Dyskeratosis congenita, autosomal dominant 1

disease
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Also known as autosomal dominant dyskeratosis congenitaDKCADKCA1dyskeratosis congenita autosomal dominantdyskeratosis congenita Scoggins typedyskeratosis congenita, autosomal dominant type 1dyskeratosis congenita, Scoggins type

Summary

Dyskeratosis congenita, autosomal dominant 1 (MONDO:0007485) is a disease caused by TERC (GenCC Definitive), with 9 cohort genes. The dominant Reactome pathway is Telomere Extension By Telomerase (3 cohort genes).

At a glance

  • Causal gene: TERC (GenCC Definitive)
  • Cohort genes: 9
  • ClinVar variants: 469

Clinical features

No curated clinical features (Orphanet) for this disease.

Identifiers

Disease identifiers

FieldValue
Canonical namedyskeratosis congenita, autosomal dominant 1
Mondo IDMONDO:0007485
MeSHC565079
OMIM127550
DOIDDOID:0070014
NCITC176921
SNOMED CT707273001
UMLSC4551974
MedGen1645250
GARD0006299
Is cancer (heuristic)no

Also known as: autosomal dominant dyskeratosis congenita · DKCA · DKCA1 · dyskeratosis congenita autosomal dominant · dyskeratosis congenita Scoggins type · dyskeratosis congenita, autosomal dominant 1 · dyskeratosis congenita, autosomal dominant type 1 · dyskeratosis congenita, Scoggins type

Data availability: 469 ClinVar variants · 6 GenCC gene-disease records.

Disease family

Classification path: disease › human disease › disease by etiologic mechanism › disease of genetic or genomic mechanism › hereditary diseasehereditary neoplastic syndromedyskeratosis congenitadyskeratosis congenita, autosomal dominant 1

Related subtypes (15): dyskeratosis congenita, autosomal recessive 1, Revesz syndrome, dyskeratosis congenita, autosomal recessive 2, dyskeratosis congenita, autosomal recessive 3, dyskeratosis congenita, autosomal dominant 2, dyskeratosis congenita, autosomal dominant 3, dyskeratosis congenita, autosomal recessive 6, dyskeratosis congenita, autosomal dominant 6, autosomal recessive dyskeratosis congenita 4, dyskeratosis congenita, digenic, DKC1-related disorder, dyskeratosis congenita, autosomal dominant 4, dyskeratosis congenita, autosomal recessive 7, dyskeratosis congenita and related telomere biology disorder, dyskeratosis congenita, autosomal recessive 8

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

469 retrieved; paginated sample, class counts are floors:

356 uncertain significance, 25 pathogenic, 22 conflicting classifications of pathogenicity, 22 likely benign, 15 likely pathogenic, 11 benign/likely benign, 10 not provided, 4 pathogenic/likely pathogenic, 4 benign

