Ankyloblepharon-ectodermal defects-cleft lip/palate syndrome

Summary

Ankyloblepharon-ectodermal defects-cleft lip/palate syndrome (MONDO:0007124) is a disease caused by TP63 (GenCC Definitive), with 1 cohort gene.

At a glance

• Prevalence: Unknown (Worldwide)
• Causal gene: TP63 (GenCC Definitive)
• Cohort genes: 1
• ClinVar variants: 87
• Phenotypes (HPO): 31

Clinical features

Signs & symptoms

Clinical features (HPO)

31 HPO clinical features (Orphanet curated; top 31 by frequency):

HPO ID	Term	Frequency
HP:0000405	Conductive hearing impairment	Very frequent (80-99%)
HP:0000431	Wide nasal bridge	Very frequent (80-99%)
HP:0000966	Hypohidrosis	Very frequent (80-99%)
HP:0001795	Hyperconvex nail	Very frequent (80-99%)
HP:0001810	Dystrophic toenail	Very frequent (80-99%)
HP:0001812	Hyperconvex fingernails	Very frequent (80-99%)
HP:0002208	Coarse hair	Very frequent (80-99%)
HP:0008070	Sparse hair	Very frequent (80-99%)
HP:0008391	Dystrophic fingernails	Very frequent (80-99%)
HP:0009755	Ankyloblepharon	Very frequent (80-99%)
HP:0100335	Non-midline cleft of the upper lip	Very frequent (80-99%)
HP:0000175	Cleft palate	Frequent (30-79%)
HP:0000176	Submucous cleft hard palate	Frequent (30-79%)
HP:0000347	Micrognathia	Frequent (30-79%)
HP:0000653	Sparse eyelashes	Frequent (30-79%)
HP:0000668	Hypodontia	Frequent (30-79%)
HP:0000682	Abnormality of dental enamel	Frequent (30-79%)
HP:0000687	Widely spaced teeth	Frequent (30-79%)
HP:0000698	Conical tooth	Frequent (30-79%)
HP:0000982	Palmoplantar keratoderma	Frequent (30-79%)
HP:0007440	Generalized hyperpigmentation	Frequent (30-79%)
HP:0011819	Submucous cleft soft palate	Frequent (30-79%)
HP:0045075	Sparse eyebrow	Frequent (30-79%)
HP:0000411	Protruding ear	Occasional (5-29%)
HP:0000684	Delayed eruption of teeth	Occasional (5-29%)
HP:0001092	Absent lacrimal punctum	Occasional (5-29%)
HP:0001608	Abnormality of the voice	Occasional (5-29%)
HP:0001629	Ventricular septal defect	Occasional (5-29%)
HP:0002558	Supernumerary nipple	Occasional (5-29%)
HP:0004209	Clinodactyly of the 5th finger	Occasional (5-29%)
HP:0006101	Finger syndactyly	Occasional (5-29%)

Identifiers

Disease identifiers

Field	Value
Canonical name	ankyloblepharon-ectodermal defects-cleft lip/palate syndrome
Mondo ID	MONDO:0007124
MeSH	C535847
OMIM	106260
Orphanet	1071
DOID	DOID:0090119
SNOMED CT	55821006
UMLS	C0406709
MedGen	98032
GARD	0006571
NORD	738
Is cancer (heuristic)	no

Also known as: AEC Syndrome · AEC syndrome · Ankyloblepharon ectodermal defects cleft lip/palate · cleft palate, ankyloblepharon, alveolar synechiae, and ectodermal defects · Hay-Wells syndrome · Rapp-Hodgkins syndrome · Seres-Santamaria Arimany Muniz syndrome

Data availability: 87 ClinVar variants · 2 GenCC gene-disease records · 3 cell lines.

Disease family

An umbrella term covering 1 Mondo subtype.

Classification path: disease › human disease › disease by body system or component › musculoskeletal system disorder › skeletal system disorder › bone disorder › bone development disease › dysostosis › ankyloblepharon-ectodermal defects-cleft lip/palate syndrome

