Congenital bile acid synthesis defect

disease
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Also known as BASDbile acid synthesis defect, congenitalcholestasis with delta(4)-3-oxosteroid-5-beta-reductase deficiency

Summary

Congenital bile acid synthesis defect (MONDO:0018841) is a disease (an umbrella term covering 6 Mondo subtypes) with 2 cohort genes.

At a glance

  • Umbrella term: 6 Mondo subtypes
  • Cohort genes: 2
  • ClinVar variants: 2

Clinical features

No curated clinical features (Orphanet) for this disease.

Identifiers

Disease identifiers

FieldValue
Canonical namecongenital bile acid synthesis defect
Mondo IDMONDO:0018841
EFOEFO:0009039
OMIM607765
Orphanet485631
DOIDDOID:0050674
UMLSC5680095
MedGen1826069
GARD0021996
Is cancer (heuristic)no

Also known as: BASD · bile acid synthesis defect, congenital · cholestasis with delta(4)-3-oxosteroid-5-beta-reductase deficiency

Data availability: 2 ClinVar variants.

Disease family

An umbrella term covering 6 Mondo subtypes.

Classification path: disease › human disease › disease by etiologic mechanism › disease of genetic or genomic mechanism › hereditary diseaseinborn errors of metabolisminherited lipid metabolism disordersteroid inherited metabolic disordercongenital bile acid synthesis defect

Related subtypes (2): apparent mineralocorticoid excess, congenital adrenal hyperplasia

Subtypes (6): congenital bile acid synthesis defect 4, congenital bile acid synthesis defect 2, congenital bile acid synthesis defect 1, congenital bile acid synthesis defect 3, congenital bile acid synthesis defect 5, congenital bile acid synthesis defect 6

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

2 retrieved; paginated sample, class counts are floors:

1 pathogenic, 1 pathogenic/likely pathogenic

ClinVarVariant (HGVS)GeneClassificationReview
5378NM_005989.4(AKR1D1):c.781C>T (p.Arg261Cys)AKR1D1Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
2885NM_025193.4(HSD3B7):c.45_46del (p.Gly17fs)HSD3B7Pathogeniccriteria provided, multiple submitters, no conflicts

Genes & proteins

Mendelian disease overlap and somatic drivers

GenCC: 0 · Orphanet: 2 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0

Orphanet rare-disease linkage (cohort genes)

GeneOrphanet IDRare disease
HSD3B7Orphanet:79301Congenital bile acid synthesis defect type 1
AKR1D1Orphanet:79303Congenital bile acid synthesis defect type 2

Cohort genes → proteins

2 cohort genes, 2 distinct canonical proteins.

Evidence partition

SubsetGenes
multi_evidence2

Cohort genes (full)

SymbolHGNCEnsemblUniProtNameEvidence
HSD3B7HGNC:18324ENSG00000099377Q9H2F33 beta-hydroxysteroid dehydrogenase type 7clinvar
AKR1D1HGNC:388ENSG00000122787P51857Aldo-keto reductase family 1 member D1clinvar

Cohort function summary

Lead sentence per gene, UniProt-curated.

SymbolProtein nameFunction (lead sentence)
HSD3B73 beta-hydroxysteroid dehydrogenase type 7The 3-beta-HSD enzymatic system plays a crucial role in the biosynthesis of all classes of hormonal steroids.
AKR1D1Aldo-keto reductase family 1 member D1Catalyzes the stereospecific NADPH-dependent reduction of the C4-C5 double bond of bile acid intermediates and steroid hormones carrying a delta(4)-3-one structure to yield an A/B cis-ring junction.

Protein-family classification

Druggable: 1 · Difficult: 0 · Unknown: 1 · Druggable fraction: 0.5

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
Enzyme (other)16.0×0.320
Other/Unknown10.9×0.805

Per-gene assignment

SymbolFamilyDruggable?ECInterPro (top 3)
HSD3B7Other/Unknownno3Beta_OHSteriod_DH/Estase, NAD(P)-bd_dom_sf, NAD(P)_dehydrat-like
AKR1D1Enzyme (other)yes1.3.1.3Aldo/ket_reductase_CS, AKR, NADP_OxRdtase_dom

Expression context

Cohort genes with no expression data: 0.

