distal arthrogryposis type 2B1

disease
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Also known as arthrogryposis, distal, type 2B1DA2B1

Summary

distal arthrogryposis type 2B1 (MONDO:0020820) is a disease caused by variants in MYH3, TNNI2, and TNNT3, with 4 cohort genes. The dominant Reactome pathway is Striated Muscle Contraction (4 cohort genes).

At a glance

  • Causal genes: MYH3 (GenCC Strong), TNNI2 (GenCC Strong), TNNT3 (GenCC Strong)
  • Cohort genes: 4
  • ClinVar variants: 209

Clinical features

No curated clinical features (Orphanet) for this disease.

Identifiers

Disease identifiers

FieldValue
Canonical namedistal arthrogryposis type 2B1
Mondo IDMONDO:0020820
OMIM601680
DOIDDOID:0111600
UMLSC5193014
MedGen1676961
GARD0009909
Is cancer (heuristic)no

Also known as: arthrogryposis, distal, type 2B1 · DA2B1

Data availability: 209 ClinVar variants · 5 GenCC gene-disease records.

Disease family

Classification path: disease › human disease › disease by etiologic mechanism › disease of genetic or genomic mechanism › hereditary disease › autosomal genetic disease › autosomal dominant disease › distal arthrogryposis type 2B1

