mucolipidosis type IV

disease
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Also known as Berman syndromeganglioside neuraminidase deficiencyganglioside sialidase deficiencyML 4ML IVML4MLIVMucolipidosis IVmucolipidosis type 4sialolipidosis

Summary

mucolipidosis type IV (MONDO:0009653) is a disease caused by MCOLN1 (GenCC Definitive), with 4 cohort genes and 5 clinical trials.

At a glance

  • Prevalence: Unknown (Worldwide) [Orphanet-validated]
  • Causal gene: MCOLN1 (GenCC Definitive)
  • Cohort genes: 4
  • ClinVar variants: 907
  • Phenotypes (HPO): 27
  • Clinical trials: 5

Clinical features

Epidemiology

Prevalence records

2 prevalence record(s), Orphanet:

TypeClassValueGeographyValidation
Prevalence at birth1-9 / 1 000 0000.1SwedenValidated
Prevalence at birth1-9 / 100 0002.5Specific populationValidated

Signs & symptoms

Clinical features (HPO)

27 HPO clinical features (Orphanet curated; top 27 by frequency):

HPO IDTermFrequency
HP:0000486StrabismusVery frequent (80-99%)
HP:0000488RetinopathyVery frequent (80-99%)
HP:0000613PhotophobiaVery frequent (80-99%)
HP:0000708Atypical behaviorVery frequent (80-99%)
HP:0001249Intellectual disabilityVery frequent (80-99%)
HP:0001288Gait disturbanceVery frequent (80-99%)
HP:0001344Absent speechVery frequent (80-99%)
HP:0001347HyperreflexiaVery frequent (80-99%)
HP:0004345Abnormality of ganglioside metabolismVery frequent (80-99%)
HP:0007281Developmental stagnationVery frequent (80-99%)
HP:0007957Corneal opacityVery frequent (80-99%)
HP:0010318Aplasia/Hypoplasia of the abdominal wall musculatureVery frequent (80-99%)
HP:0011020Abnormality of mucopolysaccharide metabolismVery frequent (80-99%)
HP:0000639NystagmusFrequent (30-79%)
HP:0001251AtaxiaFrequent (30-79%)
HP:0001252HypotoniaFrequent (30-79%)
HP:0002353EEG abnormalityFrequent (30-79%)
HP:0000232Everted lower lip vermilionOccasional (5-29%)
HP:0000252MicrocephalyOccasional (5-29%)
HP:0000280Coarse facial featuresOccasional (5-29%)
HP:0000512Abnormal electroretinogramOccasional (5-29%)
HP:0000691MicrodontiaOccasional (5-29%)
HP:0000982Palmoplantar keratodermaOccasional (5-29%)
HP:0002816Genu recurvatumOccasional (5-29%)
HP:0004422Biparietal narrowingOccasional (5-29%)
HP:0005105Abnormal nasal morphologyOccasional (5-29%)
HP:0007703Abnormality of retinal pigmentationOccasional (5-29%)

Identifiers

Disease identifiers

FieldValue
Canonical namemucolipidosis type IV
Mondo IDMONDO:0009653
OMIM252650
Orphanet578
DOIDDOID:0080490
ICD-10-CME75.11
NCITC84896
SNOMED CT111384001, 725296006
UMLSC0238286
MedGen68663
GARD0000094
NORD1460
Is cancer (heuristic)no

Also known as: Berman syndrome · ganglioside neuraminidase deficiency · ganglioside sialidase deficiency · ML 4 · ML IV · ML4 · MLIV · Mucolipidosis IV · mucolipidosis IV · mucolipidosis type 4 · mucolipidosis type IV · sialolipidosis

Data availability: 907 ClinVar variants · 7 GenCC gene-disease records · 13 cell lines.

