Imperforate anus
diseaseOn this page
Also known as anal atresiaanal stenosisanorectal malformationsanus, imperforatecongenital atresia of anus
Summary
Imperforate anus (MONDO:0001046) is a disease with 9 cohort genes and 18 clinical trials. Top therapeutic interventions include indocyanine green acid form.
At a glance
- Cohort genes: 9
- ClinVar variants: 10
- Clinical trials: 18
Clinical features
No curated clinical features (Orphanet) for this disease.
Identifiers
Disease identifiers
| Field | Value |
|---|---|
| Canonical name | imperforate anus |
| Mondo ID | MONDO:0001046 |
| MeSH | D001006 |
| OMIM | 207500, 301800 |
| DOID | DOID:10488 |
| ICD-10-CM | Q42.3 |
| ICD-11 | 290678165, 515168801 |
| NCIT | C84784 |
| SNOMED CT | 204731006 |
| UMLS | C0003466 |
| MedGen | 1997 |
| GARD | 0006769 |
| NORD | 1299 |
| Is cancer (heuristic) | no |
Also known as: anal atresia · anal stenosis · anorectal malformations · anus, imperforate · congenital atresia of anus · imperforate anus
Data availability: 10 ClinVar variants.
Disease family
Classification path: disease › human disease › disease by body system or component › digestive system disorder › intestinal disorder › large intestine disorder › rectal disorder › anus disorder › imperforate anus
Related subtypes (6): anorectal stricture, anal spasm, anus neoplasm, proctitis, levator syndrome, anal polyp
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
10 retrieved; paginated sample, class counts are floors:
6 uncertain significance, 2 likely pathogenic, 1 pathogenic/likely pathogenic, 1 pathogenic
| ClinVar | Variant (HGVS) | Gene | Classification | Review |
|---|---|---|---|---|
| 638672 | GRCh37/hg19 22q11.22-11.23(chr22:22971867-23643138) | IGLL5 | Pathogenic | no assertion criteria provided |
| 11520 | NM_005120.3(MED12):c.2881C>T (p.Arg961Trp) | MED12 | Pathogenic/Likely pathogenic | criteria provided, multiple submitters, no conflicts |
| 523403 | NM_001904.4(CTNNB1):c.1876G>T (p.Glu626Ter) | CTNNB1 | Likely pathogenic | criteria provided, single submitter |
| 1804004 | NM_001395002.1(MAP4K4):c.3458_3459del (p.Val1153fs) | MAP4K4 | Likely pathogenic | criteria provided, single submitter |
| 2570675 | NM_015089.4(CUL9):c.7237C>T (p.Arg2413Trp) | CUL9 | Uncertain significance | criteria provided, single submitter |
| 2570677 | NM_015089.4(CUL9):c.2732C>T (p.Pro911Leu) | CUL9 | Uncertain significance | criteria provided, single submitter |
| 638675 | GRCh37/hg19 15q12(chr15:27462869-27544157) | GABRG3 | Uncertain significance | no assertion criteria provided |
| 1338794 | NM_002941.4(ROBO1):c.1400C>T (p.Ala467Val) | ROBO1 | Uncertain significance | criteria provided, multiple submitters, no conflicts |
| 638673 | GRCh37/hg19 2q12.1(chr2:103090517-103148433) | SLC9A4 | Uncertain significance | no assertion criteria provided |