Related subtypes (191): autosomal dominant polycystic liver disease, cerebral arteriopathy, autosomal dominant, with subcortical infarcts and leukoencephalopathy, type 1, tuberous sclerosis, Treacher-Collins syndrome, hereditary breast ovarian cancer syndrome, autosomal dominant polycystic kidney disease, Lynch syndrome, branchio-oto-renal syndrome, autosomal dominant Aarskog syndrome, acroosteolysis dominant type, ADULT syndrome, autosomal dominant Alport syndrome, amelogenesis imperfecta type 1B, Townes-Brocks syndrome, nevoid basal cell carcinoma syndrome, blepharophimosis, ptosis, and epicanthus inversus syndrome, autosomal dominant brachyolmia, branchiooculofacial syndrome, pheochromocytoma/paraganglioma syndrome 4, cataract-aberrant oral frenula-growth delay syndrome, cherubism, autosomal dominant chondrodysplasia punctata, autosomal dominant popliteal pterygium syndrome, blepharocheilodontic syndrome, cochleosaccular degeneration-cataract syndrome, renal coloboma syndrome, Beare-Stevenson cutis gyrata syndrome, autosomal dominant vibratory urticaria, neurohypophyseal diabetes insipidus, autosomal dominant Kenny-Caffey syndrome, Rapp-Hodgkin syndrome, Ehlers-Danlos syndrome, classic type, autosomal dominant Ehlers-Danlos syndrome, vascular type, multiple endocrine neoplasia type 1, Coffin-Siris syndrome 1, isolated congenital adermatoglyphia, Flynn-Aird syndrome, Frasier syndrome, hand-foot-genital syndrome, Holt-Oram syndrome, hyperkeratosis-hyperpigmentation syndrome, autosomal dominant ichthyosis vulgaris, hyper-IgE recurrent infection syndrome 1, autosomal dominant, autosomal dominant keratitis, autosomal dominant keratitis-ichthyosis-hearing loss syndrome, LADD syndrome, trichorhinophalangeal syndrome type II, Noonan syndrome with multiple lentigines, microcephaly with or without chorioretinopathy, lymphedema, or intellectual disability, Marfan syndrome, melanoma, cutaneous malignant, susceptibility to, 2, autosomal dominant primary microcephaly, autosomal dominant progressive external ophthalmoplegia, monilethrix, Muir-Torre syndrome, autosomal dominant myoglobinuria, autosomal dominant centronuclear myopathy, nail-patella syndrome, multiple endocrine neoplasia type 2B, autosomal dominant omodysplasia, pheochromocytoma/paraganglioma syndrome 1, Pelger-Huet anomaly, multiple endocrine neoplasia type 2A, piebaldism, autosomal dominant medullary cystic kidney disease with or without hyperuricemia, generalized juvenile polyposis/juvenile polyposis coli, juvenile polyposis/hereditary hemorrhagic telangiectasia syndrome, Peutz-Jeghers syndrome, contractures, pterygia, and spondylocarpotarsal fusion syndrome 1A, autosomal dominant distal renal tubular acidosis, retinoschisis, autosomal dominant, autosomal dominant Robinow syndrome, scapuloperoneal spinal muscular atrophy, autosomal dominant, autosomal dominant sideroblastic anemia, spondyloepiphyseal dysplasia tarda, autosomal dominant, proximal symphalangism, calcaneonavicular coalition, thanatophoric dysplasia type 1, trichorhinophalangeal syndrome type I, Muckle-Wells syndrome, autosomal dominant hypophosphatemic rickets, von Hippel-Lindau disease, Denys-Drash syndrome, autosomal dominant severe congenital neutropenia, Costello syndrome, EEC syndrome, multiple cutaneous and mucosal venous malformations, diffuse nonepidermolytic palmoplantar keratoderma, Timothy syndrome, pheochromocytoma/paraganglioma syndrome 2, spondyloepimetaphyseal dysplasia with multiple dislocations, Brooke-Spiegler syndrome, macrocephaly-autism syndrome, pheochromocytoma/paraganglioma syndrome 3, Duane-radial ray syndrome, PCWH syndrome, heart-hand syndrome, Slovenian type, congenital stationary night blindness autosomal dominant 3, mandibulofacial dysostosis-microcephaly syndrome, multiple endocrine neoplasia type 4, juvenile cataract-microcornea-renal glucosuria syndrome, Crouzon syndrome-acanthosis nigricans syndrome, Birk-Barel syndrome, thrombophilia due to protein S deficiency, autosomal dominant, dyskeratosis congenita, autosomal dominant 2, dyskeratosis congenita, autosomal dominant 3, colorectal cancer, hereditary nonpolyposis, type 6, colorectal cancer, hereditary nonpolyposis, type 7, brain small vessel disease 2A, autosomal dominant, intellectual disability, autosomal dominant 14, intellectual disability, autosomal dominant 15, intellectual disability, autosomal dominant 16, hypopigmentation-punctate palmoplantar keratoderma syndrome, intellectual disability-facial dysmorphism syndrome due to SETD5 haploinsufficiency, postaxial polydactyly-anterior pituitary anomalies-facial dysmorphism syndrome, intellectual developmental disorder with microcephaly and with or without ocular malformations or hypogonadotropic hypogonadism, intellectual disability, autosomal dominant 29, intellectual disability, autosomal dominant 30, Houge-Janssens syndrome 2, severe achondroplasia-developmental delay-acanthosis nigricans syndrome, dyskeratosis congenita, autosomal dominant 6, epidermolysis bullosa simplex 6, generalized, with scarring and hair loss, autosomal dominant complex spastic paraplegia, early-onset autosomal dominant Alzheimer disease, muscular dystrophy, limb-girdle, autosomal dominant, Feingold syndrome, Carney complex, neuronopathy, distal hereditary motor, autosomal dominant, autosomal dominant coarctation of aorta, autosomal dominant spondylocostal dysostosis, autosomal dominant hypohidrotic ectodermal dysplasia, Cowden disease, autosomal dominant distal myopathy, autosomal dominant rhegmatogenous retinal detachment, palmoplantar keratoderma-spastic paralysis syndrome, Alagille syndrome due to a JAG1 point mutation, PTEN hamartoma tumor syndrome, gastric adenocarcinoma and proximal polyposis of the stomach, autosomal dominant proximal renal tubular acidosis, autosomal dominant spastic ataxia, Waardenburg syndrome, hereditary retinoblastoma, autosomal dominant hypocalcemia, Li-Fraumeni syndrome, Loeys-Dietz syndrome, hereditary hemorrhagic telangiectasia, hereditary inclusion body myopathy-joint contractures-ophthalmoplegia syndrome, microcephalic osteodysplastic dysplasia, Saul-Wilson type, autosomal dominant intermediate Charcot-Marie-Tooth disease, autosomal dominant cutis laxa, autosomal dominant nonsyndromic hearing loss, autosomal dominant optic atrophy, autosomal dominant Emery-Dreifuss muscular dystrophy, autosomal dominant cerebellar ataxia, autosomal dominant osteopetrosis, autosomal dominant epidermolytic ichthyosis, ventricular arrhythmias due to cardiac ryanodine receptor calcium release deficiency syndrome, neurofibromatosis, autosomal dominant cataract, arthrogryposis, distal, type 2B2, arthrogryposis, distal, type 2B3, Charcot-Marie-Tooth disease, demyelinating, type 1G, Delpire-McNeill syndrome, LAMA5-related multisystemic syndrome, autosomal dominant oculocutaneous albinism, Charcot-Marie-tooth disease, axonal, type 2DD, Pilarowski-Bjornsson syndrome, intellectual disability, autosomal dominant, fatty acyl-CoA reductase 1 upregulation, GUCY2D-related dominant retinopathy, RPE65-related dominant retinopathy, autosomal dominant titinopathy, NOG-related symphalangism spectrum disorder, ALPL-related autosomal dominant hypophosphatasia, MYH10-related neurodevelopmental disorder with congenital anomalies, spastic paraplegia 30A, autosomal dominant, TMEM127-related tumor predisposition, MAX-related tumor predisposition, BMPR1A-related juvenile polyposis syndrome, RP1-related dominant retinopathy, Birt-Hogg-Dube syndrome, inclusion body myopathy and brain white matter abnormalities, KINSSHIP syndrome, autosomal dominant nebulin-related myopathy, IMPG1-related dominant retinopathy, PROM1-related dominant retinopathy, PURA-related severe neonatal hypotonia-seizures-encephalopathy syndrome, ALG8-related autosomal dominant polycystic kidney and/or liver disease, NOTCH1-related AOS spectrum disorder, FLNB-associated autosomal dominant filamin related bone disorder, familial antiphospholipid 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

