Although nectin-based adhesions have not been extensively studied compared to AJs or TJs, mutations in both NECTIN1 (encoded by the PVRL1 gene) and NECTIN4 (encoded by the PVRL4 gene) cause syndromes involving orofacial clefts (NECTIN1) or phenotypes previously associated with clefting (NECTIN4), supporting their critical role in facial morphogenesis. The gene discussed is NECTIN4; the disease is orofacial cleft.