ClinVarVariant (HGVS)GeneClassificationReview
40977NC_000003.12:g.169764745_169767720delACTRT3Pathogenicno assertion criteria provided
30265NR_001566.3(TERC):n.52_55delCTAALOC110806306Pathogeniccriteria provided, multiple submitters, no conflicts
39279NC_000003.12:g.169765299AG[1]LOC110806306Pathogenicno assertion criteria provided
39280NR_001566.3(TERC):n.100T>ALOC110806306Pathogenicno assertion criteria provided
39282NR_001566.3(TERC):n.143G>ALOC110806306Pathogenicno assertion criteria provided
39285NR_001566.3(TERC):n.211_224delCCTGCGGCGGGTCGLOC110806306Pathogenicno assertion criteria provided
39288NR_001566.3(TERC):n.2G>CLOC110806306Pathogenicno assertion criteria provided
39297NR_001566.3(TERC):n.48A>GLOC110806306Pathogenicno assertion criteria provided
39299NR_001566.3(TERC):n.52_86del35LOC110806306Pathogenicno assertion criteria provided
39300NR_001566.3(TERC):n.79delCLOC110806306Pathogenicno assertion criteria provided
39301NR_001566.3(TERC):n.96_97delCTLOC110806306Pathogenicno assertion criteria provided
7321NR_001566.3(TERC):n.107_108delGCinsAGLOC110806306Pathogenicno assertion criteria provided
7322NR_001566.3(TERC):n.204C>GLOC110806306Pathogenicno assertion criteria provided
7325NR_001566.3(TERC):n.108_111delCTGALOC110806306Pathogeniccriteria provided, single submitter
950972NC_000003.12:g.169764994delLOC110806306Pathogeniccriteria provided, single submitter
7319NC_000003.12:g.169763867_169764687delLOC129937871Pathogeniccriteria provided, single submitter
446379NC_000003.12:g.169764653_169764654delinsTTTERCPathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
7320NR_001566.3(TERC):n.408C>GTERCPathogenicno assertion criteria provided
12735NM_198253.3(TERT):c.2706G>C (p.Lys902Asn)TERTPathogenicno assertion criteria provided
39103TERT:c.1710G>Y (p.Lys570Asn)TERTPathogenicno assertion criteria provided
39108NM_198253.3(TERT):c.2110C>T (p.Pro704Ser)TERTPathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
410651NM_198253.3(TERT):c.336dup (p.Glu113fs)TERTPathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
38920NM_001099274.3(TINF2):c.847C>T (p.Pro283Ser)TINF2Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
38922NM_001099274.3(TINF2):c.849dup (p.Thr284fs)TINF2Pathogeniccriteria provided, single submitter
4845227NM_001099274.3(TINF2):c.850A>C (p.Thr284Pro)TINF2Pathogenicno assertion criteria provided
5624NM_001099274.3(TINF2):c.838A>G (p.Lys280Glu)TINF2Pathogeniccriteria provided, single submitter
5625NM_001099274.3(TINF2):c.845G>A (p.Arg282His)TINF2Pathogeniccriteria provided, multiple submitters, no conflicts
5626NM_001099274.3(TINF2):c.844C>A (p.Arg282Ser)TINF2Pathogeniccriteria provided, single submitter
5627NM_001099274.3(TINF2):c.844C>T (p.Arg282Cys)TINF2Pathogeniccriteria provided, multiple submitters, no conflicts
623236NM_001134225.2(INPP4A):c.36C>T (p.Ala12=)INPP4ALikely pathogeniccriteria provided, single submitter

Genes & proteins

Mendelian disease overlap and somatic drivers

GenCC: 7 · Orphanet: 25 · 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
TERCDefinitiveAutosomal dominantdyskeratosis congenita, autosomal dominant 17

Orphanet rare-disease linkage (cohort genes)

GeneOrphanet IDRare disease
TERCOrphanet:1775Dyskeratosis congenita
TERCOrphanet:2032Idiopathic pulmonary fibrosis
TERCOrphanet:88Idiopathic aplastic anemia
TERTOrphanet:146Differentiated thyroid carcinoma
TERTOrphanet:1501Adrenocortical carcinoma
TERTOrphanet:1775Dyskeratosis congenita
TERTOrphanet:2032Idiopathic pulmonary fibrosis
TERTOrphanet:2495Meningioma
TERTOrphanet:3322Hoyeraal-Hreidarsson syndrome
TERTOrphanet:457246Clear cell sarcoma of kidney
TERTOrphanet:618Familial melanoma
TERTOrphanet:88Idiopathic aplastic anemia
TGM1Orphanet:100976Bathing suit ichthyosis
TGM1Orphanet:281122Self-improving collodion baby
TGM1Orphanet:281127Acral self-healing collodion baby
TGM1Orphanet:313Lamellar ichthyosis
TGM1Orphanet:79394Congenital ichthyosiform erythroderma
TINF2Orphanet:1775Dyskeratosis congenita
TINF2Orphanet:3088Revesz syndrome
TINF2Orphanet:3322Hoyeraal-Hreidarsson syndrome
RTEL1Orphanet:1775Dyskeratosis congenita
RTEL1Orphanet:2032Idiopathic pulmonary fibrosis
RTEL1Orphanet:3322Hoyeraal-Hreidarsson syndrome
MECOMOrphanet:402020Acute myeloid leukemia with inv(3)(q21q26.2) or t(3;3)(q21;q26.2)
MECOMOrphanet:71289Radio-ulnar synostosis-amegakaryocytic thrombocytopenia syndrome

Cohort genes → proteins

9 cohort genes, 7 distinct canonical proteins.