209 retrieved; paginated sample, class counts are floors:

69 conflicting classifications of pathogenicity, 58 uncertain significance, 51 benign/likely benign, 19 benign, 6 likely pathogenic, 4 pathogenic, 2 pathogenic/likely pathogenic

ClinVarVariant (HGVS)GeneClassificationReview
12435NM_003282.4(TNNI2):c.521G>A (p.Arg174Gln)TNNI2Pathogeniccriteria provided, multiple submitters, no conflicts
12436NM_003282.4(TNNI2):c.466C>T (p.Arg156Ter)TNNI2Pathogeniccriteria provided, multiple submitters, no conflicts
12437NM_003282.4(TNNI2):c.524AGA[1] (p.Lys176del)TNNI2Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
12439NM_003282.4(TNNI2):c.496GAG[1] (p.Glu167del)TNNI2Pathogeniccriteria provided, multiple submitters, no conflicts
212411NM_003282.4(TNNI2):c.525G>T (p.Lys175Asn)TNNI2Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
694070NM_003282.4(TNNI2):c.493A>T (p.Ile165Phe)TNNI2Pathogenicno assertion criteria provided
1333897NM_003282.4(TNNI2):c.520C>T (p.Arg174Trp)TNNI2Likely pathogeniccriteria provided, single submitter
2434182NM_003282.4(TNNI2):c.503_505dup (p.Ser169Ter)TNNI2Likely pathogeniccriteria provided, single submitter
2506365NM_003282.4(TNNI2):c.496G>T (p.Glu166Ter)TNNI2Likely pathogeniccriteria provided, single submitter
3064439NM_003282.4(TNNI2):c.486G>T (p.Arg162Ser)TNNI2Likely pathogeniccriteria provided, single submitter
4293088NM_003282.4(TNNI2):c.486G>C (p.Arg162Ser)TNNI2Likely pathogeniccriteria provided, single submitter
692080NM_003289.4(TPM2):c.307C>A (p.Gln103Lys)TPM2Likely pathogeniccriteria provided, single submitter
14145NM_002470.4(MYH3):c.700G>A (p.Ala234Thr)MYH3Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
211555NM_002470.4(MYH3):c.4910C>T (p.Ala1637Val)MYH3Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
211557NM_002470.4(MYH3):c.875C>G (p.Ser292Cys)MYH3Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
258678NM_002470.4(MYH3):c.3072C>G (p.Thr1024=)MYH3Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
321706NM_002470.4(MYH3):c.*39G>AMYH3Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
321707NM_002470.4(MYH3):c.*31T>GMYH3Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
321711NM_002470.4(MYH3):c.5660A>G (p.Asp1887Gly)MYH3Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
321712NM_002470.4(MYH3):c.5607G>T (p.Val1869=)MYH3Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
321713NM_002470.4(MYH3):c.5562+11C>TMYH3Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
321715NM_002470.4(MYH3):c.5390G>A (p.Arg1797His)MYH3Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
321716NM_002470.4(MYH3):c.5331C>T (p.Ser1777=)MYH3Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
321717NM_002470.4(MYH3):c.5299G>A (p.Ala1767Thr)MYH3Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
321720NM_002470.4(MYH3):c.5161-13C>TMYH3Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
321725NM_002470.4(MYH3):c.4323C>T (p.Ala1441=)MYH3Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
321726NM_002470.4(MYH3):c.4238C>T (p.Ala1413Val)MYH3Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
321728NM_002470.4(MYH3):c.4109C>T (p.Ala1370Val)MYH3Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
321729NM_002470.4(MYH3):c.4082C>T (p.Ala1361Val)MYH3Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
321731NM_002470.4(MYH3):c.3731C>T (p.Ala1244Val)MYH3Conflicting classifications of pathogenicitycriteria provided, conflicting classifications

