arthrogryposis, distal, type 1A

disease
On this page

Also known as AMCarthrogryposis multiplex congenitaDA1A

Summary

arthrogryposis, distal, type 1A (MONDO:0007157) is a disease caused by TPM2 (GenCC Strong), with 8 cohort genes and 5 clinical trials. The dominant Reactome pathway is Striated Muscle Contraction (3 cohort genes).

At a glance

  • Causal gene: TPM2 (GenCC Strong)
  • Cohort genes: 8
  • ClinVar variants: 272
  • Clinical trials: 5

Clinical features

No curated clinical features (Orphanet) for this disease.

Identifiers

Disease identifiers

FieldValue
Canonical namearthrogryposis, distal, type 1A
Mondo IDMONDO:0007157
OMIM108120
DOIDDOID:0111597
SNOMED CT715314008
UMLSC0220662
MedGen113099
GARD0024527
Is cancer (heuristic)no

Also known as: AMC · arthrogryposis multiplex congenita · arthrogryposis, distal, type 1A · DA1A

Data availability: 272 ClinVar variants · 3 GenCC gene-disease records.

Disease family

Classification path: disease › human disease › disease by developmental or physiological process › disorder of development or morphogenesisdevelopmental defect during embryogenesismultiple congenital anomalies/dysmorphic syndrome › multiple congenital anomalies/dysmorphic syndrome without intellectual disability › digitotalar dysmorphismarthrogryposis, distal, type 1A

Related subtypes (2): digitotalar dysmorphism; ulnar drift, hereditary, arthrogryposis, distal, type 1B

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

272 retrieved; paginated sample, class counts are floors:

119 likely benign, 89 uncertain significance, 15 conflicting classifications of pathogenicity, 13 benign, 12 likely pathogenic, 10 pathogenic, 8 benign/likely benign, 5 pathogenic/likely pathogenic, 1 pathogenic; risk factor

ClinVarVariant (HGVS)GeneClassificationReview
560980NM_003632.3(CNTNAP1):c.2015G>A (p.Trp672Ter)CNTNAP1Pathogeniccriteria provided, multiple submitters, no conflicts
446117NM_000245.4(MET):c.3701A>G (p.Tyr1234Cys)METPathogenic; risk factorno assertion criteria provided
12460NM_003289.4(TPM2):c.271C>G (p.Arg91Gly)TPM2Pathogenicno assertion criteria provided
12462NM_003289.4(TPM2):c.349G>A (p.Glu117Lys)TPM2Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
12463NM_003289.4(TPM2):c.397C>T (p.Arg133Trp)TPM2Pathogeniccriteria provided, multiple submitters, no conflicts
12464NM_003289.4(TPM2):c.121G>A (p.Glu41Lys)TPM2Pathogeniccriteria provided, single submitter
12465NM_003289.4(TPM2):c.412GAG[1] (p.Glu139del)TPM2Pathogeniccriteria provided, multiple submitters, no conflicts
140486NM_003289.4(TPM2):c.14AGA[2] (p.Lys7del)TPM2Pathogeniccriteria provided, multiple submitters, no conflicts
140493NM_003289.4(TPM2):c.628C>T (p.Gln210Ter)TPM2Pathogeniccriteria provided, single submitter
1686270NM_003289.4(TPM2):c.394_396dup (p.Asn132dup)TPM2Pathogeniccriteria provided, single submitter
2434210NM_003289.4(TPM2):c.220del (p.Ala74fs)TPM2Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
450194NM_003289.4(TPM2):c.70C>T (p.Gln24Ter)TPM2Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
569587NM_003289.4(TPM2):c.463G>A (p.Ala155Thr)TPM2Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
632042NM_003289.4(TPM2):c.663T>A (p.Tyr221Ter)TPM2Pathogeniccriteria provided, single submitter
816832NM_003289.4(TPM2):c.620_631dup (p.Gln210_Ala211insValGluAlaGln)TPM2Pathogenicno assertion criteria provided
977300NM_003289.4(TPM2):c.782A>G (p.Tyr261Cys)TPM2Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1067848NM_003289.4(TPM2):c.364G>A (p.Glu122Lys)TPM2Likely pathogeniccriteria provided, single submitter
12466NM_003289.4(TPM2):c.142AAG[1] (p.Lys49del)TPM2Likely pathogeniccriteria provided, single submitter
1468701NM_003289.4(TPM2):c.493-2A>GTPM2Likely pathogeniccriteria provided, single submitter
2017054NM_003289.4(TPM2):c.479G>T (p.Arg160Leu)TPM2Likely pathogeniccriteria provided, single submitter
3667651NM_003289.4(TPM2):c.640-1G>ATPM2Likely pathogeniccriteria provided, single submitter
458722NM_003289.4(TPM2):c.360TGA[1] (p.Asp121del)TPM2Likely pathogeniccriteria provided, single submitter
4734141NM_003289.4(TPM2):c.563+1G>TTPM2Likely pathogeniccriteria provided, single submitter
521421NM_003289.4(TPM2):c.26A>C (p.Gln9Pro)TPM2Likely pathogeniccriteria provided, multiple submitters, no conflicts
577391NM_003289.4(TPM2):c.382A>G (p.Lys128Glu)TPM2Likely pathogeniccriteria provided, multiple submitters, no conflicts
816834NM_003289.4(TPM2):c.180T>G (p.Tyr60Ter)TPM2Likely pathogenicno assertion criteria provided
848549NM_003289.4(TPM2):c.41A>T (p.Asp14Val)TPM2Likely pathogeniccriteria provided, single submitter
939822NM_003289.4(TPM2):c.606C>A (p.Asn202Lys)TPM2Likely pathogeniccriteria provided, single submitter
1302243NM_003289.4(TPM2):c.773-9_773-8insCATPM2Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
1494530NM_003289.4(TPM2):c.773-10_773-9insCGTPM2Conflicting classifications of pathogenicitycriteria provided, conflicting classifications