| 638674 | GRCh37/hg19 7q34(chr7:139478979-139550968) | TBXAS1 | Uncertain significance | no assertion criteria provided |
Genes & proteins
Mendelian disease overlap and somatic drivers
GenCC: 0 · Orphanet: 19 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0
Orphanet rare-disease linkage (cohort genes)
| Gene | Orphanet ID | Rare disease |
|---|---|---|
| ROBO1 | Orphanet:95496 | Pituitary stalk interruption syndrome |
| TBXAS1 | Orphanet:1802 | Ghosal hematodiaphyseal dysplasia |
| MED12 | Orphanet:1415 | Hardikar syndrome |
| MED12 | Orphanet:293707 | Blepharophimosis-intellectual disability syndrome, MKB type |
| MED12 | Orphanet:776 | Lujan-Fryns syndrome |
| MED12 | Orphanet:777 | X-linked non-syndromic intellectual disability |
| MED12 | Orphanet:93932 | FG syndrome type 1 |
| CTNNB1 | Orphanet:1501 | Adrenocortical carcinoma |
| CTNNB1 | Orphanet:210159 | Adult hepatocellular carcinoma |
| CTNNB1 | Orphanet:2780 | Osteopathia striata-cranial sclerosis syndrome |
| CTNNB1 | Orphanet:33402 | Pediatric hepatocellular carcinoma |
| CTNNB1 | Orphanet:404473 | Intellectual disability-eye abnormalities-microcephaly-peripheral spasticity syndrome |
| CTNNB1 | Orphanet:54595 | Craniopharyngioma |
| CTNNB1 | Orphanet:569248 | Microcystic stromal tumor |
| CTNNB1 | Orphanet:689430 | Adenoid ameloblastoma |
| CTNNB1 | Orphanet:873 | Desmoid tumor |
| CTNNB1 | Orphanet:891 | Familial exudative vitreoretinopathy |
| CTNNB1 | Orphanet:91414 | Pilomatrixoma |
| CTNNB1 | Orphanet:952 | Acrofacial dysostosis, Weyers type |
Cohort genes → proteins
9 cohort genes, 9 distinct canonical proteins.
Evidence partition
| Subset | Genes |
|---|---|
| multi_evidence | 9 |
Cohort genes (full)
| Symbol | HGNC | Ensembl | UniProt | Name | Evidence |
|---|---|---|---|---|---|
| ROBO1 | HGNC:10249 | ENSG00000169855 | Q9Y6N7 | Roundabout homolog 1 | clinvar |
| SLC9A4 | HGNC:11077 | ENSG00000180251 | Q6AI14 | Sodium/hydrogen exchanger 4 | clinvar |
| TBXAS1 | HGNC:11609 | ENSG00000059377 | P24557 | Thromboxane-A synthase | clinvar |
| MED12 | HGNC:11957 | ENSG00000184634 | Q93074 | Mediator of RNA polymerase II transcription subunit 12 | clinvar |
| CUL9 | HGNC:15982 | ENSG00000112659 | Q8IWT3 | Cullin-9 | clinvar |
| CTNNB1 | HGNC:2514 | ENSG00000168036 | P35222 | Catenin beta-1 | clinvar |
| IGLL5 | HGNC:38476 | ENSG00000254709 | B9A064 | Immunoglobulin lambda-like polypeptide 5 | clinvar |
| GABRG3 | HGNC:4088 | ENSG00000182256 | Q99928 | Gamma-aminobutyric acid receptor subunit gamma-3 | clinvar |
| MAP4K4 | HGNC:6866 | ENSG00000071054 | O95819 | Mitogen-activated protein kinase kinase kinase kinase 4 | clinvar |
Cohort function summary
Lead sentence per gene, UniProt-curated.