Genes & proteins

Mendelian disease overlap and somatic drivers

GenCC: 26 · Orphanet: 16 · 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
MYH3StrongAutosomal dominantdistal arthrogryposis type 2B114
TNNI2StrongAutosomal dominantdistal arthrogryposis type 2B15
TNNT3StrongAutosomal dominantdistal arthrogryposis type 2B17

Orphanet rare-disease linkage (cohort genes)

GeneOrphanet IDRare disease
TNNI2Orphanet:1146Distal arthrogryposis type 1
TNNI2Orphanet:1147Sheldon-Hall syndrome
TNNT3Orphanet:1146Distal arthrogryposis type 1
TNNT3Orphanet:1147Sheldon-Hall syndrome
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
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

Cohort genes → proteins

4 cohort genes, 4 distinct canonical proteins.

Evidence partition

SubsetGenes
multi_evidence4

Cohort genes (full)

SymbolHGNCEnsemblUniProtNameEvidence
TNNI2HGNC:11946ENSG00000130598P48788Troponin I, fast skeletal musclegencc,clinvar
TNNT3HGNC:11950ENSG00000130595P45378Troponin T, fast skeletal musclegencc,clinvar
MYH3HGNC:7573ENSG00000109063P11055Myosin-3gencc,clinvar
TPM2HGNC:12011ENSG00000198467P07951Tropomyosin beta chainclinvar

Cohort function summary

Lead sentence per gene, UniProt-curated.

SymbolProtein nameFunction (lead sentence)
TNNI2Troponin I, fast skeletal muscleTroponin I is the inhibitory subunit of troponin, the thin filament regulatory complex which confers calcium-sensitivity to striated muscle actomyosin ATPase activity.
TNNT3Troponin T, fast skeletal muscleTroponin T is the tropomyosin-binding subunit of troponin, the thin filament regulatory complex which confers calcium-sensitivity to striated muscle actomyosin ATPase activity.
MYH3Myosin-3Muscle contraction.
TPM2Tropomyosin beta chainBinds to actin filaments in muscle and non-muscle cells.

Protein-family classification

Druggable: 0 · Difficult: 1 · Unknown: 3 · 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.