Disease family

Classification path: disease › human disease › disease by body system or component › disorder of orbital regioneye disordermucolipidosis type IV

Related subtypes (119): ptosis, eye accommodation disease, corneal disorder, asthenopia, lens disorder, keratomalacia, scleral disorder, ocular siderosis, coloboma, luxation of globe, mucopolysaccharidosis type 1, lacrimal apparatus disorder, Foster-Kennedy syndrome, anterior dislocation of lens, uveal disorder, eyelid disorder, ocular hypotension, scotoma, exophthalmos, ophthalmia nodosa, eye degenerative disorder, refractive error, glaucoma, retinal disorder, eye allergy, ocular vascular disorder, optic neuritis, conjunctival disorder, ocular hypertension, Tietz syndrome, Alagille syndrome, glaucoma-sleep apnea syndrome, Marshall syndrome, microcornea-glaucoma-absent frontal sinuses syndrome, nail-patella syndrome, oculodentodigital dysplasia, piebaldism, Sturge-Weber syndrome, cerebrotendinous xanthomatosis, ocular cystinosis, alpha-mannosidosis, megalocornea-intellectual disability syndrome, mucopolysaccharidosis type 6, Netherton syndrome, galactosialidosis, Niemann-Pick disease type A, ocular motor apraxia, Cogan type, Peters plus syndrome, isolated Pierre-Robin syndrome, ectodermal dysplasia-blindness syndrome, Sandhoff disease, SHORT syndrome, Sjogren-Larsson syndrome, Smith-Lemli-Opitz syndrome, Tay-Sachs disease, tyrosinemia type II, Ito hypomelanosis, X-linked cone dysfunction syndrome with myopia, red color blindness, oculocerebrorenal syndrome, Lowry-MacLean syndrome, pigment dispersion syndrome, hereditary hyperferritinemia with congenital cataracts, dyssegmental dysplasia-glaucoma syndrome, mevalonic aciduria, familial cavitary optic disk anomaly, blindness - scoliosis - arachnodactyly syndrome, fatty acyl-CoA reductase 1 deficiency, microcephaly-intellectual disability-sensorineural hearing loss-epilepsy-abnormal muscle tone syndrome, neurotrophic keratopathy, Cogan syndrome, atopic keratoconjunctivitis, rhizomelic chondrodysplasia punctata, Ehlers-Danlos syndrome, kyphoscoliotic type 1, IRVAN syndrome, Rothmund-Thomson syndrome type 2, microcornea-corectopia-macular hypoplasia syndrome, isolated anophthalmia-microphthalmia syndrome, Spasmus nutans, toxic maculopathy due to antimalarial drugs, syndromic recessive X-linked ichthyosis, acute zonal occult outer retinopathy, acute annular outer retinopathy, phakomatosis pigmentovascularis, lamellar ichthyosis, idiopathic linear interstitial keratitis, chondroectodermal dysplasia with night blindness, galactosemia, GM1 gangliosidosis, Gaucher disease, visual snow syndrome, extensive peripapillary myelinated nerve fibers, IgG4-related ophthalmic disorder, global developmental delay-visual anomalies-progressive cerebellar atrophy-truncal hypotonia syndrome, vernal keratoconjunctivitis, Gardner syndrome, anterior segment dysgenesis, isolated ankyloblepharon filiforme adnatum, hereditary optic neuropathy, essential strabismus, Axenfeld anomaly, eye neoplasm, isolated blepharochalasis, punctate inner choroidopathy, eye infectious disorder, vitreous body disorder, 9q33.3q34.11 microdeletion syndrome, autoimmune/inflammatory optic neuropathy, LTBP2-related ocular dysgenesis, ocular growth disorder, ocular dysgenesis caused by defects in PAX6 regulation, choroidal neovascularization, anterior segment developmental abnormality with extraocular manifestations, congenital optic disk excavation, neuroocular syndrome, isolated angioid streaks, multiple evanescent white dot syndrome, stellate multiform amelanotic choroidopathy, macular telangiectasia

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

600 retrieved; paginated sample, class counts are floors:

440 likely benign, 60 uncertain significance, 30 pathogenic, 24 likely pathogenic, 20 conflicting classifications of pathogenicity, 16 pathogenic/likely pathogenic, 9 benign, 1 benign/likely benign

