| 2010 |
TMEM16F (ANO6) is an essential component for Ca2+-dependent exposure of phosphatidylserine on the cell surface; wild-type TMEM16F localizes to the plasma membrane and confers Ca2+-dependent bidirectional phospholipid scrambling activity. A patient with Scott syndrome carries a splice-acceptor site mutation causing premature termination of TMEM16F, linking loss-of-function to defective phospholipid scrambling. |
Expression cloning in Ba/F3 cells, FACS-based PtdSer exposure assay, plasma membrane localization by fluorescence, patient mutation sequencing |
Nature |
High |
21107324
|
| 2012 |
TMEM16F generates a small-conductance Ca2+-activated nonselective cation (SCAN) current permeable to both monovalent and divalent cations including Ca2+, with synergistic gating by Ca2+ and voltage. TMEM16F knockout mice lack Ca2+-dependent phosphatidylserine exposure and procoagulant activity in megakaryocytes, and exhibit bleeding defects and protection from arterial thrombosis. A pore-region residue determines cation vs. anion selectivity. |
TMEM16F knockout mouse generation, patch-clamp electrophysiology in megakaryocytes, heterologous expression, site-directed mutagenesis of pore region |
Cell |
High |
23021219
|
| 2013 |
TMEM16F (ANO6) functions as a component of a Ca2+-activated Cl- channel with high Ca2+ threshold (~9.6 µM), anion selectivity sequence I->Br->Cl->F->aspartate-, and outward rectification. It is not related to volume-sensitive outwardly rectifying Cl- channel (VSOR) activity. |
Whole-cell patch-clamp in TMEM16F-transfected HEK293T cells, ion substitution experiments, siRNA knockdown |
American Journal of Physiology - Cell Physiology |
High |
23426967
|
| 2013 |
ANO6-mediated Ca2+-dependent phospholipid scrambling can occur independently of its ion currents. Ca2+-independent phospholipid scrambling during apoptosis (intrinsic or extrinsic) does not require ANO6. ANO6 Cl- currents can be activated Ca2+-independently via Fas receptor stimulation. |
Patch-clamp electrophysiology, PS exposure assay (annexin V), Cl- channel blockers, siRNA knockdown, Scott syndrome patient B-lymphocytes |
Cell Death & Disease |
High |
23618909
|
| 2013 |
ANO6 (TMEM16F) mediates Ca2+-dependent phospholipid scrambling in osteoblasts; deletion in mice results in impaired PS scrambling in osteoblasts and delayed mineralization, with increased areas of uncalcified osteoid postnatally. This establishes a cell-autonomous role for ANO6 in bone mineralization via PS exposure. |
Ano6 knockout mouse generation, primary osteoblast culture, mineralization assays, Ca2+-dependent PS scrambling assay in osteoblasts |
Journal of Bone and Mineral Research |
High |
22936354
|
| 2013 |
In Scott syndrome patients, TMEM16F-dependent high-PS-exposing platelet fraction is absent upon convulxin/thrombin stimulation. TMEM16F is required for Ca2+-mobilizing agonist-induced PS exposure that depends on mitochondrial depolarization, but is not required for caspase-dependent basal PS exposure. |
Flow cytometry with annexin V, caspase inhibitors, Ca2+ chelation, Scott syndrome patient platelets vs. controls |
Blood |
High |
23303820
|
| 2013 |
Mouse TMEM16F expressed in HEK293 cells produces a Ca2+-activated anion channel current (EC50 ~100 µM Ca2+) with delayed activation, Eisenman type 1 anion selectivity, and outward rectification. Pore-region mutations (R592E, K616E, R636E) alter or abolish currents, identifying the pore region between TM5 and TM6 as functional. |
Heterologous expression in HEK293, whole-cell patch-clamp, site-directed mutagenesis of pore residues |
Journal of General Physiology |
High |
23630341
|
| 2015 |
TMEM16F is the only TMEM16 family member highly expressed in mouse platelets. Platelet-specific TMEM16F knockout causes defects in activation-induced PS exposure, microparticle shedding, and thrombin generation in vitro and in vivo (laser-induced thrombus model), without affecting granule release or clot retraction. |
