Pulmonary emphysema
diseaseOn this page
Also known as emphysemaemphysema, pulmonary
Summary
Pulmonary emphysema (MONDO:0004849) is a disease (an umbrella term covering 5 Mondo subtypes) with 10 cohort genes (37 GWAS associations across 45 studies) and 284 clinical trials. Top therapeutic interventions include formoterol, arformoterol, and sildenafil.
At a glance
- Umbrella term: 5 Mondo subtypes
- Cohort genes: 10
- GWAS associations: 37
- ClinVar variants: 2
- Clinical trials: 284
Clinical features
No curated clinical features (Orphanet) for this disease.
Identifiers
Disease identifiers
| Field | Value |
|---|---|
| Canonical name | pulmonary emphysema |
| Mondo ID | MONDO:0004849 |
| EFO | EFO:0000464 |
| MeSH | D004646, D011656 |
| DOID | DOID:9675 |
| ICD-10-CM | J43 |
| NCIT | C3348 |
| SNOMED CT | 87433001 |
| UMLS | C0034067 |
| MedGen | 18764 |
| Is cancer (heuristic) | no |
Also known as: emphysema · emphysema, pulmonary
Data availability: 2 ClinVar variants · 37 GWAS associations (45 studies).
Disease family
An umbrella term covering 5 Mondo subtypes.
Classification path: disease › human disease › disease by body system or component › respiratory system disorder › lower respiratory tract disorder › lung disorder › obstructive lung disease › chronic obstructive pulmonary disease › pulmonary emphysema
Related subtypes (4): bronchiectasis, chronic bronchitis, diffuse panbronchiolitis, COPD, severe early onset
Subtypes (5): interstitial emphysema, compensatory emphysema, hyperlucent lung, emphysema, hereditary pulmonary, congenital lobar emphysema
Genetics & variants
GWAS landscape
37 GWAS associations across 45 studies. Top hits map to 11 distinct genes (as reported by GWAS).
Top associations by p-value
| rsID | p-value | Gene | Risk allele | Odds ratio |
|---|---|---|---|---|
| rs17486278 | 4e-46 | CHRNA5 | A | 0.19 |
| chr15:78914534 | 7e-44 | C | 0.19 | |
| chr14:94378610 | 1e-20 | ? | 0.83 | |
| rs13141641 | 2e-15 | KRT18P51 - HHIP-AS1 | T | 0.11 |
| rs112635299 | 8e-15 | SERPINA2 - SERPINA1 | G | 0.34 |
| rs186994721 | 8e-12 | MFSD9 | C | 1.09 |
| chr15:78618839 | 1e-11 | ? | 0.17 | |
| rs7698250 | 2e-10 | PPARGC1A - DHX15 | T | 0.46 |
| rs10411619 | 1e-09 | ZNF490 - RPL10P16 | T | 0.18 |
| chr15:78596058 | 8e-09 | ? | 0.16 | |
| rs117084279 | 9e-09 | PIBF1 | ? | 1.37 |
| rs7221059 | 3e-08 | MGAT5B - Metazoa_SRP | C | 0.33 |
| rs142659816 | 8e-08 | SNAI1 - SCREEM1 | ? | 0.94 |
| rs7339277 | 1e-07 | KLF12 | ? | 0.76 |
| rs6897483 | 2e-07 | UBL5P1 - ZCCHC10P2 | ? | 0.43 |
| rs73547640 | 2e-07 | SOX21-AS1 - LINC00557 | ? | 1.4 |
| rs2240651 | 2e-07 | AP3D1 | ? | |
| rs56784511 | 3e-07 | KCNJ3 | ? | 0.71 |
| rs6719455 | 3e-07 | KCNJ3 | ? | 0.57 |
| rs641525 | 5e-07 | LINC03021 - CSMD1 | T | 2.19 |
| rs66771402 | 5e-07 | GLI3 - LINC01448 | ? | 0.36 |
| rs10844154 | 6e-07 | BICD1 | C | 1.46 |
| rs2417661 | 7e-07 | SLC25A6P5 - LINC01505 | ? | 1.51 |
| rs7905537 | 8e-07 | LINC02629 - PARD3 | A | 1.85 |
| rs76470312 | 9e-07 | STC1 - RNU1-148P | ? | 1.2 |
| rs143675498 | 1e-06 | CDH18 | ? | 1.42 |
| rs9292394 | 2e-06 | HPRT1P2 - RPL19P11 | T | 1.83 |
| rs149086677 | 2e-06 | FBLN2 | ? | 0.9 |
| rs79879780 | 2e-06 | RNU6-66P - RNU4-10P | ? | 1 |
| rs1012036 | 5e-06 | RN7SL292P - SGO1P2 | C | 1.47 |
Top studies (by case count)
| Study | Lead author | Year | Cases | Controls | Title |
|---|---|---|---|---|---|
| GCST90042674 | Jiang L | 2021 | 45,946 | 351,009 | A generalized linear mixed model association tool for biobank-scale data. |