| Symbol | Protein name | Function (lead sentence) |
|---|---|---|
| ROBO1 | Roundabout homolog 1 | Receptor for SLIT1 and SLIT2 that mediates cellular responses to molecular guidance cues in cellular migration, including axonal navigation at the ventral midline of the neural tube and projection of axons to different regions during neuro… |
| SLC9A4 | Sodium/hydrogen exchanger 4 | Electroneutral antiporter that exchanges sodium for protons or ammonium ions at the basolateral membrane of epithelia to regulate cell volume and intracellular pH upon hypertonic conditions. |
| TBXAS1 | Thromboxane-A synthase | Catalyzes the conversion of prostaglandin H2 (PGH2) to thromboxane A2 (TXA2), a potent inducer of blood vessel constriction and platelet aggregation. |
| MED12 | Mediator of RNA polymerase II transcription subunit 12 | Component of the Mediator complex, a coactivator involved in the regulated transcription of nearly all RNA polymerase II-dependent genes. |
| CUL9 | Cullin-9 | Core component of a Cul9-RING ubiquitin-protein ligase complex composed of CUL9 and RBX1. |
| CTNNB1 | Catenin beta-1 | Key downstream component of the canonical Wnt signaling pathway. |
| GABRG3 | Gamma-aminobutyric acid receptor subunit gamma-3 | Gamma subunit of the heteropentameric ligand-gated chloride channel gated by gamma-aminobutyric acid (GABA), a major inhibitory neurotransmitter in the brain. |
| MAP4K4 | Mitogen-activated protein kinase kinase kinase kinase 4 | Serine/threonine kinase that plays a role in the response to environmental stress and cytokines such as TNF. |
Protein-family classification
Druggable: 3 · Difficult: 1 · Unknown: 5 · Druggable fraction: 0.33
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 |
|---|---|---|---|
| Antibody/Immunoglobulin | 2 | 6.5× | 0.144 |
| Kinase | 1 | 3.1× | 0.563 |
| Other/Unknown | 5 | 1.0× | 0.687 |
| Transcription factor | 1 | 0.9× | 0.687 |
Per-gene assignment
| Symbol | Family | Druggable? | EC | InterPro (top 3) |
|---|---|---|---|---|
| ROBO1 | Antibody/Immunoglobulin | yes | Ig_sub2, Ig_sub, FN3_dom | |
| SLC9A4 | Other/Unknown | no | NHE-2/4, NaH_exchanger, Cation/H_exchanger_TM | |
| TBXAS1 | Other/Unknown | no | Cyt_P450, Cyt_P450_E_grp-I, Cyt_P450_CS | |
| MED12 | Other/Unknown | no | Mediator_Med12, Mediator_Med12_catenin-bd, Mediator_Med12_LCEWAV | |
| CUL9 | Transcription factor | no | Znf_RING, IBR_dom, APC_su10/DOC_dom | |
| CTNNB1 | Other/Unknown | no | Armadillo, ARM-like, Beta-catenin | |
| IGLL5 | Antibody/Immunoglobulin | yes | Ig/MHC_CS, Ig_C1-set, Ig-like_dom | |
| GABRG3 | Other/Unknown | no | GABRG-1/4, GABBAg3_rcpt, GABAA/Glycine_rcpt | |
| MAP4K4 | Kinase | yes | Prot_kinase_dom, CNH_dom, Ser/Thr_kinase_AS |
Expression context
Cohort genes with no expression data: 0.
9 cohort genes 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) | 9 |
| unknown | 0 |
Top tissues across cohort
| Tissue | Cohort genes |
|---|---|
| ganglionic eminence | 2 |
| ventricular zone | 2 |
| male germ line stem cell (sensu Vertebrata) in testis | 2 |
| right testis | 2 |
| cortical plate | 2 |
| tibia | 1 |
| body of stomach | 1 |
| stomach | 1 |
| leukocyte | 1 |
| monocyte | 1 |
| mononuclear cell | 1 |
| left ovary | 1 |
| right adrenal gland | 1 |
| right adrenal gland cortex | 1 |
| left testis | 1 |
| right frontal lobe | 1 |
| adrenal tissue | 1 |
| periodontal ligament | 1 |
| bone marrow cell | 1 |
| duodenum | 1 |
Per-gene tissue summary (top 30)
| Symbol | Bgee breadth | FANTOM5 breadth | SCXA | Top tissues |
|---|---|---|---|---|
| ROBO1 | 287 | ubiquitous | marker | ventricular zone, ganglionic eminence, tibia |
| SLC9A4 | 67 | tissue_specific | marker | male germ line stem cell (sensu Vertebrata) in testis, stomach, body of stomach |
| TBXAS1 | 180 | ubiquitous | marker | monocyte, mononuclear cell, leukocyte |
| MED12 | 281 | ubiquitous | marker | right adrenal gland cortex, right adrenal gland, left ovary |
| CUL9 | 275 | ubiquitous | marker | right testis, left testis, right frontal lobe |
| CTNNB1 | 295 | ubiquitous | marker | adrenal tissue, ventricular zone, periodontal ligament |
| IGLL5 | 117 | tissue_specific | marker | duodenum, rectum, bone marrow cell |
| GABRG3 | 115 | broad | marker | male germ line stem cell (sensu Vertebrata) in testis, cortical plate, right testis |
| MAP4K4 | 295 | ubiquitous | marker | C1 segment of cervical spinal cord, cortical plate, ganglionic eminence |
Protein interactions among cohort
Intra-cohort edges: 1.