Platelet-specific TMEM16F conditional KO mice, flow cytometry, thrombin generation assay, laser-induced thrombosis imaging in vivo |
PNAS |
High |
26417084
|
| 2015 |
A specific domain in ANO6 is necessary and sufficient for phospholipid scrambling activity. By analyzing ANO1-ANO6 chimeric proteins, a scramblase domain was identified in ANO6 that, when transferred to ANO1 (which normally does not scramble), confers scramblase activity. Homology modeling shows this domain forms a hydrophilic cleft facing the lipid bilayer. Ion currents in ANO6 are explained by ionic leak during phospholipid translocation. |
Patch-clamp combined with PS exposure assay, ANO1-ANO6 chimera construction, homology modeling |
eLife |
High |
26057829
|
| 2015 |
TMEM16F forms homodimers (shown by chemical cross-linking). The pore region between TM5 and TM6 is essential for both scramblase activity of TMEM16F and Cl- channel activity of TMEM16A. N-terminal and C-terminal cytoplasmic domains control plasma membrane localization and protein stability, respectively, and are functionally interchangeable between TMEM16A and TMEM16F. |
Chemical cross-linking, domain-swap chimeras, deletion analysis, functional assays in 293T cells and TMEM16F-/- thymocytes |
Journal of Biological Chemistry |
High |
24478309
|
| 2015 |
TMEM16F isoforms generated by alternative splicing (V1, V2, V5) show plasma membrane localization and Ca2+-activated ion channel and scramblase activities, while V3 isoform (unique C-terminus) is intracellularly localized and inactive. An activating mutation D409G markedly increases apparent Ca2+ sensitivity of both channel and scramblase activities, directly demonstrating TMEM16F mediates both functions. |
Whole-cell patch-clamp, annexin V binding assay for PS, subcellular localization, activating mutation introduction, siRNA knockdown |
Journal of Physiology |
High |
26108457
|
| 2016 |
TMEM16F is located in late endosomes in T lymphocytes, where it facilitates generation of multivesicular bodies for TCR degradation and signal termination. TMEM16F-deficient T cells show sustained TCR signaling, augmented activation, and increased proliferation and cytokine production in chronic viral infection, ultimately leading to T cell exhaustion. |
Conditional TMEM16F KO mice, viral chronic infection model, late endosome localization by imaging, TCR degradation assay, T cell functional assays |
Journal of Experimental Medicine |
High |
27810927
|
| 2016 |
TMEM16F conditional knockout in microglia prevents mechanical hypersensitivity after nerve injury; TMEM16F-deficient microglia show deficits in process motility and phagocytosis. This establishes TMEM16F as essential for microglial responses to nerve injury in neuropathic pain. |
Conditional TMEM16F KO in microglia, neuropathic pain behavioral testing, microglial motility and phagocytosis assays |
Cell Reports |
High |
27332874
|
| 2016 |
Ca2+ directly binds to TMEM16F; five acidic residues conserved between TMEM16F and TMEM16K are critical for Ca2+ binding (identified by comprehensive mutagenesis of TMEM16K). Point mutations of corresponding residues in TMEM16F reduce Ca2+-dependent phospholipid scrambling. Ca2+ stabilizes TMEM16F structure and induces conformational changes. |
Blue-native PAGE, comprehensive acidic-residue mutagenesis, Ca2+ binding assay, scramblase activity assay |
Biochemistry |
High |
27227820
|
| 2017 |
TMEM16F/ANO6 ion currents and phospholipid scrambling can be activated by modification of plasma membrane phospholipids via reactive oxygen species and phospholipase A2 (PLA2), independently of intracellular Ca2+. Mutations within TMEM16F similarly change both Cl- currents and phospholipid scrambling, suggesting Cl- and phospholipids use the same intramolecular pathway. |
Whole-cell patch-clamp, annexin V PS exposure assay, PLA2 activation/inhibition, ROS donors, chimera/mutant analysis |
Journal of Physiology |
High |
29134661
|
| 2018 |