| GCST90078261 | Backman JD | 2021 | 44,472 | 375,126 | Exome sequencing and analysis of 454,787 UK Biobank participants. |
| GCST90082247 | Backman JD | 2021 | 44,472 | 375,126 | Exome sequencing and analysis of 454,787 UK Biobank participants. |
| GCST90042687 | Jiang L | 2021 | 25,054 | 392,709 | A generalized linear mixed model association tool for biobank-scale data. |
| GCST90078277 | Backman JD | 2021 | 24,686 | 399,001 | Exome sequencing and analysis of 454,787 UK Biobank participants. |
| GCST90082263 | Backman JD | 2021 | 24,686 | 399,001 | Exome sequencing and analysis of 454,787 UK Biobank participants. |
| GCST90476028 | Verma A | 2024 | 11,658 | 426,590 | Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program. |
| GCST90078293 | Backman JD | 2021 | 10,430 | 361,302 | Exome sequencing and analysis of 454,787 UK Biobank participants. |
| GCST90082279 | Backman JD | 2021 | 10,430 | 361,302 | Exome sequencing and analysis of 454,787 UK Biobank participants. |
| GCST90042701 | Jiang L | 2021 | 10,227 | 346,364 | A generalized linear mixed model association tool for biobank-scale data. |
Variant details and genetic-evidence tiers
Tier distribution (top 50 variants)
| Tier | Variants |
|---|---|
| Tier 1: coding | 0 |
| Tier 2: splice/UTR | 0 |
| Tier 3: regulatory | 0 |
| Tier 4: intronic/intergenic | 32 |
MAF distribution
| Bucket | Variants |
|---|---|
| common (>=0.05) | 20 |
| low_freq (0.01-0.05) | 4 |
| rare (<0.01) | 1 |
| unknown | 7 |
Functional consequences
| Consequence | Count |
|---|---|
| intron_variant | 15 |
| intergenic_variant | 12 |
| unknown | 4 |
| non_coding_transcript_exon_variant | 1 |
Top variants
| rsID | Chr | Pos | Alleles | MAF | Consequence | Gene | p-value | Tier |
|---|---|---|---|---|---|---|---|---|
| rs17486278 | 15 | 78575140 | A>C | 0.319 | intron_variant | CHRNA5 | 4e-46 | Tier 4: intronic/intergenic |
| chr15:78914534 | 0.366 | 7e-44 | Tier 4: intronic/intergenic | |||||
| chr14:94378610 | 1e-20 | Tier 4: intronic/intergenic | ||||||
| rs13141641 | 4 | 144585304 | T>A,C | 0.41 | intron_variant | KRT18P51 - HHIP-AS1 | 2e-15 | Tier 4: intronic/intergenic |
| rs112635299 | 14 | 94371805 | G>A,C,T | 0.018 | intron_variant | SERPINA2 - SERPINA1 | 8e-15 | Tier 4: intronic/intergenic |
| rs186994721 | 2 | 102732961 | C>T | 0.004 | intron_variant | MFSD9 | 8e-12 | Tier 4: intronic/intergenic |
| chr15:78618839 | 1e-11 | Tier 4: intronic/intergenic | ||||||
| rs7698250 | 4 | 24514008 | C>T | 0.027 | intergenic_variant | PPARGC1A - DHX15 | 2e-10 | Tier 4: intronic/intergenic |
| rs10411619 | 19 | 12641611 | T>C | 0.044 | intergenic_variant | ZNF490 - RPL10P16 | 1e-09 | Tier 4: intronic/intergenic |
| chr15:78596058 | 8e-09 | Tier 4: intronic/intergenic | ||||||
| rs117084279 | 13 | 72870347 | T>A,C | 0.05 | intron_variant | PIBF1 | 9e-09 | Tier 4: intronic/intergenic |
| rs7221059 | 17 | 76992362 | C>A | 0.026 | intergenic_variant | MGAT5B - Metazoa_SRP | 3e-08 | Tier 4: intronic/intergenic |
| rs142659816 | 20 | 50018625 | G>A | intergenic_variant | SNAI1 - SCREEM1 | 8e-08 | Tier 4: intronic/intergenic | |
| rs7339277 | 13 | 73775991 | G>A,C | 0.05 | intron_variant | KLF12 | 1e-07 | Tier 4: intronic/intergenic |
| rs6897483 | 5 | 29734966 | A>G,T | 0.05 | intergenic_variant | UBL5P1 - ZCCHC10P2 | 2e-07 | Tier 4: intronic/intergenic |
| rs73547640 | 13 | 94879057 | T>A,C | 0.05 | intergenic_variant | SOX21-AS1 - LINC00557 | 2e-07 | Tier 4: intronic/intergenic |
| rs2240651 | 19 | 2113274 | G>A,C,T | 0.05 | intron_variant | AP3D1 | 2e-07 | Tier 4: intronic/intergenic |