Evidence partition

SubsetGenes
multi_evidence9

Cohort genes (full)

SymbolHGNCEnsemblUniProtNameEvidence
TERCHGNC:11727ENSG00000270141telomerase RNA componentgencc,clinvar
TERTHGNC:11730ENSG00000164362O14746Telomerase reverse transcriptaseclinvar
TGM1HGNC:11777ENSG00000092295P22735Protein-glutamine gamma-glutamyltransferase Kclinvar
TINF2HGNC:11824ENSG00000092330Q9BSI4TERF1-interacting nuclear factor 2clinvar
RTEL1HGNC:15888ENSG00000258366Q9NZ71Regulator of telomere elongation helicase 1clinvar
ACTRT3HGNC:24022ENSG00000184378Q9BYD9Actin-related protein T3clinvar
MECOMHGNC:3498ENSG00000085276Q03112Histone-lysine N-methyltransferase MECOMclinvar
RTEL1-TNFRSF6BHGNC:44095ENSG00000026036RTEL1-TNFRSF6B readthrough (NMD candidate)clinvar
INPP4AHGNC:6074ENSG00000040933Q96PE3Inositol polyphosphate-4-phosphatase type I Aclinvar

Cohort function summary

Lead sentence per gene, UniProt-curated.

SymbolProtein nameFunction (lead sentence)
TERTTelomerase reverse transcriptaseTelomerase is a ribonucleoprotein enzyme essential for the replication of chromosome termini in most eukaryotes.
TGM1Protein-glutamine gamma-glutamyltransferase KCatalyzes the cross-linking of proteins and the conjugation of polyamines to proteins.
TINF2TERF1-interacting nuclear factor 2Component of the shelterin complex (telosome) that is involved in the regulation of telomere length and protection.
RTEL1Regulator of telomere elongation helicase 1A probable ATP-dependent DNA helicase implicated in telomere-length regulation, DNA repair and the maintenance of genomic stability.
MECOMHistone-lysine N-methyltransferase MECOMFunctions as a transcriptional regulator binding to DNA sequences in the promoter region of target genes and regulating positively or negatively their expression.
INPP4AInositol polyphosphate-4-phosphatase type I ACatalyzes the hydrolysis of the 4-position phosphate of phosphatidylinositol 3,4-bisphosphate (PtdIns(3,4)P2).

Protein-family classification

Druggable: 2 · Difficult: 1 · Unknown: 6 · Druggable fraction: 0.22

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
Antibody/Immunoglobulin13.2×0.687
Enzyme (other)11.3×0.687
Other/Unknown61.2×0.687
Transcription factor10.9×0.687

Per-gene assignment

SymbolFamilyDruggable?ECInterPro (top 3)
TERCOther/Unknownno
TERTOther/UnknownnoRT_dom, Telomerase_RT, Telomerase_RBD
TGM1Antibody/Immunoglobulinyes2.3.2.13Transglutaminase_N, Transglutaminase-like, Transglutaminase_C
TINF2Other/UnknownnoTINF2_N, TINF2
RTEL1Other/UnknownnoHelicase-like_DEXD_c2, ATP-dep_Helicase_C, RAD3-like_helicase_DEAD
ACTRT3Other/UnknownnoActin, Actin/actin-like_CS, ATPase_NBD
MECOMTranscription factornoSET_dom, Znf_C2H2_type, Znf_C2H2_sf
RTEL1-TNFRSF6BOther/Unknownno
INPP4AEnzyme (other)yes3.1.3.66C2_dom, C2_domain_sf, INPP4

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)9
unknown0

Top tissues across cohort

TissueCohort genes
cerebellar hemisphere2
right hemisphere of cerebellum2
bone marrow cell1
colonic epithelium1
male germ line stem cell (sensu Vertebrata) in testis1
olfactory bulb1
stromal cell of endometrium1
type B pancreatic cell1
esophagus mucosa1
lower esophagus mucosa1
skin of leg1
granulocyte1
right adrenal gland1
right adrenal gland cortex1
sural nerve1
left testis1
right testis1
sperm1
cardia of stomach1
pylorus1

Per-gene tissue summary (top 30)