Single purified TMEM16F dimeric molecules transport phospholipids nonspecifically and bidirectionally between membrane bilayer leaflets in a Ca2+-dependent manner at ~4.5×10^4 lipids/second at 25°C, with activation free energy of 47 kJ/mol. This biophysical profile is consistent with a channel-like facilitated diffusion ('stepping-stone') mechanism. |
Purification of mouse TMEM16F from stable cell line, single-molecule scramblase assay in lipid bilayer microarray, thermodynamic analysis |
PNAS |
High |
29507235
|
| 2018 |
TMEM16F Ca2+-activated current is desensitized by brief high Ca2+ exposure associated with PIP2 depletion from the inner membrane leaflet. Application of PIP2 restores TMEM16F channel activity. PIP2 modulation requires positively charged amino acids in the cytoplasmic N-terminal domain and acts synergistically with membrane depolarization to facilitate Ca2+-gating. |
Excised patch and whole-cell patch-clamp, PIP2 application/depletion, N-terminal domain mutagenesis |
PNAS |
High |
29382763
|
| 2019 |
Cryo-EM structures of murine TMEM16F in absence and presence of Ca2+ reveal a ligand-free closed conformation and a Ca2+-bound intermediate. Both conformations resemble TMEM16A counterparts but with distinct differences in ion/lipid permeation region. Ion conduction and lipid scrambling are activated by a common Ca2+-binding mechanism but appear mediated by alternate protein conformations at equilibrium in the Ca2+-bound state. |
Cryo-EM structure determination, functional electrophysiology, Ca2+-dependent activity assays |
eLife |
High |
30785399
|
| 2019 |
Cryo-EM structural analysis reveals coexistence of an intact channel pore and PIP2-dependent membrane distortion in TMEM16F. Mutagenesis of lipid-binding residues near membrane distortion sites specifically alters onset of lipid scrambling without affecting Ca2+ influx, providing structural evidence for separate pathways for lipid scrambling and ion permeation. |
Cryo-EM, structure-based mutagenesis, functional assays for Ca2+ influx and PS exposure |
Cell Reports |
High |
31291589
|
| 2019 |
TMEM16F contains an inner activation gate formed by three hydrophobic residues (F518, Y563, I612) in the middle of the phospholipid permeation pathway. Lysine substitutions of F518 and Y563 generate constitutively active scramblases bypassing Ca2+-dependent activation. An analogous mutation (L543K) in TMEM16A confers CaPLSase activity to this otherwise Cl- channel. |
Site-directed mutagenesis, PS exposure assay, patch-clamp electrophysiology, gain-of-function and loss-of-function analysis |
Nature Communications |
High |
31015464
|
| 2019 |
TMEM16F ion selectivity dynamically shifts from cation-selective to anion-selective in response to increasing intracellular Ca2+, reflecting alteration of electrostatic field in the permeation pathway (charge-screening mechanism). The Q559K mutant reveals this selectivity shift is independent of channel activation state. |
Excised inside-out patch-clamp, ion substitution experiments with varying Ca2+ concentrations, mutagenesis |
eLife |
High |
31318330
|
| 2019 |
TMEM16F activation by Ca2+ ionophores in Jurkat T cells triggers large-scale plasma membrane expansion coinciding with phospholipid scrambling, followed by ectosome shedding. PD-1 is selectively incorporated into ectosomes in a transmembrane-sequence-dependent manner. TMEM16F-deficient cells fail to expand surface membrane and instead undergo rapid massive endocytosis with PD-1 internalization. |
Live-cell microscopy, patch-clamp, flow cytometry, TMEM16F-KO Jurkat cells, PD-1 trafficking assays |
Scientific Reports |
High |
30679690
|
| 2020 |
TMEM16F is essential for plasma membrane repair after pore-forming agent injury: pore formation triggers Ca2+ influx activating TMEM16F-mediated lipid scrambling, membrane blebbing, and extracellular vesicle release that preserve membrane integrity and cell viability. TMEM16F-deficient mice show compromised control of Listeria infection due to greater neutrophil sensitivity to listeriolysin O. |