FamilyGenesFoldFDR
Scaffold/PPI14.3×0.404
Other/Unknown31.3×0.404

Per-gene assignment

SymbolFamilyDruggable?ECInterPro (top 3)
TNNI2Other/UnknownnoTroponin, Troponin_sf, Troponin_I
TNNT3Other/UnknownnoTroponin, TNNT, Troponin_sf
MYH3Scaffold/PPInoMyosin_head_motor_dom-like, Myosin_tail, SH3_Myosin
TPM2Other/UnknownnoTropomyosin

Expression context

Cohort genes with no expression data: 0.

3 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)4
unknown0

Top tissues across cohort

TissueCohort genes
gastrocnemius2
hindlimb stylopod muscle2
skeletal muscle tissue2
left testis1
right testis1
testis1
blood vessel layer1
popliteal artery1
saphenous vein1

Per-gene tissue summary (top 30)

SymbolBgee breadthFANTOM5 breadthSCXATop tissues
TNNI2134broadmarkerhindlimb stylopod muscle, skeletal muscle tissue, gastrocnemius
TNNT3135broadmarkerhindlimb stylopod muscle, skeletal muscle tissue, gastrocnemius
MYH3203tissue_specificyesleft testis, right testis, testis
TPM2283ubiquitousmarkersaphenous vein, popliteal artery, blood vessel layer

Protein interactions among cohort

Intra-cohort edges: 4.

Hub genes (top 10 by interactor count)

SymbolInteractor count
MYH31,795
TNNI21,255
TNNT31,197
TPM2357

Intra-cohort edges

ABSources
MYH3TNNI2string_interaction
MYH3TNNT3string_interaction
MYH3TPM2biogrid_interaction
TNNI2TNNT3biogrid_interaction, string_interaction

Structural data

PDB: 1 · AlphaFold-only: 3 · No structure: 0

Cohort genes with PDB structures (top 30)

SymbolUniProtPDB entries
TNNI2P487882

AlphaFold-only cohort genes (top 30 by pLDDT)

SymbolUniProtpLDDT
TPM2P0795191.51
TNNT3P4537877.99
MYH3P1105574.35

Function

Pathway analysis

Distinct Reactome pathways touched by cohort: 3. Enrichment computed across 4 evidence-associated genes (4 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 4 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

PathwayCohort genesFoldFDRSample cohort genes
Striated Muscle Contraction4308.6×3e-10TNNI2, TNNT3, MYH3, TPM2
Smooth Muscle Contraction166.4×0.022TPM2
Muscle contraction119.3×0.051MYH3

GO biological processes by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 4 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

GO termCohort genesFoldFDRSample cohort genes
regulation of ATP-dependent activity24213.0×3e-07TNNT3, TPM2
skeletal muscle contraction3383.0×3e-07TNNI2, TNNT3, MYH3
sarcomere organization2191.5×2e-04TNNT3, MYH3
muscle contraction2104.0×5e-04MYH3, TPM2
positive regulation of calcium-dependent ATPase activity14213.0×7e-04TNNT3
regulation of striated muscle contraction1526.6×0.005TNNT3
muscle filament sliding1263.3×0.008MYH3
actin filament-based movement1200.6×0.009MYH3
face morphogenesis1123.9×0.012MYH3
ATP metabolic process1117.0×0.012MYH3
embryonic limb morphogenesis1100.3×0.012MYH3
cardiac muscle contraction1100.3×0.012TNNI2
muscle organ development141.7×0.027MYH3
actin filament organization129.7×0.036TPM2
positive regulation of DNA-templated transcription17.0×0.136TNNI2

Therapeutics

Drug target analysis

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

Druggability breadth: 2 of 4 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
TNNI200
TNNT300
MYH300
TPM200

Bioactivity and enzyme data

Enzyme cohort genes (≥1 EC): 0.

Pharmacogenomics

Cohort genes with a PharmGKB record: 4; 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 drug0
DDruggable family + AlphaFold only, no drug0
EDifficult family or no structure, no drug4TNNI2, TNNT3, MYH3, TPM2

Undrugged target profiles

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

SymbolChEMBL assaysDrugged partners (top 3)
TNNI20
TNNT30
MYH30
TPM20

Clinical trials & evidence

Clinical trials

Clinical trials: 0.