Hub genes (top 10 by interactor count)
| Symbol | Interactor count |
|---|---|
| CTNNB1 | 15,668 |
| MED12 | 3,322 |
| ROBO1 | 2,359 |
| IGLL5 | 2,327 |
| TBXAS1 | 2,072 |
| MAP4K4 | 1,975 |
| CUL9 | 1,551 |
| GABRG3 | 1,126 |
| SLC9A4 | 808 |
Intra-cohort edges
| A | B | Sources |
|---|---|---|
| CTNNB1 | MED12 | string_interaction |
Structural data
PDB: 6 · AlphaFold-only: 3 · No structure: 0
Cohort genes with PDB structures (top 30)
| Symbol | UniProt | PDB entries |
|---|---|---|
| CTNNB1 | P35222 | 50 |
| MAP4K4 | O95819 | 18 |
| ROBO1 | Q9Y6N7 | 12 |
| CUL9 | Q8IWT3 | 4 |
| MED12 | Q93074 | 3 |
| IGLL5 | B9A064 | 1 |
AlphaFold-only cohort genes (top 30 by pLDDT)
| Symbol | UniProt | pLDDT |
|---|---|---|
| TBXAS1 | P24557 | 91.50 |
| GABRG3 | Q99928 | 75.44 |
| SLC9A4 | Q6AI14 | 66.73 |
Function
Pathway analysis
Distinct Reactome pathways touched by cohort: 98. Enrichment computed across 9 evidence-associated genes (8 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 8 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.
| Pathway | Cohort genes | Fold | FDR | Sample cohort genes |
|---|---|---|---|---|
| Defective TBXAS1 causes GHDD | 1 | 1427.5× | 0.038 | TBXAS1 |
| SLIT2:ROBO1 increases RHOA activity | 1 | 356.9× | 0.038 | ROBO1 |
| LRR FLII-interacting protein 1 (LRRFIP1) activates type I IFN production | 1 | 285.5× | 0.038 | CTNNB1 |
| Regulation of cortical dendrite branching | 1 | 285.5× | 0.038 | ROBO1 |
| CDH11 homotypic and heterotypic interactions | 1 | 203.9× | 0.038 | CTNNB1 |
| Inactivation of CDC42 and RAC1 | 1 | 178.4× | 0.038 | ROBO1 |
| Regulation of CDH19 Expression and Function | 1 | 178.4× | 0.038 | CTNNB1 |
| Sodium/Proton exchangers | 1 | 158.6× | 0.038 | SLC9A4 |
| Role of ABL in ROBO-SLIT signaling | 1 | 158.6× | 0.038 | ROBO1 |
| InlA-mediated entry of Listeria monocytogenes into host cells | 1 | 158.6× | 0.038 | CTNNB1 |
| Binding of TCF/LEF:CTNNB1 to target gene promoters | 1 | 142.8× | 0.038 | CTNNB1 |
| RUNX3 regulates WNT signaling | 1 | 142.8× | 0.038 | CTNNB1 |
| Apoptotic cleavage of cell adhesion proteins | 1 | 129.8× | 0.038 | CTNNB1 |
| Regulation of CDH11 function | 1 | 129.8× | 0.038 | CTNNB1 |
| Eicosanoids | 1 | 119.0× | 0.038 | TBXAS1 |
| Regulation of commissural axon pathfinding by SLIT and ROBO | 1 | 119.0× | 0.038 | ROBO1 |
| Regulation of CDH1 Function | 1 | 119.0× | 0.038 | CTNNB1 |
| Metabolic disorders of biological oxidation enzymes | 1 | 109.8× | 0.038 | TBXAS1 |
| Activation of RAC1 | 1 | 102.0× | 0.038 | ROBO1 |