TMEM16F-deficient cell lines and mice, pore-forming toxin treatment, cell viability assays, EV quantification, Listeria infection model |
Cell Reports |
High |
31995754
|
| 2020 |
TMEM16F knockout mice show deficiency in trophoblast syncytialization and placental development leading to perinatal lethality. TMEM16F CaPLSase translocates PS to the cell surface independently of apoptosis during trophoblast fusion. |
TMEM16F KO mouse generation, placental histology, trophoblast fusion assays, PS exposure measurement |
Science Advances |
High |
32494719
|
| 2020 |
TMEM16F governs Ca2+-activated Cl- conductance in spinal motoneurons and is expressed in synaptic clusters facing cholinergic C-boutons. Tmem16f exon-deleted mice show decreased motor performance under high-demanding tasks and increased recruitment threshold of fast α-motoneurons. Loss of TMEM16F in ALS mouse model delays disease onset and preserves strength in male mice. |
Targeted exon deletion mouse, immunolocalization at C-boutons, patch-clamp in motoneurons, motor behavioral assays, ALS mouse model |
Cell Reports |
High |
32101737
|
| 2021 |
TMEM16F mediates Ca2+-dependent plasma membrane expansion via invaginations held shut by dynamin. Upon Ca2+ activation of TMEM16F, anionic phospholipids escape from the cytoplasmic monolayer and dynamins relax, opening compartments. Deletion of TMEM16F or dynamins blocks expansion; dynamin2 GTPase-inactivated mutant can regenerate reserve compartments but lipid-binding mutant cannot. |
TMEM16F KO cells, dynamin KO/re-expression, live-cell microscopy, dynamin2-GFP imaging, Ca2+-permeable mechanosensitive channel activation |
Nature Communications |
High |
34404808
|
| 2021 |
TMEM16F Ca2+-dependent activation of PS scramblase during immunological synapse formation locally redistributes PS, reducing the electrostatic potential of the plasma membrane, which increases dissociation of bystander TCR-CD3 cytoplasmic domains from the membrane and enhances TCR-dependent signaling. This establishes the molecular basis for TMEM16F-mediated bystander TCR signal amplification. |
T cell activation assays, PS externalization measurement, membrane electrostatic potential probes, TCR-CD3 membrane association assays |
Science Signaling |
High |
33758060
|
| 2021 |
TMEM16F channel and scramblase activities are strongly regulated by intracellular pH (pHi): low pHi attenuates and high pHi potentiates both activities. pHi sensitivity depends on [Ca2+]i and shows a bell-shaped relationship with [Ca2+]i. A Ca2+-binding residue mutation (E667Q) shifts the peak [Ca2+]i of pHi sensitivity, establishing that protons compete with Ca2+ at primary Ca2+-binding sites in the pore to regulate TMEM16F activation. |
Whole-cell patch-clamp, PS exposure assay at varying pHi and Ca2+ levels, Ca2+-binding residue mutagenesis (E667Q) |
Journal of General Physiology |
High |
33346788
|
| 2022 |
TMEM16F is activated by SARS-CoV-2 Spike protein binding (via ACE2) to mediate PS externalization critical for viral entry. ANO6-selective inhibitor A6-001 identified by high-throughput screening inhibits both Spike-induced PS scrambling and authentic SARS-CoV-2 replication in multiple cell types. |
SARS2 pseudotyped virus, Ca2+ imaging, annexin V flow cytometry, high-throughput drug screening, authentic SARS-CoV-2 infection assays in Vero/Calu-3/primary nasal cells |
Cell Reports |
High |
35839776
|
| 2022 |
Cryo-EM structures of activating TMEM16F mutants reveal major rearrangements leading to exposure of hydrophilic patches to the membrane, whose distortion facilitates lipid diffusion. Concomitant opening of a pore promotes ion conduction in the same protein conformation, revealing a mechanism distinct from other TMEM16 family members. |
Cryo-EM structure determination of activating mutants, functional scramblase and ion channel assays |
Nature Communications |
High |
36335104
|
| 2022 |