2 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)2
unknown0

Top tissues across cohort

TissueCohort genes
liver2
right lobe of liver2
left adrenal gland1
primordial germ cell in gonad1

Per-gene tissue summary (top 30)

SymbolBgee breadthFANTOM5 breadthSCXATop tissues
HSD3B7177ubiquitousmarkerright lobe of liver, liver, left adrenal gland
AKR1D185tissue_specificmarkerliver, right lobe of liver, primordial germ cell in gonad

Protein interactions among cohort

Intra-cohort edges: 1.

Hub genes (top 10 by interactor count)

SymbolInteractor count
HSD3B73,327
AKR1D11,544

Intra-cohort edges

ABSources
AKR1D1HSD3B7string_interaction

Structural data

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

Cohort genes with PDB structures (top 30)

SymbolUniProtPDB entries
AKR1D1P5185714

AlphaFold-only cohort genes (top 30 by pLDDT)

SymbolUniProtpLDDT
HSD3B7Q9H2F394.01

Function

Pathway analysis

Distinct Reactome pathways touched by cohort: 8. Enrichment computed across 2 evidence-associated genes (2 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 2 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

PathwayCohort genesFoldFDRSample cohort genes
Synthesis of bile acids and bile salts via 24-hydroxycholesterol2878.5×6e-06HSD3B7, AKR1D1
Synthesis of bile acids and bile salts via 27-hydroxycholesterol2761.3×6e-06HSD3B7, AKR1D1
Bile acid and bile salt metabolism2496.5×9e-06HSD3B7, AKR1D1
Synthesis of bile acids and bile salts via 7alpha-hydroxycholesterol2456.8×9e-06HSD3B7, AKR1D1
Synthesis of bile acids and bile salts2407.9×9e-06HSD3B7, AKR1D1
Metabolism of steroids2137.6×7e-05HSD3B7, AKR1D1
Metabolism of lipids231.6×0.001HSD3B7, AKR1D1
Metabolism211.6×0.007HSD3B7, AKR1D1

GO biological processes by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 2 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

GO termCohort genesFoldFDRSample cohort genes
bile acid biosynthetic process2624.1×2e-05HSD3B7, AKR1D1
bile acid catabolic process14213.0×9e-04AKR1D1
C21-steroid hormone metabolic process11685.2×0.001AKR1D1
B cell chemotaxis11404.3×0.001HSD3B7
cholesterol catabolic process1936.2×0.002AKR1D1
androgen metabolic process1443.5×0.003AKR1D1
digestion1312.1×0.003AKR1D1
steroid biosynthetic process1300.9×0.003HSD3B7

Therapeutics

Drug target analysis

Approved (phase 4): 0 · Phase ≥3: 0 · Phased (≥1): 0 · Undrugged: 2

Druggability breadth: 1 of 2 evidence-associated genes (50%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).

Top cohort targets by molecule count

SymbolMoleculesMax phase
HSD3B700
AKR1D100

Bioactivity and enzyme data

Enzyme cohort genes (≥1 EC): 1.

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

SymbolAssaysType breakdown
AKR1D11Binding:1

Cohort enzymes (BRENDA EC)

SymbolEC numbersNames
AKR1D11.3.1.3DELTA4-3-oxosteroid 5beta-reductase

Pharmacogenomics

Cohort genes with a PharmGKB record: 2; 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):

TierDefinitionGenesSymbols
AApproved (phase 4 drug)0
BPhased (≥1) drug, not yet approved0
CDruggable family + PDB, no drug1AKR1D1
DDruggable family + AlphaFold only, no drug0
EDifficult family or no structure, no drug1HSD3B7

Undrugged target profiles

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

SymbolChEMBL assaysDrugged partners (top 3)
HSD3B70
AKR1D11

Clinical trials & evidence

Clinical trials

Clinical trials: 0.