| Formation of axial mesoderm | 1 | 102.0× | 0.038 | CTNNB1 |
| Synthesis of Prostaglandins (PG) and Thromboxanes (TX) | 1 | 95.2× | 0.038 | TBXAS1 |
| Signaling by GSK3beta mutants | 1 | 95.2× | 0.038 | CTNNB1 |
| CTNNB1 S33 mutants aren’t phosphorylated | 1 | 95.2× | 0.038 | CTNNB1 |
| CTNNB1 S37 mutants aren’t phosphorylated | 1 | 95.2× | 0.038 | CTNNB1 |
| CTNNB1 S45 mutants aren’t phosphorylated | 1 | 95.2× | 0.038 | CTNNB1 |
| CTNNB1 T41 mutants aren’t phosphorylated | 1 | 95.2× | 0.038 | CTNNB1 |
| Cytochrome P450 - arranged by substrate type | 1 | 89.2× | 0.038 | TBXAS1 |
| Formation of definitive endoderm | 1 | 89.2× | 0.038 | CTNNB1 |
| Beta-catenin phosphorylation cascade | 1 | 84.0× | 0.038 | CTNNB1 |
| Germ layer formation at gastrulation | 1 | 84.0× | 0.038 | CTNNB1 |
GO biological processes by enrichment
Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 9 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.
| GO term | Cohort genes | Fold | FDR | Sample cohort genes |
|---|---|---|---|---|
| embryonic brain development | 2 | 178.3× | 0.012 | MED12, CTNNB1 |
| glial cell fate determination | 1 | 1872.4× | 0.013 | CTNNB1 |
| canonical Wnt signaling pathway involved in mesenchymal stem cell differentiation | 1 | 1872.4× | 0.013 | CTNNB1 |
| cranial ganglion development | 1 | 1872.4× | 0.013 | CTNNB1 |
| neural plate development | 1 | 936.2× | 0.013 | CTNNB1 |
| negative regulation of mesenchymal to epithelial transition involved in metanephros morphogenesis | 1 | 936.2× | 0.013 | CTNNB1 |
| chemorepulsion involved in postnatal olfactory bulb interneuron migration | 1 | 936.2× | 0.013 | ROBO1 |
| regulation of centriole-centriole cohesion | 1 | 936.2× | 0.013 | CTNNB1 |
| negative regulation of mitotic cell cycle, embryonic | 1 | 936.2× | 0.013 | CTNNB1 |
| regulation of timing of anagen | 1 | 936.2× | 0.013 | CTNNB1 |
| positive regulation of branching involved in lung morphogenesis | 1 | 936.2× | 0.013 | CTNNB1 |
| renal vesicle formation | 1 | 936.2× | 0.013 | CTNNB1 |
| renal inner medulla development | 1 | 936.2× | 0.013 | CTNNB1 |
| renal outer medulla development | 1 | 936.2× | 0.013 | CTNNB1 |
| nephron tubule formation | 1 | 936.2× | 0.013 | CTNNB1 |
| regulation of nephron tubule epithelial cell differentiation | 1 | 936.2× | 0.013 | CTNNB1 |
| mesenchymal stem cell differentiation | 1 | 936.2× | 0.013 | CTNNB1 |
| positive regulation of determination of dorsal identity | 1 | 936.2× | 0.013 | CTNNB1 |
| positive regulation of ARF protein signal transduction | 1 | 624.1× | 0.013 | MAP4K4 |