Genes & proteins

Mendelian disease overlap and somatic drivers

GenCC: 12 · Orphanet: 20 · 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.

GeneClassificationInheritanceDiseaseRecords
TPM2StrongAutosomal dominantarthrogryposis, distal, type 1A12

Orphanet rare-disease linkage (cohort genes)

GeneOrphanet IDRare disease
TPM2Orphanet:1146Distal arthrogryposis type 1
TPM2Orphanet:1147Sheldon-Hall syndrome
TPM2Orphanet:171436Typical nemaline myopathy
TPM2Orphanet:171439Childhood-onset nemaline myopathy
TPM2Orphanet:171881Cap myopathy
TPM2Orphanet:2020Congenital fiber-type disproportion myopathy
METOrphanet:319298Papillary renal cell carcinoma
METOrphanet:33402Pediatric hepatocellular carcinoma
METOrphanet:47044Hereditary papillary renal cell carcinoma
METOrphanet:488265Osteofibrous dysplasia
METOrphanet:90636Rare autosomal recessive non-syndromic sensorineural deafness type DFNB
MYH3Orphanet:1146Distal arthrogryposis type 1
MYH3Orphanet:1147Sheldon-Hall syndrome
MYH3Orphanet:2053Freeman-Sheldon syndrome
MYH3Orphanet:2990Autosomal recessive multiple pterygium syndrome
MYH3Orphanet:3275Spondylocarpotarsal synostosis
MYH3Orphanet:65743Autosomal dominant multiple pterygium syndrome
MYH8Orphanet:319340Carney complex-trismus-pseudocamptodactyly syndrome
MYH8Orphanet:3377Trismus-pseudocamptodactyly syndrome
CNTNAP1Orphanet:2680Hypomyelination neuropathy-arthrogryposis syndrome

Cohort genes → proteins

8 cohort genes, 7 distinct canonical proteins.

Evidence partition

SubsetGenes
multi_evidence8

Cohort genes (full)

SymbolHGNCEnsemblUniProtNameEvidence
TPM2HGNC:12011ENSG00000198467P07951Tropomyosin beta chaingencc,clinvar
GLIPR2HGNC:18007ENSG00000122694Q9H4G4Golgi-associated plant pathogenesis-related protein 1clinvar
FAM219AHGNC:19920ENSG00000164970Q8IW50Protein FAM219Aclinvar
MYHASHGNC:50609ENSG00000272975myosin heavy chain gene cluster antisense RNAclinvar
METHGNC:7029ENSG00000105976P08581Hepatocyte growth factor receptorclinvar
MYH3HGNC:7573ENSG00000109063P11055Myosin-3clinvar
MYH8HGNC:7578ENSG00000133020P13535Myosin-8clinvar
CNTNAP1HGNC:8011ENSG00000108797P78357Contactin-associated protein 1clinvar

Cohort function summary

Lead sentence per gene, UniProt-curated.