Related subtypes (107): trigonocephaly, spondylocostal dysostosis, synostosis, Adams-Oliver syndrome, adactylia, unilateral, ADULT syndrome, Cooks syndrome, brachydactyly-arterial hypertension syndrome, fibular aplasia-ectrodactyly syndrome, brachytelephalangy-dysmorphism-Kallmann syndrome, congenital pseudoarthrosis of clavicle, external auditory canal atresia-vertical talus-hypertelorism syndrome, femoral-facial syndrome, hand-foot-genital syndrome, oculoauriculovertebral spectrum with radial defects, IVIC syndrome, nail-patella syndrome, patella aplasia/hypoplasia, pelvis-shoulder dysplasia, phocomelia-ectrodactyly-deafness-sinus arrhythmia syndrome, postaxial tetramelic oligodactyly, Currarino triad, radio-renal syndrome, splenogonadal fusion-limb defects-micrognathia syndrome, Karsch-Neugebauer syndrome, tetramelic monodactyly, tibia, hypoplasia or aplasia of, with polydactyly, humerus trochlea aplasia, Aphalangy-hemivertebrae-urogenital-intestinal dysgenesis syndrome, camptodactyly syndrome, Guadalajara type 2, camptodactyly with fibrous tissue hyperplasia and skeletal dysplasia, split hand-foot malformation 1 with sensorineural hearing loss, EEM syndrome, lethal faciocardiomelic dysplasia, femur-fibula-ulna complex, Gollop-Wolfgang complex, acromesomelic dysplasia 2B, Fuhrmann syndrome, absence deformity of leg-cataract syndrome, intellectual disability-spasticity-ectrodactyly syndrome, fibular aplasia, tibial campomelia, and oligosyndactyly syndrome, otoonychoperoneal syndrome, pelviscapular dysplasia, rapadilino syndrome, EEC syndrome, spondylocostal dysostosis-anal and genitourinary malformations syndrome, tetraamelia-multiple malformations syndrome, thrombocytopenia-absent radius syndrome, phocomelia, Schinzel type, ulna hypoplasia-intellectual disability syndrome, absent radius-anogenital anomalies syndrome, ulnar hypoplasia-split foot syndrome, aphalangy-syndactyly-microcephaly syndrome, absent tibia-polydactyly-arachnoid cyst syndrome, autosomal recessive amelia, pelvic dysplasia-arthrogryposis of lower limbs syndrome, camptodactyly, myopia, and fibrosis of the medial rectus muscle of eye, radio-ulnar synostosis-amegakaryocytic thrombocytopenia syndrome, genitopatellar syndrome, Duane-radial ray syndrome, intellectual disability-brachydactyly-Pierre Robin syndrome, camptodactyly syndrome, Guadalajara type 3, mammary-digital-nail syndrome, postaxial polydactyly-anterior pituitary anomalies-facial dysmorphism syndrome, split-foot malformation-mesoaxial polydactyly syndrome, amniotic band syndrome, radial deficiency-tibial hypoplasia syndrome, mandibulofacial dysostosis, oromandibular-limb anomalies syndrome, congenital pseudoarthrosis of the limbs, oculomaxillofacial dysostosis, shoulder and thorax deformity-congenital heart disease syndrome, femoral agenesis/hypoplasia, progressive non-infectious anterior vertebral fusion, hemimelia, heart-hand syndrome, split hand-foot malformation, Melhem-Fahl syndrome, limb transversal defect-cardiac anomaly syndrome, frontonasal dysplasia, imperforate oropharynx-costo vetebral anomalies syndrome, non-syndromic amelia, congenital absence of upper arm and forearm with hand present, congenital absence of thigh and lower leg with foot present, congenital absence of both forearm and hand, congenital absence of both lower leg and foot, acheiria, apodia, split hand, split foot, hyperphalangy, Prata-Liberal-Goncalves syndrome, syngnathia multiple anomalies, hereditary thrombocytosis with transverse limb defect, thalidomide embryopathy, tibial aplasia-ectrodactyly syndrome, bipartite talus, acrofacial dysostosis, adactyly of foot, neurodevelopmental disorder-craniofacial dysmorphism-cardiac defect-hip dysplasia syndrome, Rubinstein-Taybi syndrome, ischio-vertebral syndrome, congenital progressive bone marrow failure-B-cell immunodeficiency-skeletal dysplasia syndrome, omphalocele-diaphragmatic hernia-cardiovascular anomalies-radial ray defect syndrome, preaxial digit brachydactyly-webbed fingers, proximal femoral focal deficiency, dysostosis multiplex, Ain-Naz type

Subtypes (1): Rosselli-Gulienetti syndrome

Genetics & variants

GWAS landscape

No GWAS associations recorded — common-variant (GWAS) studies don’t cover this disease (typical for Mendelian / rare diseases). See the curated gene cohort and Mendelian overlap below.