ClinVarVariant (HGVS)GeneClassificationReview
2426564NC_000019.9:g.(?6361586)(8212364_?)delADGRE1Pathogeniccriteria provided, single submitter
1878328NC_000019.10:g.7521739_7528168delLOC130063376Pathogeniccriteria provided, single submitter
1067111NM_020533.3(MCOLN1):c.405+1G>CMCOLN1Pathogeniccriteria provided, single submitter
1068939NM_020533.3(MCOLN1):c.594del (p.Glu199fs)MCOLN1Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1072052NM_020533.3(MCOLN1):c.159C>A (p.Cys53Ter)MCOLN1Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1072635NM_020533.3(MCOLN1):c.169C>T (p.Arg57Ter)MCOLN1Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1072781NM_020533.3(MCOLN1):c.724del (p.Leu242fs)MCOLN1Pathogeniccriteria provided, single submitter
1074644NM_020533.3(MCOLN1):c.499C>T (p.Gln167Ter)MCOLN1Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1323272NM_020533.3(MCOLN1):c.278del (p.Phe93fs)MCOLN1Pathogeniccriteria provided, single submitter
1377765NM_020533.3(MCOLN1):c.419del (p.Pro140fs)MCOLN1Pathogeniccriteria provided, single submitter
1386426NM_020533.3(MCOLN1):c.948dup (p.Ala317fs)MCOLN1Pathogeniccriteria provided, single submitter
1402137NM_020533.3(MCOLN1):c.66T>G (p.Tyr22Ter)MCOLN1Pathogeniccriteria provided, single submitter
1414260NM_020533.3(MCOLN1):c.165del (p.Lys55fs)MCOLN1Pathogeniccriteria provided, single submitter
1451357NM_020533.3(MCOLN1):c.230del (p.Thr77fs)MCOLN1Pathogeniccriteria provided, single submitter
1452230NM_020533.3(MCOLN1):c.95dup (p.Pro33fs)MCOLN1Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1452538NM_020533.3(MCOLN1):c.654C>A (p.Tyr218Ter)MCOLN1Pathogeniccriteria provided, single submitter
1453483NM_020533.3(MCOLN1):c.504del (p.Tyr169fs)MCOLN1Pathogeniccriteria provided, single submitter
1454517NM_020533.3(MCOLN1):c.1627C>T (p.Gln543Ter)MCOLN1Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1455180NM_020533.3(MCOLN1):c.844C>T (p.Gln282Ter)MCOLN1Pathogeniccriteria provided, single submitter
1456674NC_000019.9:g.(?7587627)(7587677_?)delMCOLN1Pathogeniccriteria provided, single submitter
1460387NM_020533.3(MCOLN1):c.507C>G (p.Tyr169Ter)MCOLN1Pathogeniccriteria provided, single submitter
1468549NM_020533.3(MCOLN1):c.405+2T>CMCOLN1Pathogeniccriteria provided, single submitter
1725915NM_020533.3(MCOLN1):c.608del (p.Pro203fs)MCOLN1Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1997684NM_020533.3(MCOLN1):c.1005G>A (p.Trp335Ter)MCOLN1Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
2005775NM_020533.3(MCOLN1):c.1569del (p.Ile524fs)MCOLN1Pathogeniccriteria provided, single submitter
2055678NM_020533.3(MCOLN1):c.1208_1218del (p.Arg403fs)MCOLN1Pathogeniccriteria provided, single submitter
208020AF287270:g.511_6943delMCOLN1Pathogenicno assertion criteria provided
208021NM_020533.3(MCOLN1):c.694A>C (p.Thr232Pro)MCOLN1Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
208025NM_020533.3(MCOLN1):c.1615del (p.Ala539fs)MCOLN1Pathogeniccriteria provided, multiple submitters, no conflicts
208028NM_020533.3(MCOLN1):c.1210dup (p.Tyr404fs)MCOLN1Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts

Genes & proteins

Mendelian disease overlap and somatic drivers

GenCC: 9 · Orphanet: 3 · 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
MCOLN1DefinitiveAutosomal recessivemucolipidosis type IV9

Orphanet rare-disease linkage (cohort genes)

GeneOrphanet IDRare disease
MCOLN1Orphanet:578Mucolipidosis type IV
ADAMTS10Orphanet:3449Weill-Marchesani syndrome
ARHGEF18Orphanet:791Retinitis pigmentosa

Cohort genes → proteins

4 cohort genes, 4 distinct canonical proteins.