TRPV4 Ca2+ influx channel is functionally coupled to TMEM16F within Ca2+ microdomains in human trophoblasts. TRPV4-specific agonist activates TMEM16F in trophoblasts; pharmacological inhibition or gene silencing of TRPV4 impairs TMEM16F activation and subsequent trophoblast syncytialization. |
Patch-clamp electrophysiology, TRPV4 agonist/antagonist treatment, gene silencing, PS exposure assay, trophoblast fusion assay |
eLife |
High |
35670667
|
| 2023 |
Cryo-EM structures of TMEM16F with bound niclosamide or 1PBC reveal a lipid scrambling pathway along a groove outside the ion permeation pore containing a drug-binding pocket. Mutations in this groove specifically affect lipid scrambling but not ion conduction; some mutations preferentially reduce inhibition of PS exposure vs. Ca2+ influx, providing structural evidence for separate ion permeation and lipid scrambling pathways. |
Cryo-EM structure determination with bound drugs, mutagenesis, patch-clamp, PS exposure assay |
Nature Communications |
High |
37573365
|
| 2024 |
TMEM16F (the RBC Ca2+-activated phospholipid scramblase) is activated downstream of Ca2+ influx through the mechanosensitive channel PIEZO1 in red blood cells. In hereditary xerocytosis (PIEZO1 gain-of-function), enhanced PIEZO1-TMEM16F coupling increases propensity for PS exposure, contributing to anemia, splenomegaly and thrombosis. Inhibition of PIEZO1 with benzbromarone prevents force-induced PS exposure. |
Electrophysiology, flow cytometry, imaging in RBCs from HX patients and controls; pharmacological PIEZO1 inhibition; functional hemolysis and PS assays |
Blood |
High |
38033286
|
| 2024 |
TMEM16F deficiency in neurons (but not microglia) reduces tau pathology and microgliosis in a PS19 tauopathy mouse model. TMEM16F mediates aberrant PS exposure in neurons with phospho-tau burden, establishing a neuronal-autonomous role for TMEM16F in tau pathology. |
Cell-type-specific TMEM16F KO in PS19 tau mouse model, immunohistochemistry, PS exposure assay in neurons |
PNAS |
High |
38941274
|
| 2024 |
TMEM16F deficiency in endothelial cells impairs developmental retinal angiogenesis. Biochemically, TMEM16F absence enhances plasma membrane association of activated Src kinase (Y416 phosphorylation), increases VE-cadherin phosphorylation and downregulation, suppressing angiogenesis. This establishes an intracellular signaling role for TMEM16F in endothelial cells. |
Endothelial-specific TMEM16F KO mice, retinal angiogenesis assay, Src kinase phosphorylation, VE-cadherin Western blot/immunofluorescence, HUVEC siRNA knockdown |
Journal of Cell Science |
High |
38940198
|
| 2024 |
TMEM16F regulates pathologic α-synuclein (α-synA53T) spread in neurons. Neurons from TMEM16F KO mice show reduced donor-to-recipient spread of α-synA53T. In vivo PD mouse model shows attenuated α-synA53T spread upon TMEM16F ablation. A missense SNP (Ala703Ser) in TMEM16F with enhanced scramblase activity is associated with altered α-synA53T secretion in Ashkenazi Jewish PD patients. |
TMEM16F KO neurons with reporter-based spread assay, in vivo PD mouse model, lipid scramblase activity assay for Ala703Ser variant |
Aging Cell |
High |
39487963
|
| 2018 |
ANO6/TMEM16F Cl- channel activation kinetics are negatively regulated by the intact actin cytoskeleton (cytochalasin-D accelerates, phalloidin/jasplakinolide inhibit activation) and positively modulated by intracellular MgATP (prevents inactivation). Inside-out patches show immediate Ca2+-dependent activation, suggesting cytosolic factors including cytoskeleton and ATP mediate the slow whole-cell activation. |
Whole-cell and inside-out patch-clamp, cytoskeleton-disrupting/stabilizing agents, intracellular ATP manipulation |
Biochemical and Biophysical Research Communications |
Medium |
29964013
|
| 2023 |
ANO6-dependent trogocytosis in cancer-associated fibroblasts (CAFs) is triggered by cytosolic Ca2+ influx via Orai channels, which activates ANO6 causing PS exposure on CAF plasma membranes, initiating membrane lipid transfer (including cholesterol) to pancreatic cancer cells. ANO6-dependent trogocytosis also supports immunosuppressive function of CAFs toward cytotoxic T cells. |
