FBF1) recruit TTBK2 and MARK4, which remove CP110 from the mother centriole to initiate ciliogenesis; OFD1 is required at the distal centriole/appendages for this program to proceed (synopses and experimental context) (ekumi2020biochemicalandcellular pages 24-26, magistrati2022myosinviregulates pages 3-5).

Current applications and real‑world implementations - Renal surveillance and management: Given the risk of renal cystic disease and chronic kidney disease in OFD1 syndrome, clinical sources recommend periodic renal imaging and multidisciplinary management; mechanistic nephrology literature underscores the autophagy–cilia connection in kidney epithelia (Genes, 2023; HMG, 2020; URLs above) (papuc2023autisticbehavioras pages 5-7, iaconis2020thehopscomplex pages 10-10).

Expert opinions and authoritative analyses - Autophagy–cilia field leadership (2023): Morleo et al. synthesize “the current knowledge about [the cilia–autophagy] axis and challenges… as well as the implication for ciliopathies,” explicitly placing OFD1 within autophagy‑regulated ciliogenesis (Autophagy, 2023, URL: https://doi.org/10.1080/15548627.2022.2067383) (morleo2023crosstalkbetweencilia pages 9-10). - UPS signaling at centrosomes (2021): EMBO Journal study establishes a centrosomal transduction unit “that links GPCR signalling to ubiquitylation and proteolysis of the ciliopathy protein OFD1,” setting a paradigm for proteostatic gating of ciliogenesis (URL: https://doi.org/10.15252/embj.2020106503) (senatore2021thetbc1d31praja2complex pages 1-2). - Distal appendage homeostasis and motor coupling (2022): EMBO reports identifies myosin VI as a regulator that tunes OFD1 mobility and CEP164 levels, adding actomyosin regulation to centriole‑distal architecture control (URL: https://doi.org/10.15252/embr.202154160) (magistrati2022myosinviregulates pages 9-10, magistrati2022myosinviregulates pages 3-5). - Cytoskeletal integration (2023): Nature Communications reveals OFD1 as a class II NPF for Arp2/3, “linking actin filament branching surveillance” to ciliogenesis and cell‑cycle transitions (URL: https://doi.org/10.1038/s41467-023-37340-z) (cao2023anactinfilament pages 1-2, cao2023anactinfilament pages 3-4).

Relevant statistics and data - Experimental quantitation: Myosin VI depletion increased OFD1 and CEP164 intensities at centrioles in cultured cells with n>140 cells per condition and p‑values reported, demonstrating robust effects on distal appendage homeostasis (EMBO reports, 2022, URL: https://doi.org/10.15252/embr.202154160) (magistrati2022myosinviregulates pages 3-5). - Clinical spectrum: OFD1 is consistently characterized as a multisystem ciliopathy with oral, facial, digital, brain, and renal involvement; recent case documentation extends neurobehavioral features to include autistic behavior in a female with de novo OFD1 variant (Genes, 2023, URL: https://doi.org/10.3390/genes14020327) (papuc2023autisticbehavioras pages 9-11, papuc2023autisticbehavioras pages 5-7).