Evidence partition

SubsetGenes
multi_evidence4

Cohort genes (full)

SymbolHGNCEnsemblUniProtNameEvidence
MCOLN1HGNC:13356ENSG00000090674Q9GZU1Mucolipin-1gencc,clinvar
ADAMTS10HGNC:13201ENSG00000142303Q9H324A disintegrin and metalloproteinase with thrombospondin motifs 10clinvar
ARHGEF18HGNC:17090ENSG00000104880Q6ZSZ5Rho guanine nucleotide exchange factor 18clinvar
ADGRE1HGNC:3336ENSG00000174837Q14246Adhesion G protein-coupled receptor E1clinvar

Cohort function summary

Lead sentence per gene, UniProt-curated.

SymbolProtein nameFunction (lead sentence)
MCOLN1Mucolipin-1Nonselective cation channel probably playing a role in the regulation of membrane trafficking events and of metal homeostasis.
ADAMTS10A disintegrin and metalloproteinase with thrombospondin motifs 10Metalloprotease that participate in microfibrils assembly.
ARHGEF18Rho guanine nucleotide exchange factor 18Acts as a guanine nucleotide exchange factor (GEF) for RhoA GTPases.
ADGRE1Adhesion G protein-coupled receptor E1Orphan receptor involved in cell adhesion and probably in cell-cell interactions specifically involving cells of the immune system.

Protein-family classification

Druggable: 2 · Difficult: 1 · 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
Protease19.2×0.314
GPCR16.0×0.314
Transcription factor12.1×0.538
Other/Unknown10.5×0.962

Per-gene assignment

SymbolFamilyDruggable?ECInterPro (top 3)
MCOLN1Other/UnknownnoPKD1_2_channel, Mucolipin, ML1_ELD
ADAMTS10ProteaseyesTSP1_rpt, Peptidase_M12B, Peptidase_M12B_N
ARHGEF18Transcription factornoDH_dom, PH_domain, PH-like_dom_sf
ADGRE1GPCRyesEGF-type_Asp/Asn_hydroxyl_site, GPS, EGF

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
right adrenal gland1
right adrenal gland cortex1
spleen1
descending thoracic aorta1
kidney epithelium1
right coronary artery1
ileal mucosa1
pancreatic ductal cell1
thymus1
leukocyte1
monocyte1
mononuclear cell1

Per-gene tissue summary (top 30)

SymbolBgee breadthFANTOM5 breadthSCXATop tissues
MCOLN1255ubiquitousmarkerspleen, right adrenal gland cortex, right adrenal gland
ADAMTS10254ubiquitousyesdescending thoracic aorta, right coronary artery, kidney epithelium
ARHGEF18284ubiquitousmarkerpancreatic ductal cell, thymus, ileal mucosa
ADGRE1138broadmarkermonocyte, mononuclear cell, leukocyte

Protein interactions among cohort

Intra-cohort edges: 0.

Hub genes (top 10 by interactor count)

SymbolInteractor count
MCOLN11,412
ADGRE11,148
ARHGEF18880
ADAMTS10710

Structural data

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

Cohort genes with PDB structures (top 30)

SymbolUniProtPDB entries
MCOLN1Q9GZU125

AlphaFold-only cohort genes (top 30 by pLDDT)

SymbolUniProtpLDDT
ADGRE1Q1424676.75
ADAMTS10Q9H32473.88
ARHGEF18Q6ZSZ562.10

Function

Pathway analysis

Distinct Reactome pathways touched by cohort: 33. 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
TGF-beta receptor signaling in EMT (epithelial to mesenchymal transition)1167.9×0.055ARHGEF18
TRP channels1102.0×0.055MCOLN1
Transferrin endocytosis and recycling192.1×0.055MCOLN1
Iron uptake and transport186.5×0.055MCOLN1
Defective B3GALTL causes PpS177.2×0.055ADAMTS10
O-glycosylation of TSR domain-containing proteins175.1×0.055ADAMTS10
Cell death signalling via NRAGE, NRIF and NADE154.9×0.055ARHGEF18
Diseases associated with O-glycosylation of proteins153.9×0.055ADAMTS10
Signaling by TGF-beta Receptor Complex150.1×0.055ARHGEF18
Class B/2 (Secretin family receptors)147.6×0.055ADGRE1
p75 NTR receptor-mediated signalling146.8×0.055ARHGEF18
NRAGE signals death through JNK146.0×0.055ARHGEF18
Signaling by GPCR220.0×0.055ARHGEF18, ADGRE1
O-linked glycosylation136.1×0.055ADAMTS10
Death Receptor Signaling134.8×0.055ARHGEF18
G alpha (12/13) signalling events134.4×0.055ARHGEF18
Stimuli-sensing channels134.0×0.055MCOLN1
Diseases of glycosylation132.8×0.055ADAMTS10
Signaling by TGFB family members128.8×0.059ARHGEF18
Ion channel transport124.0×0.068MCOLN1
Diseases of metabolism120.1×0.075ADAMTS10
RHOA GTPase cycle118.7×0.075ARHGEF18
Signal Transduction25.1×0.075ARHGEF18, ADGRE1
GPCR ligand binding116.0×0.082ADGRE1
RAC1 GTPase cycle115.3×0.082ARHGEF18
RHO GTPase cycle115.0×0.082ARHGEF18
GPCR downstream signalling110.9×0.109ARHGEF18
Signaling by Rho GTPases18.6×0.130ARHGEF18
Signaling by Rho GTPases, Miro GTPases and RHOBTB318.4×0.130ARHGEF18
Transport of small molecules16.3×0.165MCOLN1