CRISPR KO of ANO6, Ca2+ imaging, annexin V/PS exposure assay, cholesterol transfer assay, T cell cytotoxicity assay |
bioRxiv (preprint)preprint |
Medium |
37745612
|
| 2025 |
High-resolution cryo-EM of TMEM16F active in liposomes reveals two conformations in high-activity conditions: the canonical Ca2+-bound closed state and a novel X-shaped groove conformation where upward rotation of the cytosolic domain forms a transmembrane pore and locally thins the membrane. Mutagenesis, functional assays, and MD simulations show the X-shaped groove mediates nonselective ion flux and lipid scrambling through distinct pathways (ions within the pore, lipids skirting the groove). |
Cryo-EM in liposomes, site-directed mutagenesis, functional ion flux and scramblase assays, molecular dynamics simulations |
Nature Structural & Molecular Biology |
High |
41998358
|
| 2025 |
TMEM16F preferentially scrambles phosphatidylserine and phosphatidylcholine over phosphatidylethanolamine on the plasma membrane of living cells, contrary to the prevailing view that scramblases act without headgroup preference. |
Cell-based fluorescence polarization scrambling assay with NBD-labeled phospholipids, kinetic monitoring on live cell plasma membranes |
PNAS |
Medium |
41166415
|
| 2019 |
TMEM16F activation contributes to ferroptotic cell death: ferroptosis inducers (erastin, RSL3) activate TMEM16F currents in intestinal epithelium and macrophages, and cell death is largely reduced in tissue-specific TMEM16F KO mice. Inhibitors of ferroptosis (ferrostatin-1) block TMEM16F currents. |
Tissue-specific TMEM16F KO mice, ferroptosis induction with erastin/RSL3, cell death assays, patch-clamp recording |
Cancers |
High |
31060306
|
| 2018 |
TMEM16F contributes to pyroptotic cell death downstream of gasdermin-D pore formation. GD-N expression induces Ca2+ elevation activating TMEM16F, which generates large whole-cell currents; knockdown or inhibition of TMEM16F suppresses these currents and reduces cell death in HEK293 and HAP1 cells. |
GD-N expression, TMEM16F knockdown/inhibition, whole-cell patch-clamp, cell viability assays |
Cell Death & Disease |
Medium |
29463790
|
| 2021 |
N-terminal domain of ANO6 contains a putative Ca2+-transferring reservoir (Nt-CaRes) that regulates Ca2+ sensitivity. Chimera ANO6-1-6 (with ANO1 Nt-CaRes substituted) shows higher Ca2+ sensitivity than ANO6. Mutagenesis of acidic amino acids in Nt-CaRes reduces Ca2+ sensitivity, consistent with direct Ca2+ interactions at these residues. |
Chimera construction, site-directed mutagenesis of acidic residues, patch-clamp Ca2+ dose-response, molecular dynamics simulation |
Molecules and Cells |
Medium |
33658434
|
| 2024 |
Atomic force microscopy under physiological conditions reveals structurally and mechanically diverse TMEM16F assemblies with variable inter-subunit dimerization interfaces. Ca2+-induced activation is associated with stepwise changes in the pore region affecting mechanical properties of TM3, TM4, and TM6. Direct observation of membrane remodeling links structural heterogeneity to ion and lipid permeation. |
Atomic force microscopy in physiological conditions, cryo-EM comparison, patch-clamp electrophysiology |
Nature Communications |
High |
38167485
|
| 2026 |
Plasmalemmal lipid scrambling by TMEM16F (using inducible active form) is sufficient to release apoptotic-like vesicles without changes in cytosolic Ca2+ or submembrane cytoskeleton. Scrambling causes segregation of exofacial lipids, redistribution of cholesterol to inner leaflet, GPI-anchored protein clustering forming convex curvature, and PE accumulation forming concave curvature facilitating vesicle scission. |
Inducible constitutively active TMEM16F, live-cell imaging, lipid domain analysis, extracellular vesicle quantification |
Molecular Biology of the Cell |
High |
41604453
|