| astrocyte-dopaminergic neuron signaling | 1 | 624.1× | 0.013 | CTNNB1 |
| regulation of fibroblast proliferation | 1 | 624.1× | 0.013 | CTNNB1 |
| negative regulation of negative chemotaxis | 1 | 624.1× | 0.013 | ROBO1 |
| oviduct development | 1 | 624.1× | 0.013 | CTNNB1 |
| lung induction | 1 | 624.1× | 0.013 | CTNNB1 |
| positive regulation of epithelial cell proliferation involved in prostate gland development | 1 | 624.1× | 0.013 | CTNNB1 |
| fungiform papilla formation | 1 | 624.1× | 0.013 | CTNNB1 |
| regulation of centromeric sister chromatid cohesion | 1 | 624.1× | 0.013 | CTNNB1 |
| axis elongation involved in somitogenesis | 1 | 624.1× | 0.013 | MED12 |
| MAPK cascade | 2 | 34.0× | 0.013 | CTNNB1, MAP4K4 |
| regulation of secondary heart field cardioblast proliferation | 1 | 468.1× | 0.014 | CTNNB1 |
Therapeutics
Drug target analysis
Approved (phase 4): 4 · Phase ≥3: 4 · Phased (≥1): 5 · Undrugged: 4
Druggability breadth: 6 of 9 evidence-associated genes (67%) 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.
| Symbol | Example approved molecule |
|---|---|
| TBXAS1 | CLOTRIMAZOLE |
| CTNNB1 | DITHIAZANINE IODIDE |
| GABRG3 | ENZALUTAMIDE |
| MAP4K4 | PONATINIB |
Top cohort targets by molecule count
| Symbol | Molecules | Max phase |
|---|---|---|
| MAP4K4 | 62 | 4 |
| TBXAS1 | 46 | 4 |
| GABRG3 | 15 | 4 |
| CTNNB1 | 4 | 4 |
| MED12 | 1 | 2 |
| ROBO1 | 0 | 0 |
| SLC9A4 | 0 | 0 |
| CUL9 | 0 | 0 |
| IGLL5 | 0 | 0 |
Drugs targeting cohort genes (top 30)
| Molecule | Max phase | Targets in cohort |
|---|---|---|
| CLOTRIMAZOLE | 4 | TBXAS1 |
| CISPLATIN | 4 | TBXAS1 |
| SAQUINAVIR | 4 | TBXAS1 |
| AMPRENAVIR | 4 | TBXAS1 |
| OZAGREL | 4 | TBXAS1 |
| GRAMICIDIN | 4 | TBXAS1 |
| ROSIGLITAZONE | 4 | TBXAS1 |
| SULCONAZOLE | 4 | TBXAS1 |
| OXICONAZOLE | 4 | TBXAS1 |
| KETOCONAZOLE | 4 | TBXAS1 |
| VINBLASTINE | 4 | TBXAS1 |
| RITONAVIR | 4 | TBXAS1 |
| NIFEDIPINE | 4 | TBXAS1 |
| BITHIONOL | 4 | TBXAS1 |
| 3,3’,4’,5-TETRACHLOROSALICYLANILIDE | 4 | TBXAS1 |
| TROGLITAZONE | 4 | TBXAS1 |
| DIETHYLSTILBESTROL | 4 | TBXAS1 |
| SULFASALAZINE | 4 | TBXAS1 |
| TROVAFLOXACIN | 4 | TBXAS1 |
| ERGOTAMINE | 4 | TBXAS1 |
| AMINOGLUTETHIMIDE | 4 | TBXAS1 |
| HEXACHLOROPHENE | 4 | TBXAS1 |
| TANNIC ACID | 4 | TBXAS1 |
| NELFINAVIR | 4 | TBXAS1 |
| INDOMETHACIN | 4 | TBXAS1 |
| ZAFIRLUKAST | 4 | TBXAS1 |
| MONTELUKAST | 4 | TBXAS1 |
| ECONAZOLE | 4 | TBXAS1 |
| TAMOXIFEN | 4 | TBXAS1 |
| MICONAZOLE | 4 | TBXAS1 |
Bioactivity and enzyme data
Enzyme cohort genes (≥1 EC): 0.