| rs56784511 | 2 | 154785257 | A>G | 0.05 | intron_variant | KCNJ3 | 3e-07 | Tier 4: intronic/intergenic |
| rs6719455 | 2 | 154784114 | C>A | 0.05 | intron_variant | KCNJ3 | 3e-07 | Tier 4: intronic/intergenic |
| rs641525 | 8 | 2882980 | T>G | 0.05 | intron_variant | LINC03021 - CSMD1 | 5e-07 | Tier 4: intronic/intergenic |
| rs66771402 | 7 | 42527478 | C>G,T | 0.05 | intergenic_variant | GLI3 - LINC01448 | 5e-07 | Tier 4: intronic/intergenic |
| rs10844154 | 12 | 32227567 | A>C,G,T | 0.42 | non_coding_transcript_exon_variant | BICD1 | 6e-07 | Tier 4: intronic/intergenic |
| rs2417661 | 9 | 105918965 | A>G,T | 0.05 | intergenic_variant | SLC25A6P5 - LINC01505 | 7e-07 | Tier 4: intronic/intergenic |
| rs7905537 | 10 | 33942347 | A>C,T | 0.25 | intergenic_variant | LINC02629 - PARD3 | 8e-07 | Tier 4: intronic/intergenic |
| rs76470312 | 8 | 24029710 | A>G | intergenic_variant | STC1 - RNU1-148P | 9e-07 | Tier 4: intronic/intergenic | |
| rs143675498 | 5 | 19849940 | A>G,T | intron_variant | CDH18 | 1e-06 | Tier 4: intronic/intergenic | |
| rs9292394 | 5 | 30661466 | G>A,C,T | 0.22 | intron_variant | HPRT1P2 - RPL19P11 | 2e-06 | Tier 4: intronic/intergenic |
| rs149086677 | 3 | 13587575 | G>A | intron_variant | FBLN2 | 2e-06 | Tier 4: intronic/intergenic | |
| rs79879780 | 13 | 73125266 | C>A,T | 0.05 | intergenic_variant | RNU6-66P - RNU4-10P | 2e-06 | Tier 4: intronic/intergenic |
| rs1012036 | 7 | 52404754 | C>T | 0.23 | intergenic_variant | RN7SL292P - SGO1P2 | 5e-06 | Tier 4: intronic/intergenic |
ClinVar germline variants
2 retrieved; paginated sample, class counts are floors:
1 conflicting classifications of pathogenicity, 1 likely pathogenic
| ClinVar | Variant (HGVS) | Gene | Classification | Review |
|---|---|---|---|---|
| 691941 | NM_014681.6(DHX34):c.466C>T (p.Gln156Ter) | DHX34 | Likely pathogenic | no assertion criteria provided |
| 599283 | NM_002317.7(LOX):c.760G>A (p.Val254Ile) | SRFBP1 | Conflicting classifications of pathogenicity | criteria provided, conflicting classifications |
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)
| Gene | Orphanet ID | Rare disease |
|---|---|---|
| MAN2B1 | Orphanet:309282 | Alpha-mannosidosis, infantile form |
| MAN2B1 | Orphanet:309288 | Alpha-mannosidosis, adult form |
Cohort genes → proteins
10 cohort genes, 10 distinct canonical proteins.
Evidence partition
| Subset | Genes |
|---|---|
| gwas_only | 8 |
| multi_evidence | 2 |
Cohort genes (full)
| Symbol | HGNC | Ensembl | UniProt | Name | Evidence |
|---|---|---|---|---|---|
| BICD1 | HGNC:1049 | ENSG00000151746 | Q96G01 | Protein bicaudal D homolog 1 | gwas |
| CSMD1 | HGNC:14026 | ENSG00000183117 | Q96PZ7 | CUB and sushi domain-containing protein 1 | gwas |
| PARD3 | HGNC:16051 | ENSG00000148498 | Q8TEW0 | Partitioning defective 3 homolog | gwas |
| DHX34 | HGNC:16719 | ENSG00000134815 | Q14147 | Probable ATP-dependent RNA helicase DHX34 | clinvar |
| CDH6 | HGNC:1765 | ENSG00000113361 | P55285 | Cadherin-6 | gwas |
| ADARB2 | HGNC:227 | ENSG00000185736 | Q9NS39 | Inactive double-stranded RNA-specific editase B2 | gwas |
| MGAT5B | HGNC:24140 | ENSG00000167889 | Q3V5L5 | Alpha-1,6-mannosylglycoprotein 6-beta-N-acetylglucosaminyltransferase B | gwas |
| SRFBP1 | HGNC:26333 | ENSG00000151304 | Q8NEF9 | Serum response factor-binding protein 1 | clinvar |
| DHX15 | HGNC:2738 | ENSG00000109606 | O43143 | ATP-dependent RNA helicase DHX15 | gwas |
| MAN2B1 | HGNC:6826 | ENSG00000104774 | O00754 | Lysosomal alpha-mannosidase | gwas |
Cohort function summary
Lead sentence per gene, UniProt-curated.