Variant details and genetic-evidence tiers

ClinVar germline variants

87 retrieved; paginated sample, class counts are floors:

49 uncertain significance, 11 conflicting classifications of pathogenicity, 10 likely benign, 7 benign/likely benign, 5 pathogenic, 4 likely pathogenic, 1 pathogenic/likely pathogenic

ClinVar	Variant (HGVS)	Gene	Classification	Review
208163	NM_003722.5(TP63):c.740A>G (p.His247Arg)	TP63	Pathogenic	criteria provided, multiple submitters, no conflicts
6527	NM_003722.5(TP63):c.727C>T (p.Arg243Trp)	TP63	Pathogenic	criteria provided, multiple submitters, no conflicts
6534	NM_003722.5(TP63):c.1028G>A (p.Arg343Gln)	TP63	Pathogenic/Likely pathogenic	criteria provided, multiple submitters, no conflicts
6535	NM_003722.5(TP63):c.1659A>T (p.Leu553Phe)	TP63	Pathogenic	no assertion criteria provided
6544	NM_003722.5(TP63):c.1646T>C (p.Ile549Thr)	TP63	Pathogenic	no assertion criteria provided
6553	NM_003722.5(TP63):c.1833_1843dup (p.His615fs)	TP63	Pathogenic	no assertion criteria provided
3589070	NM_003722.5(TP63):c.345dup (p.Leu116fs)	TP63	Likely pathogenic	criteria provided, single submitter
3589074	NM_003722.5(TP63):c.1129+1G>A	TP63	Likely pathogenic	criteria provided, single submitter
4796625	NM_003722.5(TP63):c.733C>T (p.Pro245Ser)	TP63	Likely pathogenic	criteria provided, single submitter
6536	NM_003722.5(TP63):c.1681T>G (p.Cys561Gly)	TP63	Likely pathogenic	criteria provided, single submitter
1370798	NM_003722.5(TP63):c.1537G>C (p.Ala513Pro)	TP63	Conflicting classifications of pathogenicity	criteria provided, conflicting classifications
1412118	NM_003722.5(TP63):c.1814G>A (p.Arg605Gln)	TP63	Conflicting classifications of pathogenicity	criteria provided, conflicting classifications
1433359	NM_003722.5(TP63):c.1807G>C (p.Asp603His)	TP63	Conflicting classifications of pathogenicity	criteria provided, conflicting classifications
1476128	NM_003722.5(TP63):c.2003G>A (p.Arg668His)	TP63	Conflicting classifications of pathogenicity	criteria provided, conflicting classifications
1503085	NM_003722.5(TP63):c.1352C>G (p.Thr451Ser)	TP63	Conflicting classifications of pathogenicity	criteria provided, conflicting classifications
1561066	NM_003722.5(TP63):c.475C>T (p.Leu159Phe)	TP63	Conflicting classifications of pathogenicity	criteria provided, conflicting classifications
1598420	NM_003722.5(TP63):c.1367C>T (p.Pro456Leu)	TP63	Conflicting classifications of pathogenicity	criteria provided, conflicting classifications
1600102	NM_003722.5(TP63):c.1480A>G (p.Thr494Ala)	TP63	Conflicting classifications of pathogenicity	criteria provided, conflicting classifications
2721206	NM_003722.5(TP63):c.1661C>T (p.Ala554Val)	TP63	Conflicting classifications of pathogenicity	criteria provided, conflicting classifications
725955	NM_003722.5(TP63):c.84T>G (p.His28Gln)	TP63	Conflicting classifications of pathogenicity	criteria provided, conflicting classifications
899830	NM_003722.5(TP63):c.210G>C (p.Gln70His)	TP63	Conflicting classifications of pathogenicity	criteria provided, conflicting classifications
1038841	NM_003722.5(TP63):c.1121C>T (p.Thr374Met)	TP63	Uncertain significance	criteria provided, multiple submitters, no conflicts
1042494	NM_003722.5(TP63):c.1697C>T (p.Thr566Met)	TP63	Uncertain significance	criteria provided, multiple submitters, no conflicts
1314992	NM_003722.5(TP63):c.2021G>A (p.Arg674His)	TP63	Uncertain significance	criteria provided, multiple submitters, no conflicts
1370657	NM_003722.5(TP63):c.1831TCC[1] (p.Ser612del)	TP63	Uncertain significance	criteria provided, multiple submitters, no conflicts
1375700	NM_003722.5(TP63):c.1507+6_1507+7del	TP63	Uncertain significance	criteria provided, multiple submitters, no conflicts
1385690	NM_003722.5(TP63):c.1583C>A (p.Pro528Gln)	TP63	Uncertain significance	criteria provided, multiple submitters, no conflicts
1398414	NM_003722.5(TP63):c.110G>A (p.Arg37Gln)	TP63	Uncertain significance	criteria provided, multiple submitters, no conflicts
1421645	NM_003722.5(TP63):c.50C>G (p.Pro17Arg)	TP63	Uncertain significance	criteria provided, multiple submitters, no conflicts
1494162	NM_003722.5(TP63):c.1612A>G (p.Thr538Ala)	TP63	Uncertain significance	criteria provided, multiple submitters, no conflicts

Genes & proteins

Mendelian disease overlap and somatic drivers

GenCC: 16 · Orphanet: 9 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0

GenCC gene–disease validity (cohort genes)

the Disease column is the GenCC-asserted condition — a cohort gene’s strongest validity may be for a related predisposition syndrome.