SymbolBgee breadthFANTOM5 breadthSCXATop tissues
TERC113ubiquitousyesbone marrow cell, colonic epithelium, male germ line stem cell (sensu Vertebrata) in testis
TERT105broadyesstromal cell of endometrium, type B pancreatic cell, olfactory bulb
TGM1135broadmarkerlower esophagus mucosa, esophagus mucosa, skin of leg
TINF2144ubiquitousmarkergranulocyte, right adrenal gland, right adrenal gland cortex
RTEL1134ubiquitousyessural nerve, right hemisphere of cerebellum, cerebellar hemisphere
ACTRT3162broadyessperm, left testis, right testis
MECOM276ubiquitousmarkercardia of stomach, renal medulla, pylorus
RTEL1-TNFRSF6B135markerright hemisphere of cerebellum, cerebellar hemisphere, cerebellum
INPP4A279ubiquitousmarkerBrodmann (1909) area 23, endothelial cell, tibia

Protein interactions among cohort

Intra-cohort edges: 3.

Hub genes (top 10 by interactor count)

SymbolInteractor count
TERT5,717
MECOM2,442
RTEL12,324
ACTRT32,105
TGM11,978
TINF21,769
INPP4A801
TERC0
RTEL1-TNFRSF6B0

Intra-cohort edges

ABSources
RTEL1TERTstring_interaction
RTEL1TINF2string_interaction
TERTTINF2string_interaction

Structural data

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

Cohort genes with PDB structures (top 30)

SymbolUniProtPDB entries
TERTO1474623
TINF2Q9BSI43
RTEL1Q9NZ713
TGM1P227351
MECOMQ031121

AlphaFold-only cohort genes (top 30 by pLDDT)

SymbolUniProtpLDDT
ACTRT3Q9BYD994.47
INPP4AQ96PE380.39

Function

Pathway analysis

Distinct Reactome pathways touched by cohort: 53. Enrichment computed across 9 evidence-associated genes (6 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 6 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

PathwayCohort genesFoldFDRSample cohort genes
Telomere Extension By Telomerase3228.4×1e-05TERT, TINF2, RTEL1
Extension of Telomeres2200.3×0.001TERT, RTEL1
Telomere Maintenance2122.8×0.002TERT, RTEL1
Chromosome Maintenance270.5×0.004TERT, RTEL1
Regulation of MITF-M-dependent genes involved in DNA replication, damage repair and senescence1271.9×0.031TERT
Telomere C-strand synthesis initiation1135.9×0.031TINF2
Kidney development1135.9×0.031MECOM
Processive synthesis on the C-strand of the telomere1126.9×0.031TINF2
Telomere C-strand (Lagging Strand) Synthesis1126.9×0.031TINF2
Synthesis of IP2, IP, and Ins in the cytosol1126.9×0.031INPP4A
Cytosolic iron-sulfur cluster assembly1126.9×0.031RTEL1
Synthesis of PIPs at the early endosome membrane1119.0×0.031INPP4A
Removal of the Flap Intermediate from the C-strand1105.7×0.031TINF2
Resolution of D-Loop Structures1105.7×0.031RTEL1
Formation of the nephric duct1105.7×0.031MECOM
Developmental Biology37.2×0.031TERT, TGM1, MECOM
Cell Cycle212.0×0.033TERT, RTEL1
Inositol phosphate metabolism179.3×0.037INPP4A
Polymerase switching on the C-strand of the telomere170.5×0.039TINF2
Resolution of D-loop Structures through Synthesis-Dependent Strand Annealing (SDSA)165.6×0.040RTEL1
PI Metabolism159.5×0.042INPP4A
Homology Directed Repair151.4×0.044RTEL1
HDR through Homologous Recombination (HRR) or Single Strand Annealing (SSA)151.4×0.044RTEL1
DNA Double-Strand Break Repair141.4×0.050RTEL1
PTEN Regulation138.1×0.050MECOM
Packaging Of Telomere Ends136.6×0.050TINF2
Synthesis of PIPs at the plasma membrane135.2×0.050INPP4A
Recognition and association of DNA glycosylase with site containing an affected purine134.0×0.050TINF2
Cleavage of the damaged purine134.0×0.050TINF2
Phospholipid metabolism133.4×0.050INPP4A