| Symbol | Protein name | Function (lead sentence) |
|---|---|---|
| BICD1 | Protein bicaudal D homolog 1 | Regulates coat complex coatomer protein I (COPI)-independent Golgi-endoplasmic reticulum transport by recruiting the dynein-dynactin motor complex. |
| CSMD1 | CUB and sushi domain-containing protein 1 | Potential suppressor of squamous cell carcinomas. |
| PARD3 | Partitioning defective 3 homolog | Adapter protein involved in asymmetrical cell division and cell polarization processes. |
| DHX34 | Probable ATP-dependent RNA helicase DHX34 | Probable ATP-binding RNA helicase required for nonsense-mediated decay (NMD) degradation of mRNA transcripts containing premature stop codons. |
| CDH6 | Cadherin-6 | Cadherins are calcium-dependent cell adhesion proteins. |
| ADARB2 | Inactive double-stranded RNA-specific editase B2 | Single- and double-stranded RNA-binding protein that interferes with the RNA editing activities of ADAR/ADAR1 and ADARB1/ADAR2. |
| MGAT5B | Alpha-1,6-mannosylglycoprotein 6-beta-N-acetylglucosaminyltransferase B | Glycosyltransferase that acts on alpha-linked mannose of N-glycans and O-mannosyl glycans. |
| SRFBP1 | Serum response factor-binding protein 1 | May be involved in regulating transcriptional activation of cardiac genes during the aging process. |
| DHX15 | ATP-dependent RNA helicase DHX15 | RNA helicase involved in mRNA processing and antiviral innate immunity. |
| MAN2B1 | Lysosomal alpha-mannosidase | Can hydrolyze a variety of glycan substrates containing terminal alpha-mannosidic linkages. |
Protein-family classification
Druggable: 2 · Difficult: 2 · Unknown: 6 · Druggable fraction: 0.2
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 |
|---|---|---|---|
| Complement | 1 | 26.8× | 0.184 |
| Scaffold/PPI | 1 | 1.7× | 0.725 |
| Enzyme (other) | 1 | 1.2× | 0.725 |
| Other/Unknown | 6 | 1.1× | 0.725 |
| Transcription factor | 1 | 0.8× | 0.725 |
Per-gene assignment
| Symbol | Family | Druggable? | EC | InterPro (top 3) |
|---|---|---|---|---|
| BICD1 | Other/Unknown | no | BICD | |
| CSMD1 | Complement | yes | Sushi_SCR_CCP_dom, CUB_dom, Sperma_CUB_dom_sf | |
| PARD3 | Scaffold/PPI | no | PDZ, Par3/HAL_N, PDZ_sf | |
| DHX34 | Transcription factor | no | 3.6.4.13 | Helicase_C-like, Helicase-assoc_dom, DEAD/DEAH_box_helicase_dom |
| CDH6 | Other/Unknown | no | Cadherin_Y-type_LIR, Cadherin-like_dom, Cadherin-like_sf | |
| ADARB2 | Other/Unknown | no | A_deamin, dsRBD_dom, ADAR3_DSRM_1 | |
| MGAT5B | Other/Unknown | no | GT18_cat, MGAT5_Glycosyltransferase | |
| SRFBP1 | Other/Unknown | no | Bud22_dom, Bud22/SRFB1 | |
| DHX15 | Other/Unknown | no | Helicase_C-like, DNA/RNA_helicase_DEAH_CS, Helicase-assoc_dom | |
| MAN2B1 | Enzyme (other) | yes | 3.2.1.24 | Glyco_hydro_38_N, Gal_mutarotase_sf_dom, Glyco_hydro/deAcase_b/a-brl |
Expression context
Cohort genes with no expression data: 0.
10 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) | 10 |
| unknown | 0 |
Top tissues across cohort
| Tissue | Cohort genes |
|---|---|
| tongue squamous epithelium | 2 |
| ganglionic eminence | 1 |
| sural nerve | 1 |
| ventricular zone | 1 |
| Brodmann (1909) area 23 | 1 |
| middle temporal gyrus | 1 |
| primary visual cortex | 1 |
| cervix squamous epithelium | 1 |
| secondary oocyte | 1 |
| blood | 1 |
| left testis | 1 |
| right testis | 1 |
| olfactory bulb | 1 |
| type B pancreatic cell | 1 |
| C1 segment of cervical spinal cord | 1 |
| spinal cord | 1 |
| substantia nigra | 1 |
| Brodmann (1909) area 9 | 1 |
| oocyte | 1 |
| right frontal lobe | 1 |
Per-gene tissue summary (top 30)
| Symbol | Bgee breadth | FANTOM5 breadth | SCXA | Top tissues |
|---|---|---|---|---|
| BICD1 | 259 | ubiquitous | marker | ventricular zone, sural nerve, ganglionic eminence |
| CSMD1 | 179 | broad | marker | Brodmann (1909) area 23, middle temporal gyrus, primary visual cortex |
| PARD3 | 278 | ubiquitous | marker | cervix squamous epithelium, tongue squamous epithelium, secondary oocyte |
| DHX34 | 217 | ubiquitous | marker | right testis, blood, left testis |
| CDH6 | 228 | broad | marker | olfactory bulb, type B pancreatic cell, tongue squamous epithelium |
| ADARB2 | 184 | broad | marker | C1 segment of cervical spinal cord, spinal cord, substantia nigra |
| MGAT5B | 158 | broad | marker | right frontal lobe, Brodmann (1909) area 9, oocyte |
| SRFBP1 | 235 | ubiquitous | marker | calcaneal tendon, male germ line stem cell (sensu Vertebrata) in testis, colonic epithelium |
| DHX15 | 295 | ubiquitous | marker | cartilage tissue, tibia, germinal epithelium of ovary |
| MAN2B1 | 138 | ubiquitous | marker | bone marrow cell, granulocyte, monocyte |
Protein interactions among cohort
Intra-cohort edges: 0.