Evidence artifact | Mechanistic theme | Specific finding | Experimental system/context | Key molecules | Implication for OFD1 disease | Citation (journal, year) | DOI/URL | |---|---|---|---|---|---|---| | Autophagy-mediated OFD1 clearance | Selective autophagic removal of OFD1 from centriolar satellites is required to initiate ciliogenesis | Cell culture (serum starvation), animal models (Medaka), reviews | OFD1, ATG proteins, LC3 (centriolar satellite pool), CP110 (downstream) | Failure to clear OFD1 → blocked ciliogenesis → ciliopathy phenotypes (kidney cysts, brain malformations) | Autophagy, 2023 (morleo2023crosstalkbetweencilia pages 9-10), Hum Mol Genet, 2020 (iaconis2020thehopscomplex pages 10-10) | https://doi.org/10.1080/15548627.2022.2067383 | | PKA–Praja2 ubiquitylation of OFD1 | PKA phosphorylation (Ser735) promotes PRAJA2-mediated ubiquitylation and proteasomal degradation of OFD1 linking GPCR–cAMP to ciliogenesis control | Serum-deprived cells; Medaka in vivo perturbation | OFD1 (pSer735), PKA, PRAJA2 (E3), TBC1D31 | Misregulation → altered OFD1 stability and defective cilium morphology/dynamics → developmental defects | The EMBO Journal, 2021 (senatore2021thetbc1d31praja2complex pages 1-2) | https://doi.org/10.15252/embj.2020106503 | | Myosin VI promotes OFD1 turnover and distal appendage homeostasis | Myosin VI binds OFD1 and promotes its turnover at centrioles; myosin VI depletion increases OFD1 and CEP164 at centrioles and impairs ciliogenesis | Human non-tumoral cell lines; IF, FRAP, biochemical pull-downs | OFD1, Myosin VI, CEP164, PCM1 | Perturbed myosin VI → OFD1 accumulation/altered CEP164 recruitment → defective distal appendage function and ciliogenesis | EMBO Reports, 2022 (magistrati2022myosinviregulates pages 9-10, magistrati2022myosinviregulates pages 3-5) | https://doi.org/10.15252/embr.202154160 | | VPS39 (HOPS) links endolysosomal/autophagy machinery to ciliogenesis | VPS39 (HOPS) controls autophagy-dependent regulation of centriolar satellite proteins, affecting OFD1 distribution and ciliogenesis | Human renal cells; medaka in vivo models | VPS39 (HOPS), OFD1, autophagy components (LC3, lysosomal machinery) | Dysregulated VPS39/autophagy → altered OFD1 satellite pool → defective ciliogenesis, kidney ciliopathy phenotypes | Human Molecular Genetics, 2020 (iaconis2020thehopscomplex pages 10-10, iaconis2020thehopscomplex pages 9-10) | https://doi.org/10.1093/hmg/ddaa029 | | OFD1–Arp2/3 / actin branching link | OFD1 directly binds Arp2/3 and acts as a class II nucleation promoting factor to promote centrosomal actin branching; OFD1 loss reduces centrosomal F-actin | Biochemistry (pulldown, actin polymerization assays), cultured cells (HeLa, MEFs) | OFD1, Arp2/3 complex (ARP2/ARP3/ARPC2), actin | Loss of OFD1 → reduced centrosomal actin branching → impacts ciliogenesis and cell-cycle coupling; provides mechanistic link to cytoskeleton-dependent ciliogenesis | Nature Communications, 2023 (cao2023anactinfilament pages 1-2, cao2023anactinfilament pages 3-4) | https://doi.org/10.1038/s41467-023-37340-z | | Distal appendage (CEP164/TTBK2) and CP110 removal program | Distal appendage proteins (Cep83/Cep164/SCLT1/FBF1) recruit kinases (TTBK2/MARK4) to trigger CP110 removal from the mother centriole; OFD1 is required for distal centriole/appendage assembly | Cell biology studies, reviews, IF and molecular perturbation assays | CEP164, TTBK2, MARK4, CP110, OFD1, C2CD3 | Improper OFD1 function/distribution → defective distal appendage assembly, failed CP110 removal → blocked axoneme elongation and ciliogenesis | (mechanistic reviews/experimental reports) EMBO Reports 2022, Ekumi 2020 (magistrati2022myosinviregulates pages 3-5, ekumi2020biochemicalandcellular pages 24-26) | https://doi.org/10.15252/embr.202154160 | | Disrupted ciliary signaling (Hedgehog/Wnt) after OFD1 loss | OFD1 deficiency perturbs cilia-dependent signaling (Shh/Hedgehog and Wnt) during development, contributing to brain and craniofacial defects | Cellular models and developmental/animal studies; genetic analyses | OFD1, components of SHH and WNT pathways, IFT machinery | Altered signaling → neurodevelopmental malformations, midline/brain defects, patterning abnormalities seen in OFD1 patients | Genes, 2023 (ekumi2020biochemicalandcellular pages 24-26, papuc2023autisticbehavioras pages 5-7) | https://doi.org/10.3390/genes14020327 | | Clinical application: kidney replacement in OFD1-related ESKD | Reports document progression to end-stage kidney disease (ESKD) in OFD1 patients and case descriptions of kidney transplantation in affected individuals | Case reports / case series (clinical transplant reports) | OFD1 (genetic diagnosis), clinical management teams | Kidney transplantation has been performed in OFD1-related ESKD; highlights need for renal surveillance and multidisciplinary care | BMC Pediatrics / clinical case series, 2024 (iaconis2020thehopscomplex pages 10-10, papuc2023autisticbehavioras pages 5-7) | https://doi.org/10.1186/s12887-024-05304-x |

Table: Key mechanistic themes, experimental contexts, molecular players, disease implications, and primary citations (context IDs) summarizing OFD1-related pathophysiology from the gathered evidence.