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
calcium ion export11053.2×0.008MCOLN1
positive regulation of lysosome organization11053.2×0.008MCOLN1
adaptive immune response242.1×0.008MCOLN1, ADGRE1
iron ion transmembrane transport1601.9×0.009MCOLN1
cellular response to pH1526.6×0.009MCOLN1
protein localization to cell-cell junction1468.1×0.009ARHGEF18
transferrin transport1383.0×0.009MCOLN1
phagosome maturation1300.9×0.010MCOLN1
monoatomic cation transport1191.5×0.014MCOLN1
negative regulation of stress fiber assembly1145.3×0.017ARHGEF18
regulation of Rho protein signal transduction1127.7×0.017ARHGEF18
intracellular zinc ion homeostasis1120.4×0.017MCOLN1
autophagosome maturation187.8×0.021MCOLN1
release of sequestered calcium ion into cytosol186.0×0.021MCOLN1
protein homotetramerization159.3×0.028MCOLN1
calcium ion transmembrane transport152.7×0.029MCOLN1
cellular response to calcium ion150.1×0.029MCOLN1
small GTPase-mediated signal transduction145.8×0.030ARHGEF18
regulation of cell shape130.8×0.040ARHGEF18
extracellular matrix organization130.5×0.040ADAMTS10
actin cytoskeleton organization119.8×0.059ARHGEF18
cell surface receptor signaling pathway116.0×0.069ADGRE1
cell adhesion19.4×0.110ADGRE1
G protein-coupled receptor signaling pathway19.1×0.110ADGRE1
proteolysis18.6×0.112ADAMTS10

Therapeutics

Drug target analysis

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

Druggability breadth: 1 of 4 evidence-associated genes (25%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).

Top cohort targets by molecule count

SymbolMoleculesMax phase
MCOLN100
ADAMTS1000
ARHGEF1800
ADGRE100

Bioactivity and enzyme data

Enzyme cohort genes (≥1 EC): 0.

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

SymbolAssaysType breakdown
MCOLN19Binding:9

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 drug2ADAMTS10, ADGRE1
EDifficult family or no structure, no drug2MCOLN1, ARHGEF18

Undrugged target profiles

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

SymbolChEMBL assaysDrugged partners (top 3)
MCOLN19
ADAMTS100
ARHGEF180
ADGRE10

Clinical trials & evidence

Clinical trials

Clinical trials: 5.

Phase distribution (across all retrieved trials)

PhaseTrials
Not specified4
PHASE11

Top trials by phase / activity

NCTPhaseStatusTitle
NCT07398872PHASE1ENROLLING_BY_INVITATIONSafety and Efficacy of AAV9. hMCOLN1co For Patients With Mucolipidosis Type IV
NCT01793168Not specifiedRECRUITINGRare Disease Patient Registry & Natural History Study - Coordination of Rare Diseases at Sanford
NCT05782387Not specifiedACTIVE_NOT_RECRUITINGMucolipidosis Type IV Natural History Study
NCT00015782Not specifiedCOMPLETEDThe Natural History and Pathogenesis of Mucolipidosis Type IV
NCT01067742Not specifiedTERMINATEDThe Natural History of Mucolipidosis Type IV