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ETFA

electron transfer flavoprotein subunit alpha

The ETFA gene provides instructions for the alpha subunit of electron transfer flavoprotein, an enzyme critical for breaking down fats and proteins to produce energy within cellular mitochondria. The ETFA gene is fundamental for cellular energy production, encoding a component of an enzyme involved in metabolism.

Chromosome 15q24.2-q24.3 Autosomal recessive HGNC:3481 Tier C
ETFA 15q24.2-q24.3 p arm q arm 15

ETFA is located on the long (q) arm of chromosome 15, at band 15q24.2-q24.3. Arm ratio per GRCh38 - banding schematic.

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Overview

The ETFA gene, or electron transfer flavoprotein subunit alpha, is vital for metabolic processes within the human body. It provides the genetic blueprint for one part of the electron transfer flavoprotein enzyme. This enzyme plays a crucial role in the mitochondria, often referred to as the 'powerhouses' of the cell, where it helps convert fats and proteins into usable energy.

What the gene does

The electron transfer flavoprotein (ETF) enzyme, partly encoded by the ETFA gene, is essential for mitochondrial energy production. Specifically, the ETFA gene codes for the alpha subunit of this enzyme. ETF acts as an electron acceptor from several acyl-CoA dehydrogenases, transferring these electrons further down the electron transport chain. This process is integral to the beta-oxidation of fatty acids and the catabolism of certain amino acids, ensuring the cell can efficiently extract energy from these nutrient sources. When the ETF enzyme is deficient or non-functional due to variants in ETFA, the body's ability to break down these molecules is impaired, leading to an accumulation of metabolic intermediates.

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Chromosome location

The ETFA gene is located on chromosome 15, specifically within the 15q24.2-q24.3 region. This chromosomal band position helps geneticists and clinicians pinpoint its precise location within the human genome.

Protein structure

The protein encoded by the ETFA gene is 333 amino acids long and forms the alpha subunit of the electron transfer flavoprotein. This subunit contains two distinct regions: Domain I, spanning amino acids 20-204, and Domain II, encompassing amino acids 205-333. These domains are crucial for the protein's overall structure and its ability to interact with other components of the electron transfer flavoprotein complex and facilitate electron transfer.

Domain map · 333 amino acids
Domain I (20-204)Domain II (205-333)Domain I20-204Domain II205-3331~167333
Region - functional region
🧬 Explore 3D structure on AlphaFold
UniProt:P13804Length:333 aaStructure:AlphaFold

Key variants

Variants within the ETFA gene can affect the production or function of the electron transfer flavoprotein alpha subunit. These genetic changes can lead to a range of impacts, from completely preventing the enzyme's formation to producing a defective enzyme that cannot perform its metabolic role effectively.

The table below shows the top 10 pathogenic or likely-pathogenic variants currently classified in ClinVar for ETFA.
View all on ClinVar →

Sample of pathogenic variants

10 pathogenic / likely-pathogenic variants from ClinVar, ranked by review status (expert-panel-reviewed first). This is a sample; recurrent founder variants in a specific population may not appear here - see the full ClinVar listing via the link above.

Variant (HGVS) Protein change Classification Evidence Associated condition
c.177del
Deletion
p.Lys59fs Pathogenic/Likely pathogenic ★★☆☆ Multiple acyl-CoA dehydrogenase deficiency
c.1A>G
single nucleotide variant
p.Met1Val Pathogenic ★★☆☆ Glutaric acidemia type 2A
c.203_204del
Deletion
p.Leu67_Cys68insTer Pathogenic/Likely pathogenic ★★☆☆ Glutaric acidemia type 2A
c.284dup
Duplication
p.Leu95fs Pathogenic/Likely pathogenic ★★☆☆ Multiple acyl-CoA dehydrogenase deficiency
c.298_325del
Deletion
p.Gln100fs Pathogenic/Likely pathogenic ★★☆☆ Multiple acyl-CoA dehydrogenase deficiency
c.321_322del
Microsatellite
p.Ile108fs Pathogenic/Likely pathogenic ★★☆☆ Multiple acyl-CoA dehydrogenase deficiency
c.3G>A
single nucleotide variant
p.Met1Ile Pathogenic/Likely pathogenic ★★☆☆ Fetal anomalies with a likely genetic cause
c.44C>A
single nucleotide variant
p.Ser15Ter Pathogenic/Likely pathogenic ★★☆☆ Glutaric acidemia type 2A
c.693dup
Duplication
p.Lys232Ter Pathogenic/Likely pathogenic ★★☆☆ Multiple acyl-CoA dehydrogenase deficiency
c.826_833dup
Duplication
p.Gly279fs Pathogenic/Likely pathogenic ★★☆☆ Glutaric acidemia type 2A

Evidence stars indicate ClinVar review status. Individual variant interpretation should always be performed by a qualified clinical laboratory - many variants remain classified as Variants of Uncertain Significance (VUS) pending more research.