Gene	Classification	Inheritance	Disease	Records
TP63	Definitive	Autosomal dominant	ectrodactyly, ectodermal dysplasia, and cleft lip-palate syndrome 3	16

Orphanet rare-disease linkage (cohort genes)

Gene	Orphanet ID	Rare disease
TP63	Orphanet:1072	Ankyloblepharon filiforme adnatum-cleft palate syndrome
TP63	Orphanet:141291	Cleft lip and alveolus
TP63	Orphanet:1896	EEC syndrome
TP63	Orphanet:199302	Isolated cleft lip
TP63	Orphanet:199306	Cleft lip/palate
TP63	Orphanet:2440	Isolated split hand-split foot malformation
TP63	Orphanet:69085	Limb-mammary syndrome
TP63	Orphanet:93930	Classic bladder exstrophy
TP63	Orphanet:978	ADULT syndrome

Cohort genes → proteins

1 cohort genes, 1 distinct canonical proteins.

Evidence partition

Subset	Genes
multi_evidence	1

Cohort genes (full)

Symbol	HGNC	Ensembl	UniProt	Name	Evidence
TP63	HGNC:15979	ENSG00000073282	Q9H3D4	Tumor protein 63	gencc,clinvar

Cohort function summary

Lead sentence per gene, UniProt-curated.

Symbol	Protein name	Function (lead sentence)
TP63	Tumor protein 63	Acts as a sequence specific DNA binding transcriptional activator or repressor.

Protein-family classification

Druggable: 0 · Difficult: 1 · Unknown: 0 · Druggable fraction: 0.0

Family distribution

Cohort families vs a genome-wide background (hypergeometric, BH-FDR; fold = observed/expected). Counts kept; sorted by enrichment, so the catch-all Other/Unknown bucket no longer leads.

Family	Genes	Fold	FDR
Transcription factor	1	8.3×	0.121

Per-gene assignment

Symbol	Family	Druggable?	EC	InterPro (top 3)
TP63	Transcription factor	no		SAM, p53_tumour_suppressor, p53-like_TF_DNA-bd_sf

Expression context

Cohort genes with no expression data: 0.

1 cohort gene are a single-cell marker in ≥1 SCXA experiment.

Breadth distribution (Bgee present_calls)

Bucket	Genes
narrow (1-5 tissues)	0
moderate (6-20)	0
broad (>20)	1
unknown	0

Top tissues across cohort

Tissue	Cohort genes
skin of hip	1
upper arm skin	1
upper leg skin	1

Per-gene tissue summary (top 30)

Symbol	Bgee breadth	FANTOM5 breadth	SCXA	Top tissues
TP63	207	broad	marker	upper leg skin, skin of hip, upper arm skin

Protein interactions among cohort

Intra-cohort edges: 0.

Hub genes (top 10 by interactor count)

Symbol	Interactor count
TP63	2,893

Structural data

PDB: 1 · AlphaFold-only: 0 · No structure: 0

Cohort genes with PDB structures (top 30)

Symbol	UniProt	PDB entries
TP63	Q9H3D4	26

Function

Pathway analysis

Distinct Reactome pathways touched by cohort: 12. Enrichment computed across 1 evidence-associated genes (1 with Reactome annotation).

Pathways by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 1 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

Pathway	Cohort genes	Fold	FDR	Sample cohort genes
Activation of PUMA and translocation to mitochondria	1	1142.0×	0.003	TP63
TP53 Regulates Transcription of Caspase Activators and Caspases	1	951.7×	0.003	TP63
TP53 Regulates Transcription of Death Receptors and Ligands	1	951.7×	0.003	TP63
Regulation of TP53 Activity through Association with Co-factors	1	815.7×	0.003	TP63
TP53 regulates transcription of several additional cell death genes whose specific roles in p53-dependent apoptosis remain uncertain	1	761.3×	0.003	TP63
Developmental Lineage of Mammary Stem Cells	1	761.3×	0.003	TP63
TP53 Regulates Transcription of Genes Involved in Cytochrome C Release	1	543.8×	0.003	TP63
Developmental Lineage of Mammary Gland Myoepithelial Cells	1	543.8×	0.003	TP63
Developmental Lineage of Mammary Gland Luminal Epithelial Cells	1	456.8×	0.003	TP63
Pyroptosis	1	423.0×	0.003	TP63
Differentiation of Keratinocytes in Interfollicular Epidermis in Mammalian Skin	1	278.5×	0.004	TP63
TP53 Regulates Metabolic Genes	1	129.8×	0.008	TP63