Hub genes (top 10 by interactor count)
| Symbol | Interactor count |
|---|---|
| DHX15 | 5,376 |
| PARD3 | 3,034 |
| SRFBP1 | 2,607 |
| DHX34 | 2,501 |
| MGAT5B | 2,104 |
| CSMD1 | 1,577 |
| BICD1 | 1,462 |
| ADARB2 | 1,322 |
| CDH6 | 1,169 |
| MAN2B1 | 1,077 |
Structural data
PDB: 4 · AlphaFold-only: 6 · No structure: 0
Cohort genes with PDB structures (top 30)
| Symbol | UniProt | PDB entries |
|---|---|---|
| DHX15 | O43143 | 9 |
| CSMD1 | Q96PZ7 | 1 |
| PARD3 | Q8TEW0 | 1 |
| CDH6 | P55285 | 1 |
AlphaFold-only cohort genes (top 30 by pLDDT)
| Symbol | UniProt | pLDDT |
|---|---|---|
| MAN2B1 | O00754 | 91.78 |
| MGAT5B | Q3V5L5 | 82.58 |
| DHX34 | Q14147 | 80.85 |
| BICD1 | Q96G01 | 72.36 |
| ADARB2 | Q9NS39 | 71.69 |
| SRFBP1 | Q8NEF9 | 62.20 |
Function
Pathway analysis
Distinct Reactome pathways touched by cohort: 22. Enrichment computed across 10 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.
| Pathway | Cohort genes | Fold | FDR | Sample cohort genes |
|---|---|---|---|---|
| Lysosomal oligosaccharide catabolism | 1 | 475.8× | 0.029 | MAN2B1 |
| DAG1 core M2 glycosylations | 1 | 380.7× | 0.029 | MGAT5B |
| TGF-beta receptor signaling in EMT (epithelial to mesenchymal transition) | 1 | 112.0× | 0.065 | PARD3 |
| Tight junction interactions | 1 | 61.4× | 0.087 | PARD3 |
| Adherens junctions interactions | 1 | 41.4× | 0.087 | CDH6 |
| Cell-cell junction organization | 1 | 41.4× | 0.087 | CDH6 |
| COPI-independent Golgi-to-ER retrograde traffic | 1 | 34.6× | 0.087 | BICD1 |
| Cell junction organization | 1 | 31.2× | 0.087 | CDH6 |
| Cell-Cell communication | 1 | 22.9× | 0.095 | CDH6 |
| Golgi-to-ER retrograde transport | 1 | 22.1× | 0.095 | BICD1 |
| Metabolism of carbohydrates and carbohydrate derivatives | 1 | 20.0× | 0.095 | MAN2B1 |
| CHD1 and CHD2 subfamily | 1 | 18.1× | 0.095 | DHX15 |
| Intra-Golgi and retrograde Golgi-to-ER traffic | 1 | 17.5× | 0.095 | BICD1 |
| mRNA Polyadenylation | 1 | 14.6× | 0.104 | DHX15 |
| mRNA Splicing - Major Pathway | 1 | 9.1× | 0.154 | DHX15 |
| Dengue Virus-Host Interactions | 1 | 7.6× | 0.171 | DHX15 |
| Membrane Trafficking | 1 | 6.2× | 0.196 | BICD1 |
| Vesicle-mediated transport | 1 | 5.8× | 0.196 | BICD1 |
| Innate Immune System | 1 | 4.2× | 0.247 | MAN2B1 |
| Neutrophil degranulation | 1 | 3.9× | 0.257 | MAN2B1 |
| Immune System | 1 | 2.2× | 0.401 | MAN2B1 |
| Metabolism | 1 | 1.9× | 0.417 | MAN2B1 |
GO biological processes by enrichment
Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 10 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.