Associated conditions

Pathogenic variants in the ETFA gene are primarily associated with an inherited metabolic disorder known as Multiple acyl-CoA dehydrogenase deficiency (MADD), also referred to as Glutaric acidaemia type II (GA-II). This condition is inherited in an autosomal recessive pattern. It arises when the dysfunctional electron transfer flavoprotein impairs the body's ability to break down fats and proteins, leading to an accumulation of partially broken-down compounds.

  • Multiple acyl-CoA dehydrogenase deficiency (MADD / GA-II)
    IEM
    AR
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Inheritance pattern

Conditions caused by pathogenic ETFA variants typically follow autosomal recessive inheritance.

♀ Carrier parent 1 altered copy ♂ Carrier parent 1 altered copy Affected Carrier Carrier Unaffected Affected Carrier Unaffected Circles = females · Squares = males

When both parents are carriers, each child has a 25% chance of being affected, 50% of being a carrier, and 25% of being unaffected.

Carrier frequency by population How common is heterozygous ETFA carrier status across ancestry groups?

UK clinical status

The ETFA gene is recognised within the UK's NHS Genomic Medicine Service pathways. It is included on several green-rated PanelApp panels, indicating strong evidence for its association with conditions such as Acute rhabdomyolysis, Foetal anomalies, Hyperammonaemia, Intellectual disability, and as a cause of Likely inborn errors of metabolism and Rhabdomyolysis and metabolic muscle disorders.

Frequently asked questions

What is the primary function of the ETFA gene?

The ETFA gene provides instructions for the alpha subunit of electron transfer flavoprotein, an enzyme crucial for breaking down fats and proteins into energy within the mitochondria of cells.

What condition is associated with variants in the ETFA gene?

Pathogenic variants in the ETFA gene are primarily associated with Multiple acyl-CoA dehydrogenase deficiency (MADD), also known as Glutaric acidaemia type II (GA-II), an inherited metabolic disorder.

How is Multiple acyl-CoA dehydrogenase deficiency inherited?

Multiple acyl-CoA dehydrogenase deficiency (MADD) is inherited in an autosomal recessive pattern, meaning an individual must inherit two copies of a pathogenic ETFA variant (one from each parent) to develop the condition.

References

  1. Schiff M, Froissart R, Olsen RK. Electron transfer flavoprotein deficiency: functional and molecular aspects. Molecular genetics and metabolism. 2006. PMID: 16510302
  2. Olsen RK, Andresen BS, Christensen E. DNA-based prenatal diagnosis for severe and variant forms of multiple acyl-CoA dehydrogenation deficiency. Prenatal diagnosis. 2005. PMID: 15662686
  3. Olsen RK, Andresen BS, Christensen E. Clear relationship between ETF/ETFDH genotype and phenotype in patients with multiple acyl-CoA dehydrogenation deficiency. Human mutation. 2003. PMID: 12815589
  4. Purevjav E, Kimura M, Takusa Y. Molecular study of electron transfer flavoprotein alpha-subunit deficiency in two Japanese children with different phenotypes of glutaric acidemia type II. European journal of clinical investigation. 2002. PMID: 12486872
  5. Bross P, Pedersen P, Winter V. A polymorphic variant in the human electron transfer flavoprotein alpha-chain (alpha-T171) displays decreased thermal stability and is overrepresented in very-long-chain acyl-CoA dehydrogenase-deficient patients with mild childhood presentation. Molecular genetics and metabolism. 1999. PMID: 10356313
  6. Salazar D, Zhang L, deGala GD. Expression and characterization of two pathogenic mutations in human electron transfer flavoprotein. The Journal of biological chemistry. 1997. PMID: 9334218
  7. White RA, Dowler LL, Angeloni SV. Assignment of Etfdh, Etfb, and Etfa to chromosomes 3, 7, and 13: the mouse homologs of genes responsible for glutaric acidemia type II in human. Genomics. 1996. PMID: 8617498
Educational content. This page is not medical or genetic advice, is not individually reviewed by a clinician for each reader, and should not replace a consultation with a qualified healthcare professional or genetic counsellor. If you are considering genetic testing or acting on a test result, book a consultation.
Data sources Last updated 4 October 2026. Content compiled from HGNC · MedlinePlus Genetics · ClinGen · Genomics England PanelApp · NHS National Genomic Test Directory · ClinVar · UniProt · AlphaFold .