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
DNA strand displacement12808.7×0.003RTEL1
RNA-templated transcription12808.7×0.003TERT
DNA strand elongation12808.7×0.003TERT
siRNA transcription12808.7×0.003TERT
positive regulation of transdifferentiation12808.7×0.003TERT
regulation of telomere maintenance via telomere lengthening12808.7×0.003TINF2
negative regulation of telomere maintenance in response to DNA damage12808.7×0.003RTEL1
positive regulation of telomeric loop disassembly12808.7×0.003RTEL1
positive regulation of telomere maintenance2170.2×0.003TINF2, RTEL1
telomere maintenance289.2×0.003TERT, RTEL1
RNA-templated DNA biosynthetic process11404.3×0.004TERT
positive regulation of hair cycle11404.3×0.004TERT
telomeric loop disassembly11404.3×0.004RTEL1
cell envelope organization1936.2×0.005TGM1
mitotic telomere maintenance via semi-conservative replication1936.2×0.005RTEL1
negative regulation of t-circle formation1936.2×0.005RTEL1
telomere assembly1702.2×0.006TINF2
positive regulation of telomere capping1561.7×0.007RTEL1
positive regulation of telomere maintenance via telomere lengthening1468.1×0.008RTEL1
positive regulation of protein localization to nucleolus1468.1×0.008TERT
establishment of protein localization to telomere1351.1×0.010TERT
siRNA processing1312.1×0.010TERT
telomere maintenance in response to DNA damage1312.1×0.010RTEL1
telomere maintenance via recombination1255.3×0.011TERT
protein localization to chromosome, telomeric region1255.3×0.011TINF2
telomere capping1216.1×0.012TINF2
heterochromatin organization1216.1×0.012MECOM
negative regulation of DNA recombination1187.2×0.013RTEL1
cornification1175.5×0.013TGM1
regulation of double-strand break repair via homologous recombination1165.2×0.013RTEL1

Therapeutics

Drug target analysis

Approved (phase 4): 1 · Phase ≥3: 1 · Phased (≥1): 1 · Undrugged: 8

Druggability breadth: 3 of 9 evidence-associated genes (33%) 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
TERTBERBERINE

Top cohort targets by molecule count

SymbolMoleculesMax phase
TERT104
TERC00
TGM100
TINF200
RTEL100
ACTRT300
MECOM00
RTEL1-TNFRSF6B00
INPP4A00

Drugs targeting cohort genes (top 30)

MoleculeMax phaseTargets in cohort
BERBERINE4TERT
DOXORUBICIN4TERT
RESVERATROL3TERT
EPIGALOCATECHIN GALLATE3TERT
PERIFOSINE3TERT
ISOMETAMIDIUM2TERT
HOMIDIUM BROMIDE2TERT
ALLICIN2TERT
OLEIC ACID2TERT
ETHACRIDINE2TERT

Bioactivity and enzyme data

Enzyme cohort genes (≥1 EC): 2.

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

SymbolAssaysType breakdown
TERT391Binding:389, Functional:2
TGM111Binding:11
MECOM1Binding:1

Cohort enzymes (BRENDA EC)

SymbolEC numbersNames
TGM12.3.2.13protein-glutamine gamma-glutamyltransferase
INPP4A3.1.3.66phosphatidylinositol-3,4-bisphosphate 4-phosphatase

Cohort genes with high screening signal

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

SymbolChEMBL assays
TERT391

Pharmacogenomics

Cohort genes with a PharmGKB record: 8; with CPIC/DPWG dosing guidelines: 0.

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

Chemical tractability of cohort targets

10 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)
BERBERINE4TERT
DOXORUBICIN4TERT
RESVERATROL3TERT
EPIGALOCATECHIN GALLATE3TERT
PERIFOSINE3TERT
ISOMETAMIDIUM2TERT
HOMIDIUM BROMIDE2TERT
ALLICIN2TERT
OLEIC ACID2TERT
ETHACRIDINE2TERT

Druggability pyramid

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

TierDefinitionGenesSymbols
AApproved (phase 4 drug)1TERT
BPhased (≥1) drug, not yet approved0
CDruggable family + PDB, no drug1TGM1
DDruggable family + AlphaFold only, no drug1INPP4A
EDifficult family or no structure, no drug6TERC, TINF2, RTEL1, ACTRT3, MECOM, RTEL1-TNFRSF6B

Undrugged target profiles

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

SymbolChEMBL assaysDrugged partners (top 3)
TERC0
TGM111
TINF20
RTEL10
ACTRT30
MECOM1
RTEL1-TNFRSF6B0
INPP4A0

Clinical trials & evidence

Clinical trials

Clinical trials: 0.