| GO term | Cohort genes | Fold | FDR | Sample cohort genes |
|---|---|---|---|---|
| microtubule anchoring at microtubule organizing center | 1 | 842.6× | 0.020 | BICD1 |
| negative regulation of mRNA modification | 1 | 842.6× | 0.020 | ADARB2 |
| negative regulation of phospholipase C-activating G protein-coupled receptor signaling pathway | 1 | 842.6× | 0.020 | BICD1 |
| RNA processing | 2 | 43.8× | 0.020 | BICD1, ADARB2 |
| oviduct epithelium development | 1 | 561.7× | 0.023 | CSMD1 |
| mammary gland branching involved in pregnancy | 1 | 421.3× | 0.023 | CSMD1 |
| minus-end-directed organelle transport along microtubule | 1 | 421.3× | 0.023 | BICD1 |
| adenosine to inosine editing | 1 | 337.0× | 0.023 | ADARB2 |
| negative regulation of peptidyl-threonine phosphorylation | 1 | 337.0× | 0.023 | PARD3 |
| constitutive secretory pathway | 1 | 280.9× | 0.023 | BICD1 |
| asymmetric cell division | 1 | 240.7× | 0.023 | PARD3 |
| positive regulation of protein localization to centrosome | 1 | 240.7× | 0.023 | BICD1 |
| mannose metabolic process | 1 | 210.7× | 0.023 | MAN2B1 |
| intracellular mRNA localization | 1 | 210.7× | 0.023 | BICD1 |
| negative regulation of nuclear-transcribed mRNA catabolic process, nonsense-mediated decay | 1 | 187.2× | 0.023 | DHX34 |
| establishment of centrosome localization | 1 | 168.5× | 0.023 | PARD3 |
| conditioned place preference | 1 | 168.5× | 0.023 | CSMD1 |
| virion assembly | 1 | 153.2× | 0.023 | BICD1 |
| response to alkaloid | 1 | 153.2× | 0.023 | DHX15 |
| mRNA processing | 2 | 15.8× | 0.023 | ADARB2, DHX15 |
| establishment of epithelial cell polarity | 1 | 120.4× | 0.027 | PARD3 |
| startle response | 1 | 112.3× | 0.028 | CSMD1 |
| glycoprotein catabolic process | 1 | 105.3× | 0.028 | MAN2B1 |
| myelination in peripheral nervous system | 1 | 88.7× | 0.030 | PARD3 |
| positive regulation of phosphorylation | 1 | 84.3× | 0.030 | DHX34 |
| female gonad development | 1 | 80.2× | 0.030 | CSMD1 |
| positive regulation of receptor-mediated endocytosis | 1 | 80.2× | 0.030 | BICD1 |
| nuclear-transcribed mRNA catabolic process | 1 | 76.6× | 0.030 | DHX34 |
| maturation of SSU-rRNA | 1 | 76.6× | 0.030 | SRFBP1 |
| positive regulation of myelination | 1 | 76.6× | 0.030 | PARD3 |
Therapeutics
Drugs indicated for this disease
2 approved, 4 in late-stage (phase 3) trials. Disease-direct ChEMBL indications, not inferred from the associated-gene cohort below.
| Drug | Development status |
|---|---|
| Budesonide | Approved (phase 4) |
| Fluticasone Propionate | Approved (phase 4) |
| Arformoterol | Phase 3 (in late-stage trials) |
| Basiliximab | Phase 3 (in late-stage trials) |
| Formoterol | Phase 3 (in late-stage trials) |
| Salmeterol | Phase 3 (in late-stage trials) |
Earlier-phase candidates (phase 2, investigational — efficacy not yet established): Belimumab, Ibuprofen, Isotretinoin, Sodium Chloride, Tretinoin.
Drug target analysis
Approved (phase 4): 0 · Phase ≥3: 0 · Phased (≥1): 2 · Undrugged: 8
Druggability breadth: 2 of 10 evidence-associated genes (20%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).
Top cohort targets by molecule count
| Symbol | Molecules | Max phase |
|---|---|---|
| DHX15 | 1 | 2 |
| MAN2B1 | 1 | 2 |
| BICD1 | 0 | 0 |
| CSMD1 | 0 | 0 |
| PARD3 | 0 | 0 |
| DHX34 | 0 | 0 |
| CDH6 | 0 | 0 |
| ADARB2 | 0 | 0 |
| MGAT5B | 0 | 0 |
| SRFBP1 | 0 | 0 |
Drugs targeting cohort genes (top 30)
| Molecule | Max phase | Targets in cohort |
|---|---|---|
| MOLIBRESIB | 2 | DHX15 |
| TRIDOLGOSIR | 2 | MAN2B1 |
Bioactivity and enzyme data
Enzyme cohort genes (≥1 EC): 2.
Cohort genes with ChEMBL bioactivity (full, sorted by assay count)
| Symbol | Assays | Type breakdown |
|---|---|---|
| MAN2B1 | 53 | Binding:52, ADMET:1 |
| DHX15 | 10 | Binding:10 |
Cohort enzymes (BRENDA EC)
| Symbol | EC numbers | Names |
|---|---|---|
| DHX34 | 3.6.4.13 | RNA helicase |
| MAN2B1 | 3.2.1.24 | alpha-mannosidase |
Pharmacogenomics
Cohort genes with a PharmGKB record: 10; with CPIC/DPWG dosing guidelines: 0.
No cohort gene has a CPIC/DPWG genotype-guided dosing guideline (PharmGKB).