Ontology‑ready annotations (narrative labels) - Gene/protein (HGNC): OFD1; CEP164; CEP83; SCLT1; FBF1; TTBK2; MARK4; CP110; PCM1; MYO6; VPS39; PRKACA/PRKACB; PJA2; ACTR2/ACTR3/ARPCs (iaconis2020thehopscomplex pages 10-10, magistrati2022myosinviregulates pages 3-5, cao2023anactinfilament pages 1-2, senatore2021thetbc1d31praja2complex pages 1-2). - Biological process (GO): cilium assembly; ciliary transition from CP110‑capped basal body to axoneme initiation; distal appendage organization; centriolar satellite organization; selective macroautophagy; ubiquitin‑dependent protein catabolism; GPCR–cAMP–PKA signaling; actin filament branching via Arp2/3; Hedgehog/Wnt signal transduction (morleo2023crosstalkbetweencilia pages 9-10, ekumi2020biochemicalandcellular pages 24-26, cao2023anactinfilament pages 1-2, senatore2021thetbc1d31praja2complex pages 1-2). - Cellular component (GO): centriole/basal body distal appendage; centriolar satellite; transition zone; primary cilium; autophagosome; pericentriolar actin network (magistrati2022myosinviregulates pages 3-5, iaconis2020thehopscomplex pages 10-10, cao2023anactinfilament pages 1-2). - Phenotype (HP): oral cavity malformations (e.g., lobulated tongue, cleft palate), facial dysmorphism, digital anomalies, brain malformations/neurodevelopmental delay, renal cystic disease; emerging neurobehavioral feature: autistic behavior (papuc2023autisticbehavioras pages 5-7, papuc2023autisticbehavioras pages 9-11). - Cell types (CL): renal tubular epithelial cells; neural progenitors/neurons; craniofacial epithelial/mesenchymal cells (iaconis2020thehopscomplex pages 10-10, papuc2023autisticbehavioras pages 5-7). - Anatomy (UBERON): kidney; brain; craniofacial/oral tissues; limb/digits; centrosome/basal body; transition zone (iaconis2020thehopscomplex pages 10-10, papuc2023autisticbehavioras pages 5-7). - Chemicals (CHEBI): cAMP; actin (G‑actin/F‑actin polymers) (senatore2021thetbc1d31praja2complex pages 1-2, cao2023anactinfilament pages 1-2).

Selected direct quotes supporting key statements - “Upon GPCR‑cAMP stimulation, PKA phosphorylates OFD1 at ser735, thus promoting OFD1 proteolysis through the praja2‑UPS circuitry… This pathway is essential for ciliogenesis.” (EMBO Journal, 2021; URL: https://doi.org/10.15252/embj.2020106503) (senatore2021thetbc1d31praja2complex pages 1-2). - “Myosin VI regulates the localisation of OFD1 at the centrioles and, as a consequence, the recruitment of the distal appendage protein cep164… loss of myosin VI triggers a severe defect in ciliogenesis that could be causally linked to an impairment in the autophagic removal of OFD1 from satellites.” (EMBO reports, 2022; URL: https://doi.org/10.15252/embr.202154160) (magistrati2022myosinviregulates pages 9-10). - “OFD1‑Flag pulled down the purified 7‑subunit Arp2/3 complex,” and “OFD1 functions as a class II Nucleation promoting factor to promote Arp2/3 complex‑mediated actin branching.” (Nature Communications, 2023; URL: https://doi.org/10.1038/s41467-023-37340-z) (cao2023anactinfilament pages 3-4, cao2023anactinfilament pages 1-2).

Limitations - Some genotype–phenotype correlations (e.g., exon‑level associations, X‑inactivation details) and clinical management statistics require broader clinical cohorts; we cite recent case‑level and mechanistic sources within 2020–2024, but comprehensive epidemiology was not available in the retrieved context (papuc2023autisticbehavioras pages 5-7).

References (with URLs and publication dates) - Morleo M. et al. Crosstalk between cilia and autophagy: implication for human diseases. Autophagy. 2023 May;19:24–43. URL: https://doi.org/10.1080/15548627.2022.2067383 (morleo2023crosstalkbetweencilia pages 9-10). - Senatore E. et al. The TBC1D31/praja2 complex controls primary ciliogenesis through PKA‑directed OFD1 ubiquitylation. The EMBO Journal. 2021 May 2;40(10). URL: https://doi.org/10.15252/embj.2020106503 (senatore2021thetbc1d31praja2complex pages 1-2). - Magistrati E. et al. Myosin VI regulates ciliogenesis by promoting the turnover of the centrosomal/satellite protein OFD1. EMBO Reports. 2022 Dec;23(3). URL: https://doi.org/10.15252/embr.202154160 (magistrati2022myosinviregulates pages 9-10, magistrati2022myosinviregulates pages 3-5). - Iaconis D. et al. The HOPS complex subunit VPS39 controls ciliogenesis through autophagy. Human Molecular Genetics. 2020 Feb;29(6):1018–1029. URL: https://doi.org/10.1093/hmg/ddaa029 (iaconis2020thehopscomplex pages 10-10, iaconis2020thehopscomplex pages 9-10). - Cao M. et al. An actin filament branching surveillance system regulates cell cycle progression, cytokinesis and primary ciliogenesis. Nature Communications. 2023 Mar;14: (article number). URL: https://doi.org/10.1038/s41467-023-37340-z (cao2023anactinfilament pages 1-2, cao2023anactinfilament pages 3-4). - Papuc S.M. et al. Autistic Behavior as Novel Clinical Finding in OFD1 Syndrome. Genes. 2023 Jan;14(2):327. URL: https://doi.org/10.3390/genes14020327 (papuc2023autisticbehavioras pages 9-11, papuc2023autisticbehavioras pages 5-7). - Additional mechanistic synopsis (distal appendages/CP110 program): distal appendage proteins recruit TTBK2/MARK4 to remove CP110 and initiate ciliogenesis; OFD1 supports distal centriole/appendage assembly (context synthesis from retrieved sources) (ekumi2020biochemicalandcellular pages 24-26, magistrati2022myosinviregulates pages 3-5).

References

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