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PHEX

Chr Xp22.11

phosphate regulating endopeptidase X-linked

Aliases:
PEX, HPDR1, HYP1, XLH
MANE:
ENST00000379374.5

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Predicted protein structure

Clinical relevance (Genomics England PanelApp)

Diagnostic Grade (Green)

  • DDG2P

    X-LINKED: hemizygous mutation in males, monoallelic mutations in females may cause disease (may be less severe, later onset than males)
  • Hypophosphataemia or rickets

    X-LINKED: hemizygous mutation in males, monoallelic mutations in females may cause disease (may be less severe, later onset than males)
  • Nephrocalcinosis or nephrolithiasis

    X-LINKED: hemizygous mutation in males, monoallelic mutations in females may cause disease (may be less severe, later onset than males)
  • Rare syndromic craniosynostosis or isolated multisuture synostosis

    X-LINKED: hemizygous mutation in males, monoallelic mutations in females may cause disease (may be less severe, later onset than males)
  • Skeletal dysplasia

    X-LINKED: hemizygous mutation in males, monoallelic mutations in females may cause disease (may be less severe, later onset than males)
  • Fetal anomalies

    X-LINKED: hemizygous mutation in males, monoallelic mutations in females may cause disease (may be less severe, later onset than males)
  • Monogenic hearing loss

  • Osteogenesis imperfecta

Disease associations (Open Targets)

  • X-linked hypophosphatemia

    0.85
  • X-linked dominant hypophosphatemic rickets

    0.78
  • hypophosphatemic rickets

    0.64
  • Dent disease

    0.39
  • Bowing of the legs

    0.34
  • Lower limb pain

    0.34
  • autosomal dominant hypophosphatemic rickets

    0.29
  • response to vaccine

    0.27
  • hypophosphatemia

    0.26
  • vitamin D-dependent rickets, type 2

    0.26

Score is the Open Targets composite evidence score (0-1). Higher = stronger gene-disease association.

Protein function (UniProt)

Phosphate-regulating neutral endopeptidase PHEX

Peptidase that cleaves SIBLING (small integrin-binding ligand, N-linked glycoprotein)-derived ASARM peptides, thus regulating their biological activity (PubMed:15664000, PubMed:18162525, PubMed:18597632, PubMed:9593714). Cleaves ASARM peptides between Ser and Glu or Asp residues (PubMed:18597632). Regulates osteogenic cell differentiation and bone mineralization through the cleavage of the MEPE-derived ASARM peptide (PubMed:18597632). Promotes dentin mineralization and renal phosphate reabsorption by cleaving DMP1- and MEPE-derived ASARM peptides (PubMed:18162525, PubMed:18597632). Inhibits the cleavage of MEPE by CTSB/cathepsin B thus preventing MEPE degradation (PubMed:12220505)

Data sources: HGNC (CC BY 4.0), AlphaFold (CC BY 4.0, Jumper et al. Nature 2021), Genomics England PanelApp (CC BY 4.0), ClinGen, Open Targets (CC0), UniProt.

Not for sole clinical decision-making. Always verify against primary sources.