SymbolProtein nameFunction (lead sentence)
TPM2Tropomyosin beta chainBinds to actin filaments in muscle and non-muscle cells.
METHepatocyte growth factor receptorReceptor tyrosine kinase that transduces signals from the extracellular matrix into the cytoplasm by binding to hepatocyte growth factor/HGF ligand.
MYH3Myosin-3Muscle contraction.
MYH8Myosin-8Muscle contraction.
CNTNAP1Contactin-associated protein 1Required, with CNTNAP2, for radial and longitudinal organization of myelinated axons.

Protein-family classification

Druggable: 1 · Difficult: 2 · Unknown: 5 · Druggable fraction: 0.12

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.

FamilyGenesFoldFDR
Scaffold/PPI24.3×0.223
Kinase13.5×0.382
Other/Unknown51.1×0.496

Per-gene assignment

SymbolFamilyDruggable?ECInterPro (top 3)
TPM2Other/UnknownnoTropomyosin
GLIPR2Other/UnknownnoCRISP-related, CAP_dom, Allrgn_V5/Tpx1_CS
FAM219AOther/UnknownnoFAM219
MYHASOther/Unknownno
METKinaseyes2.7.10.1Prot_kinase_dom, Ser-Thr/Tyr_kinase_cat_dom, Semap_dom
MYH3Scaffold/PPInoMyosin_head_motor_dom-like, Myosin_tail, SH3_Myosin
MYH8Scaffold/PPInoMyosin_head_motor_dom-like, Myosin_tail, SH3_Myosin
CNTNAP1Other/UnknownnoFA58C, EGF, Laminin_G

Expression context

Cohort genes with no expression data: 0.

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

Breadth distribution (Bgee present_calls)

BucketGenes
narrow (1-5 tissues)0
moderate (6-20)0
broad (>20)8
unknown0

Top tissues across cohort

TissueCohort genes
blood vessel layer1
popliteal artery1
saphenous vein1
granulocyte1
leukocyte1
monocyte1
medulla oblongata1
superior vestibular nucleus1
ventricular zone1
hindlimb stylopod muscle1
muscle of leg1
skeletal muscle tissue1
cartilage tissue1
germinal epithelium of ovary1
pigmented layer of retina1
left testis1
right testis1
testis1
quadriceps femoris1
skeletal muscle tissue of rectus abdominis1

Per-gene tissue summary (top 30)

SymbolBgee breadthFANTOM5 breadthSCXATop tissues
TPM2283ubiquitousmarkersaphenous vein, popliteal artery, blood vessel layer
GLIPR2251ubiquitousmarkermonocyte, leukocyte, granulocyte
FAM219A245ubiquitousyesventricular zone, superior vestibular nucleus, medulla oblongata
MYHAS65tissue_specificyesskeletal muscle tissue, hindlimb stylopod muscle, muscle of leg
MET270ubiquitousmarkerpigmented layer of retina, germinal epithelium of ovary, cartilage tissue
MYH3203tissue_specificyesleft testis, right testis, testis
MYH867tissue_specificmarkervastus lateralis, quadriceps femoris, skeletal muscle tissue of rectus abdominis
CNTNAP1209ubiquitousmarkerright hemisphere of cerebellum, cerebellar hemisphere, cerebellar cortex

Protein interactions among cohort

Intra-cohort edges: 1.

Hub genes (top 10 by interactor count)

SymbolInteractor count
MET5,823
MYH31,795
MYH81,719
CNTNAP11,292
GLIPR21,054
FAM219A411
TPM2357
MYHAS0

Intra-cohort edges

ABSources
MYH3TPM2biogrid_interaction

Structural data

PDB: 2 · AlphaFold-only: 5 · No structure: 1

Cohort genes with PDB structures (top 30)

SymbolUniProtPDB entries
METP08581130
GLIPR2Q9H4G43

AlphaFold-only cohort genes (top 30 by pLDDT)

SymbolUniProtpLDDT
TPM2P0795191.51
CNTNAP1P7835781.51
MYH8P1353575.13
MYH3P1105574.35
FAM219AQ8IW5063.93

Function

Pathway analysis

Distinct Reactome pathways touched by cohort: 48. Enrichment computed across 8 evidence-associated genes (5 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 5 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