Chemical tractability of cohort targets
2 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) |
|---|---|---|
| MOLIBRESIB | 2 | DHX15 |
| TRIDOLGOSIR | 2 | MAN2B1 |
Druggability pyramid
Cohort genes binned by druggability tier (high → low):
| Tier | Definition | Genes | Symbols |
|---|---|---|---|
| A | Approved (phase 4 drug) | 0 | |
| B | Phased (≥1) drug, not yet approved | 2 | DHX15, MAN2B1 |
| C | Druggable family + PDB, no drug | 1 | CSMD1 |
| D | Druggable family + AlphaFold only, no drug | 0 | |
| E | Difficult family or no structure, no drug | 7 | BICD1, PARD3, DHX34, CDH6, ADARB2, MGAT5B, SRFBP1 |
Undrugged target profiles
8 cohort genes are undrugged. Ranked by ‘starting-point quality’ (assay depth + drugged-partner adjacency).
| Symbol | ChEMBL assays | Drugged partners (top 3) |
|---|---|---|
| BICD1 | 0 | — |
| CSMD1 | 0 | — |
| PARD3 | 0 | — |
| DHX34 | 0 | — |
| CDH6 | 0 | — |
| ADARB2 | 0 | — |
| MGAT5B | 0 | — |
| SRFBP1 | 0 | — |
Clinical trials & evidence
Clinical trials
Clinical trials: 284.
Phase distribution (across all retrieved trials)
| Phase | Trials |
|---|---|
| Not specified | 187 |
| PHASE2 | 31 |
| PHASE4 | 23 |
| PHASE3 | 16 |
| PHASE1 | 11 |
| PHASE1/PHASE2 | 8 |
| PHASE2/PHASE3 | 6 |
| EARLY_PHASE1 | 2 |
Top trials by phase / activity
| NCT | Phase | Status | Title |
|---|---|---|---|
| NCT02682147 | PHASE4 | ACTIVE_NOT_RECRUITING | Functional CT Assessment of Pulmonary Arterial Dysfunction in Smoking Associated Emphysema |
| NCT07326592 | PHASE4 | NOT_YET_RECRUITING | Phase 4, Double-blind Study Evaluating the Response on Computed Tomography (CT) Lung Density Decline Rates of Respreeza / Zemaira Weekly for 3 Years in Adults With alpha1 Antitrypsin Deficiency (AATD) |
| NCT00175565 | PHASE4 | COMPLETED | Inhaled Steroid Reduces Systemic Inflammation in COPD |
| NCT00181207 | PHASE4 | COMPLETED | Airway Clearance for Prevention of Chronic Obstructive Pulmonary Disease (COPD) Exacerbation |
| NCT00261833 | PHASE4 | COMPLETED | Zemaira in Subjects With Emphysema Due to Alpha1-Proteinase Inhibitor Deficiency |
| NCT00424528 | PHASE4 | COMPLETED | Efficacy Safety Study of Arformoterol/Tiotropium Combination Versus Either Therapy Alone in Chronic Obstructive Pulmonary Disease (COPD) |
| NCT00633776 | PHASE4 | WITHDRAWN | Perforomist Versus Foradil Evaluated by Inspiratory Capacity and High Resolution Computed Tomography (HRCT) |
| NCT00670007 | PHASE4 | COMPLETED | Extension Study of Zemaira® i.v. Administration in Subjects With Emphysema Due to alpha1-proteinase Inhibitor Deficiency. |
| NCT00680056 | PHASE4 | COMPLETED | Add-on Effects of Tiotropium Over Formoterol in Exercise Tolerance on Chronic Obstructive Pulmonary Disease Patients |
| NCT00680641 | PHASE4 | UNKNOWN | Simvastatin in Chronic Obstructive Pulmonary Disease (COPD) |
| NCT00720226 | PHASE4 | COMPLETED | Efficacy of Losartan in Preventing Progression of COPD |
| NCT00730301 | PHASE4 | UNKNOWN | EUROPT Clinical Trial to Study the Efficacy of One-Way Valve Implantation (New Treatment Algorithm) in Patients With Heterogeneous Emphysema |
| NCT00857038 | PHASE4 | UNKNOWN | Doxycycline and Airway Inflammation in Chronic Obstructive Pulmonary Disease (COPD) |
| NCT01336283 | PHASE4 | COMPLETED | Effectiveness of Different Exercise Training Programs to the Profile of COPD Patients |
| NCT01361984 | PHASE4 | UNKNOWN | Sunovion Brovana Versus Serevent Inspiratory Capacity High Resolution Computed Tomography |
| NCT01431625 | PHASE4 | UNKNOWN | Effects of Exercise Training on Systemic Inflammation an Muscle Repair According to the Obstructive Chronic Pulmonary Disease (COPD) Phenotype |
| NCT01460108 | PHASE4 | UNKNOWN | AeriSeal System in Patients With Advanced Upper Lobe Predominant Emphysema and Collateral Ventilation |
| NCT01466712 | PHASE4 | UNKNOWN | Evaluate the Effects of Formoterol and Beclomethasone Dipropionate Combination Therapy on Small Airways Function |