GO biological processes by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 1 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

GO term	Cohort genes	Fold	FDR	Sample cohort genes
ectoderm and mesoderm interaction	1	16852.0×	0.001	TP63
epidermal cell division	1	16852.0×	0.001	TP63
cloacal septation	1	8426.0×	0.001	TP63
squamous basal epithelial stem cell differentiation involved in prostate gland acinus development	1	8426.0×	0.001	TP63
positive regulation of somatic stem cell population maintenance	1	8426.0×	0.001	TP63
regulation of epidermal cell division	1	5617.3×	0.001	TP63
female genitalia morphogenesis	1	5617.3×	0.001	TP63
negative regulation of mesoderm development	1	5617.3×	0.001	TP63
prostatic bud formation	1	4213.0×	0.001	TP63
polarized epithelial cell differentiation	1	2808.7×	0.002	TP63
negative regulation of keratinocyte differentiation	1	1685.2×	0.003	TP63
positive regulation of fibroblast apoptotic process	1	1685.2×	0.003	TP63
epithelial cell development	1	1532.0×	0.003	TP63
skin morphogenesis	1	1404.3×	0.003	TP63
negative regulation of intracellular estrogen receptor signaling pathway	1	1123.5×	0.003	TP63
positive regulation of cell cycle G1/S phase transition	1	1123.5×	0.003	TP63
establishment of planar polarity	1	1053.2×	0.003	TP63
positive regulation of keratinocyte proliferation	1	991.3×	0.003	TP63
sympathetic nervous system development	1	936.2×	0.003	TP63
cranial skeletal system development	1	936.2×	0.003	TP63
post-anal tail morphogenesis	1	732.7×	0.003	TP63
proximal/distal pattern formation	1	648.1×	0.003	TP63
negative regulation of cellular senescence	1	648.1×	0.003	TP63
protein tetramerization	1	624.1×	0.003	TP63
embryonic hindlimb morphogenesis	1	581.1×	0.003	TP63
keratinocyte proliferation	1	581.1×	0.003	TP63
positive regulation of apoptotic signaling pathway	1	581.1×	0.003	TP63
positive regulation of stem cell proliferation	1	526.6×	0.003	TP63
hair follicle morphogenesis	1	495.6×	0.003	TP63
embryonic forelimb morphogenesis	1	495.6×	0.003	TP63

Therapeutics

Drug target analysis

Approved (phase 4): 0 · Phase ≥3: 0 · Phased (≥1): 0 · Undrugged: 1

Druggability breadth: 0 of 1 evidence-associated genes (0%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).

Top cohort targets by molecule count

Symbol	Molecules	Max phase
TP63	0	0

Bioactivity and enzyme data

Enzyme cohort genes (≥1 EC): 0.

Pharmacogenomics

Cohort genes with a PharmGKB record: 1; with CPIC/DPWG dosing guidelines: 0.

No cohort gene has a CPIC/DPWG genotype-guided dosing guideline (PharmGKB).

Chemical tractability of cohort targets

0 approved/phased compounds have measured bioactivity against a cohort gene (and aren’t yet in disease-level trials). This is a research / tractability signal, NOT a therapeutic recommendation — a bioactivity row often reflects off-target or screening binding (e.g. promiscuous kinase inhibitors against a cohort kinase), implying no disease mechanism.

Druggability pyramid

Cohort genes binned by druggability tier (high → low):

Tier	Definition	Genes	Symbols
A	Approved (phase 4 drug)	0
B	Phased (≥1) drug, not yet approved	0
C	Druggable family + PDB, no drug	0
D	Druggable family + AlphaFold only, no drug	0
E	Difficult family or no structure, no drug	1	TP63

Undrugged target profiles

1 cohort genes are undrugged. Ranked by ‘starting-point quality’ (assay depth + drugged-partner adjacency).

Symbol	ChEMBL assays	Drugged partners (top 3)
TP63	0	—

Clinical trials & evidence

Clinical trials

Clinical trials: 0.