PathwayCohort genesFoldFDRSample cohort genes
Striated Muscle Contraction3185.2×1e-05TPM2, MYH3, MYH8
Drug-mediated inhibition of MET activation11142.0×0.016MET
MET activates STAT31761.3×0.016MET
MET activates PTPN111456.8×0.016MET
MET interacts with TNS proteins1456.8×0.016MET
MET Receptor Activation1380.7×0.016MET
MET activates PI3K/AKT signaling1380.7×0.016MET
Muscle contraction230.9×0.016MYH3, MYH8
Sema4D mediated inhibition of cell attachment and migration1285.5×0.016MET
Neurofascin interactions1285.5×0.016CNTNAP1
MET receptor recycling1228.4×0.016MET
MET activates RAS signaling1207.6×0.016MET
MET activates RAP1 and RAC11207.6×0.016MET
Listeria monocytogenes entry into host cells1207.6×0.016MET
InlB-mediated entry of Listeria monocytogenes into host cell1152.3×0.021MET
Sema4D in semaphorin signaling1134.3×0.022MET
MET promotes cell motility1120.2×0.022MET
MECP2 regulates neuronal receptors and channels1120.2×0.022MET
Regulation of MITF-M-dependent genes involved in cell cycle and proliferation1114.2×0.022MET
Negative regulation of MET activity1103.8×0.023MET
Semaphorin interactions178.8×0.028MET
MET activates PTK2 signaling176.1×0.028MET
PI3K/AKT Signaling in Cancer173.7×0.028MET
Bacterial Infection Pathways167.2×0.029MET
Signaling by MET163.4×0.029MET
Transcriptional Regulation by MECP2163.4×0.029MET
Negative regulation of the PI3K/AKT network155.7×0.032MET
Smooth Muscle Contraction153.1×0.032TPM2
MITF-M-dependent gene expression136.2×0.045MET
MAPK1/MAPK3 signaling126.2×0.060MET

GO biological processes by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 6 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

GO termCohort genesFoldFDRSample cohort genes
muscle contraction3104.0×1e-04TPM2, MYH3, MYH8
muscle filament sliding2351.1×3e-04MYH3, MYH8
skeletal muscle contraction2170.2×8e-04MYH3, MYH8
ATP metabolic process2156.0×8e-04MYH3, MYH8
neuromuscular junction development, skeletal muscle fiber12808.7×0.003CNTNAP1
regulation of ATP-dependent activity11404.3×0.004TPM2
postsynaptic density organization11404.3×0.004CNTNAP1
paranodal junction maintenance11404.3×0.004CNTNAP1
protein localization to paranode region of axon1702.2×0.006CNTNAP1
protein localization to juxtaparanode region of axon1702.2×0.006CNTNAP1
negative regulation of hydrogen peroxide-mediated programmed cell death1702.2×0.006MET
paranodal junction assembly1468.1×0.008CNTNAP1
hepatocyte growth factor receptor signaling pathway1351.1×0.010MET
neuronal action potential propagation1234.1×0.014CNTNAP1
endothelial cell morphogenesis1175.5×0.016MET
neuromuscular process controlling posture1175.5×0.016CNTNAP1
central nervous system myelination1165.2×0.016CNTNAP1
positive regulation of endothelial cell chemotaxis1165.2×0.016MET
regulation of synapse maturation1156.0×0.016CNTNAP1
myelination in peripheral nervous system1147.8×0.016CNTNAP1
actin filament-based movement1133.8×0.016MYH3
positive chemotaxis1133.8×0.016MET
branching morphogenesis of an epithelial tube1122.1×0.017MET
pancreas development1112.3×0.017MET
face morphogenesis182.6×0.023MYH3
excitatory postsynaptic potential173.9×0.024MET
positive regulation of epithelial cell migration168.5×0.024GLIPR2
embryonic limb morphogenesis166.9×0.024MYH3
semaphorin-plexin signaling pathway166.9×0.024MET
sarcomere organization163.8×0.024MYH3

Therapeutics

Drug target analysis

Approved (phase 4): 1 · Phase ≥3: 1 · Phased (≥1): 1 · Undrugged: 7

Druggability breadth: 1 of 8 evidence-associated genes (12%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).

Genes with an approved drug

The molecule shown is one approved compound that hits the gene — not necessarily a drug of choice or one indicated for this disease.