Cohort genes with ChEMBL bioactivity (full, sorted by assay count)
| Symbol | Assays | Type breakdown |
|---|---|---|
| MAP4K4 | 407 | Binding:400, ADMET:5, Functional:1, Toxicity:1 |
| CTNNB1 | 361 | Binding:358, Functional:3 |
| TBXAS1 | 210 | Binding:138, Functional:72 |
| GABRG3 | 191 | Binding:172, Functional:15, Toxicity:3, ADMET:1 |
| MED12 | 6 | Binding:6 |
| CUL9 | 2 | Binding:2 |
Cohort genes with high screening signal
≥100 ChEMBL assays — a studied-ness signal; see Therapeutics for approved-drug status.
| Symbol | ChEMBL assays |
|---|---|
| TBXAS1 | 210 |
| CTNNB1 | 361 |
| GABRG3 | 191 |
| MAP4K4 | 407 |
Pharmacogenomics
Cohort genes with a PharmGKB record: 9; 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.
| Compound | Max phase | Cohort target (bioactivity) |
|---|---|---|
| CLOTRIMAZOLE | 4 | TBXAS1 |
| CISPLATIN | 4 | TBXAS1 |
| SAQUINAVIR | 4 | TBXAS1 |
| AMPRENAVIR | 4 | TBXAS1 |
| OZAGREL | 4 | TBXAS1 |
| GRAMICIDIN | 4 | TBXAS1 |
| ROSIGLITAZONE | 4 | TBXAS1 |
| SULCONAZOLE | 4 | TBXAS1 |
| OXICONAZOLE | 4 | TBXAS1 |
| KETOCONAZOLE | 4 | TBXAS1 |
| VINBLASTINE | 4 | TBXAS1 |
| RITONAVIR | 4 | TBXAS1 |
| NIFEDIPINE | 4 | TBXAS1 |
| BITHIONOL | 4 | TBXAS1 |
| 3,3’,4’,5-TETRACHLOROSALICYLANILIDE | 4 | TBXAS1 |
| TROGLITAZONE | 4 | TBXAS1 |
| DIETHYLSTILBESTROL | 4 | TBXAS1 |
| SULFASALAZINE | 4 | TBXAS1 |
| TROVAFLOXACIN | 4 | TBXAS1 |
| ERGOTAMINE | 4 | TBXAS1 |
| AMINOGLUTETHIMIDE | 4 | TBXAS1 |
| HEXACHLOROPHENE | 4 | TBXAS1 |
| TANNIC ACID | 4 | TBXAS1 |
| NELFINAVIR | 4 | TBXAS1 |
| INDOMETHACIN | 4 | TBXAS1 |
| ZAFIRLUKAST | 4 | TBXAS1 |
| MONTELUKAST | 4 | TBXAS1 |
| ECONAZOLE | 4 | TBXAS1 |
| TAMOXIFEN | 4 | TBXAS1 |
| MICONAZOLE | 4 | TBXAS1 |
Druggability pyramid
Cohort genes binned by druggability tier (high → low):
| Tier | Definition | Genes | Symbols |
|---|---|---|---|
| A | Approved (phase 4 drug) | 4 | TBXAS1, CTNNB1, GABRG3, MAP4K4 |
| B | Phased (≥1) drug, not yet approved | 1 | MED12 |
| C | Druggable family + PDB, no drug | 2 | ROBO1, IGLL5 |
| D | Druggable family + AlphaFold only, no drug | 0 | |
| E | Difficult family or no structure, no drug | 2 | SLC9A4, CUL9 |
Undrugged target profiles
4 cohort genes are undrugged. Ranked by ‘starting-point quality’ (assay depth + drugged-partner adjacency).