| NCT01520740 | PHASE4 | TERMINATED | Collateral Ventilation Effects on Response to AeriSeal System Treatment in Upper Lobe Predominant Emphysema |
| NCT02696564 | PHASE4 | COMPLETED | Losartan Effects on Emphysema Progression |
| NCT03073798 | PHASE4 | COMPLETED | The Effectiveness of Roflumilast in Improving Mucociliary Clearance in Patients With COPD and Chronic Bronchitis |
| NCT03382106 | PHASE4 | COMPLETED | Smoking Cessation and Functional CT Assessment |
| NCT03733470 | PHASE4 | COMPLETED | Hypoxic Pulmonary Vasoconstriction Pilot Study |
| NCT00000606 | PHASE3 | COMPLETED | National Emphysema Treatment Trial (NETT) |
| NCT00064402 | PHASE3 | COMPLETED | Determine the Safety and Efficacy of (R,R)-Formoterol in the Treatment of Subjects With COPD |
| NCT00064415 | PHASE3 | COMPLETED | To Evaluate the Long-term Safety of (R,R)-Formoterol in Subjects With COPD |
| NCT00129584 | PHASE3 | COMPLETED | Endobronchial Valve for Emphysema Palliation Trial (VENT) |
| NCT00137956 | PHASE3 | TERMINATED | Endobronchial Valve for Emphysema PalliatioN Trial (VENT) Cost-effectiveness Sub-Study |
| NCT00188825 | PHASE3 | COMPLETED | Study Comparing Simulect Plus Standard Immunosuppression to Standard Immunosuppression Alone for the Prevention of Acute Rejection and Bronchiolitis Obliterans in Lung Transplant |
| NCT00207337 | PHASE2/PHASE3 | COMPLETED | Exhale (R) Stent for Emphysema |
| NCT00250679 | PHASE3 | COMPLETED | Safety and Efficacy of Arformoterol Tartrate Inhalation Solution in Subjects With Chronic Obstructive Pulmonary Disease |
| NCT00288964 | PHASE3 | WITHDRAWN | Use of the Hattler Respiratory Assist Catheter in Severe Respiratory Failure |
| NCT00391612 | PHASE3 | UNKNOWN | EASE Trial: Exhale Airway Stents for Emphysema |
| NCT00613860 | PHASE3 | WITHDRAWN | Sequential Endoscopic Lung Volume Reduction |
| NCT00995852 | PHASE2/PHASE3 | UNKNOWN | Unilateral Versus Bilateral Endoscopic Lung Volume Reduction A Comparative Case Study |
| NCT01181466 | PHASE2/PHASE3 | COMPLETED | AeriSeal® System for Lung Volume Reduction in Patients With Advanced Emphysema |
| NCT01217671 | PHASE2/PHASE3 | COMPLETED | International Study Evaluating the Safety and Efficacy of Inhaled, Human, Alpha-1 Antitrypsin (AAT) in Alpha-1 Antitrypsin Deficient Patients With Emphysema |
| NCT01320566 | PHASE2/PHASE3 | TERMINATED | A Continuation Study of the AeriSeal® System Administered at 3 to 4 Sites During a Single Treatment Session for Lung Volume Reduction in Patients With Advanced Emphysema |
| NCT01421082 | PHASE2/PHASE3 | COMPLETED | Evaluation of Physiologic Parameters to Study the Mechanism of Action of the Lung Volume Reduction Coil in Subjects With Homogeneous Emphysema |
| NCT01449292 | PHASE3 | TERMINATED | Study of the AeriSeal System for HyPerInflation Reduction in Emphysema (ASPIRE) |
Drugs tested across these trials (top 30)
| Molecule | Max phase | Trials referencing |
|---|---|---|
| FORMOTEROL | 4 | 7 |
| ARFORMOTEROL | 4 | 6 |
| SILDENAFIL | 4 | 6 |
| LOSARTAN | 4 | 4 |
| TIOTROPIUM | 4 | 4 |
| .ALPHA.1-PROTEINASE INHIBITOR HUMAN | 4 | 3 |
| DOXYCYCLINE ANHYDROUS | 4 | 3 |
| SALMETEROL | 4 | 3 |
| BASILIXIMAB | 4 | 1 |
| BECLOMETHASONE DIPROPIONATE | 4 | 1 |
| BELIMUMAB | 4 | 1 |
| ROFLUMILAST | 4 | 1 |
| SIMVASTATIN | 4 | 1 |
| TRETINOIN | 4 | 1 |
| XENON XE-129, HYPERPOLARIZED | 4 | 1 |
| ABAMECTIN | 3 | 2 |
| QUERCETIN | 3 | 1 |
| ALVELESTAT | 2 | 1 |
| BECLOMETHASONE | 2 | 1 |
| RETINOIC ACID RECEPTOR .GAMMA. | 2 | 1 |
| VAPENDAVIR | 2 | 1 |
| CHEMBL4650755 | 0 | 2 |
| CHEMBL4303430 | 0 | 1 |
| CHEMBL4792718 | 0 | 1 |
| CHEMBL5439651 | 0 | 1 |
Related Atlas pages
- Cohort genes: BICD1, CSMD1, PARD3, DHX34, CDH6, ADARB2, MGAT5B, SRFBP1, DHX15, MAN2B1
- Drugs: Formoterol, Arformoterol, Sildenafil, Losartan, Tiotropium, .ALPHA.1-PROTEINASE INHIBITOR HUMAN, Doxycycline, Salmeterol, Basiliximab, Beclomethasone Dipropionate, Belimumab, Roflumilast, Simvastatin, Tretinoin, XENON XE-129, HYPERPOLARIZED, Abamectin, Quercetin