SymbolExample approved molecule
METAFATINIB

Top cohort targets by molecule count

SymbolMoleculesMax phase
MET954
TPM200
GLIPR200
FAM219A00
MYHAS00
MYH300
MYH800
CNTNAP100

Drugs targeting cohort genes (top 30)

MoleculeMax phaseTargets in cohort
AFATINIB4MET
FEDRATINIB4MET
TIVOZANIB4MET
AXITINIB4MET
SORAFENIB4MET
NERATINIB4MET
INFIGRATINIB PHOSPHATE4MET
INFIGRATINIB4MET
PALBOCICLIB4MET
ENTRECTINIB4MET
DABRAFENIB4MET
CABOZANTINIB S-MALATE4MET
AFATINIB DIMALEATE4MET
CABOZANTINIB4MET
CERITINIB4MET
VANDETANIB4MET
BOSUTINIB4MET
CAPMATINIB4MET
TEPOTINIB4MET
BRIGATINIB4MET
ENSARTINIB4MET
PAZOPANIB4MET
NINTEDANIB4MET
SUNITINIB4MET
ERLOTINIB4MET
CRIZOTINIB4MET
MIDOSTAURIN4MET
GEFITINIB4MET
LINSITINIB3MET
RIGOSERTIB3MET

Bioactivity and enzyme data

Enzyme cohort genes (≥1 EC): 1.

Cohort genes with ChEMBL bioactivity (full, sorted by assay count)

SymbolAssaysType breakdown
MET2,015Binding:2005, Functional:6, ADMET:4

Cohort enzymes (BRENDA EC)

SymbolEC numbersNames
MET2.7.10.1receptor protein-tyrosine kinase

Cohort genes with high screening signal

≥100 ChEMBL assays — a studied-ness signal; see Therapeutics for approved-drug status.

SymbolChEMBL assays
MET2,015

Pharmacogenomics

Cohort genes with a PharmGKB record: 7; with CPIC/DPWG dosing guidelines: 0.

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

Chemical tractability of cohort targets

30 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.

CompoundMax phaseCohort target (bioactivity)
AFATINIB4MET
FEDRATINIB4MET
TIVOZANIB4MET
AXITINIB4MET
SORAFENIB4MET
NERATINIB4MET
INFIGRATINIB PHOSPHATE4MET
INFIGRATINIB4MET
PALBOCICLIB4MET
ENTRECTINIB4MET
DABRAFENIB4MET
CABOZANTINIB S-MALATE4MET
AFATINIB DIMALEATE4MET
CABOZANTINIB4MET
CERITINIB4MET
VANDETANIB4MET
BOSUTINIB4MET
CAPMATINIB4MET
TEPOTINIB4MET
BRIGATINIB4MET
ENSARTINIB4MET
PAZOPANIB4MET
NINTEDANIB4MET
SUNITINIB4MET
ERLOTINIB4MET
CRIZOTINIB4MET
MIDOSTAURIN4MET
GEFITINIB4MET
LINSITINIB3MET
RIGOSERTIB3MET

Druggability pyramid

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

TierDefinitionGenesSymbols
AApproved (phase 4 drug)1MET
BPhased (≥1) drug, not yet approved0
CDruggable family + PDB, no drug0
DDruggable family + AlphaFold only, no drug0
EDifficult family or no structure, no drug7TPM2, GLIPR2, FAM219A, MYHAS, MYH3, MYH8, CNTNAP1

Undrugged target profiles

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

SymbolChEMBL assaysDrugged partners (top 3)
TPM20
GLIPR20
FAM219A0
MYHAS0
MYH30
MYH80
CNTNAP10

Clinical trials & evidence

Clinical trials

Clinical trials: 5.

Phase distribution (across all retrieved trials)

PhaseTrials
Not specified5

Top trials by phase / activity

NCTPhaseStatusTitle
NCT07360574Not specifiedNOT_YET_RECRUITINGPiezo2-related Arthrogryposis & physiopathOLOgy 3
NCT01144741Not specifiedTERMINATEDSurvey Study and Records Review of Treatment Outcomes in Freeman-Sheldon Syndrome
NCT05393375Not specifiedCOMPLETEDArthrogryposis Multiplex Congenita in Pediatric Age: Correlation Between MUScular MRI and Functional Evaluation
NCT05673265Not specifiedUNKNOWNPediatric and Adult Registry for Patients With ARThrogryposis
NCT06130592Not specifiedUNKNOWNTechnical Feasibility Study of Ultrasound Muscle Imaging in Antenatal Ultrasound