| Symbol | ChEMBL assays | Drugged partners (top 3) |
|---|---|---|
| ROBO1 | 0 | — |
| SLC9A4 | 0 | — |
| CUL9 | 2 | — |
| IGLL5 | 0 | — |
Clinical trials & evidence
Clinical trials
Clinical trials: 18.
Phase distribution (across all retrieved trials)
| Phase | Trials |
|---|---|
| Not specified | 17 |
| PHASE3 | 1 |
Top trials by phase / activity
| NCT | Phase | Status | Title |
|---|---|---|---|
| NCT04904081 | PHASE3 | UNKNOWN | Feasibility of Use of Indocyanine Green in Pediatric Colorectal Surgery |
| NCT05450991 | Not specified | RECRUITING | Long-term Qualitative and Quantitative Outcomes of Children With Hirschsprung’s Disease and Anorectal Malformations |
| NCT07029984 | Not specified | RECRUITING | Baylor Continence Scale Validity in Anorectal Malformation |
| NCT07366476 | Not specified | NOT_YET_RECRUITING | Effectiveness of Electrical Stimulation and Biofeedback on Fecal Incontinence in Children With Repaired Anorectal Malformation |
| NCT07438691 | Not specified | RECRUITING | Outcomes in ARMs: Comparison Between Surgical Techniques in Patients With Perineal or Vestibular Fistula - a Multicenter Italian Study |
| NCT00883571 | Not specified | COMPLETED | Comparative Study of the House Advancement Flap, Rhomboid Flap, and Y-V Anoplasty |
| NCT04106947 | Not specified | UNKNOWN | Transition of Care for Patients With Hirschsprung Disease and Anorectal Malformations |
| NCT04710433 | Not specified | COMPLETED | Non-invasive Sacral Nerve Stimulation in Children and Adolescents With Chronic Constipation |
| NCT04713085 | Not specified | COMPLETED | Sacral Neuromodulation in Children and Adolescents |
| NCT04901819 | Not specified | COMPLETED | Longterm Outcomes of Individuals With Anorectal Malformations |
| NCT05045560 | Not specified | COMPLETED | Study of Antenatal and Postnatal Data of Anorectal Malformations Diagnosed at Montpellier University Hospital Over a 10-year Period (2010-2020) |
| NCT05293353 | Not specified | UNKNOWN | Neokare Safety and Tolerability Assessment in Neonates With GI Problems |
| NCT05621629 | Not specified | COMPLETED | Management of FI After Surgery of ARM |
| NCT05749406 | Not specified | UNKNOWN | Parental Attitudes to Neoanus Dilatations Post-reconstruction in Anorectal Malformations |
| NCT06065995 | Not specified | TERMINATED | StoMakker Mobile Application |
| NCT06234020 | Not specified | COMPLETED | Frequency of Vertebrospinal Anomalies in Patients Presenting With Anorectal Malformations |
| NCT06860906 | Not specified | COMPLETED | V-Y Flap for Anal Stenosis |
| NCT07099339 | Not specified | COMPLETED | Effect of Pudendal Nerve Electrical Stimulation on Fecal Incontinence in Children With Repaired Anorectal Malformation |
Drugs tested across these trials (top 30)
| Molecule | Max phase | Trials referencing |
|---|---|---|
| INDOCYANINE GREEN ACID FORM | 4 | 2 |