ASPN
gene geneOn this page
Also known as FLJ20129SLRR1CPLAP-1
Summary
ASPN (asporin, HGNC:14872) is a protein-coding gene on chromosome 9q22.31, encoding Asporin (Q9BXN1). Negatively regulates periodontal ligament (PDL) differentiation and mineralization to ensure that the PDL is not ossified and to maintain homeostasis of the tooth-supporting system.
This gene encodes a cartilage extracellular protein that is member of the small leucine-rich proteoglycan family. The encoded protein may regulate chondrogenesis by inhibiting transforming growth factor-beta 1-induced gene expression in cartilage. This protein also binds collagen and calcium and may induce collagen mineralization. Polymorphisms in the aspartic acid repeat region of this gene are associated with a susceptibility to osteoarthritis, and also with intervertebral disc disease. Alternative splicing of this gene results in multiple transcript variants.
Source: NCBI Gene 54829 — RefSeq curated summary.
At a glance
- Gene–disease (curated): osteoarthritis susceptibility 3 (Limited, GenCC)
- GWAS associations: 3
- Clinical variants (ClinVar): 42 total — 2 pathogenic
- Regional missense constraint (gnomAD): 1 of 3 regions constrained (≈4% of expected missense variation)
- GTEx eGene: eQTL in 7 tissues, sQTL in 1 (q < 0.05)
- Phenotypes (HPO): 6
- Constraint (gnomAD): pLI 0.00 (LoF-tolerant), LOEUF 1.53 (unconstrained)
- MANE Select transcript:
NM_017680
Identifiers
Gene identifiers
| Field | Value |
|---|---|
| HGNC ID | HGNC:14872 |
| Approved symbol | ASPN |
| Name | asporin |
| Location | 9q22.31 |
| Locus type | gene with protein product |
| Status | Approved |
| Aliases | FLJ20129, SLRR1C, PLAP-1 |
| Ensembl gene | ENSG00000106819 |
| Ensembl biotype | protein_coding |
| OMIM | 608135 |
| Entrez | 54829 |
Gene structure
Transcript identifiers
Ensembl transcripts: 9 — 8 protein_coding, 1 nonsense_mediated_decay
Transcript support level (Ensembl TSL; 1 = fully mRNA-supported): TSL 1: 1, TSL 2: 1
ENST00000375543, ENST00000375544, ENST00000650794, ENST00000651738, ENST00000907468, ENST00000907469, ENST00000907470, ENST00001116555, ENST00001136630
RefSeq mRNA: 2 — MANE Select: NM_017680
NM_001193335, NM_017680
Canonical transcript exons
ENST00000375544 — 8 exons
| Exon | Start | End |
|---|---|---|
| ENSE00000711478 | 92459632 | 92459770 |
| ENSE00000711479 | 92460474 | 92460567 |
| ENSE00000711481 | 92464919 | 92465029 |
| ENSE00000869933 | 92470669 | 92470781 |
| ENSE00000869936 | 92466358 | 92466571 |
| ENSE00001031659 | 92482293 | 92482506 |
| ENSE00001467400 | 92474624 | 92474927 |
| ENSE00003647036 | 92456205 | 92457485 |
Expression profiles
Bgee: expression breadth ubiquitous, 243 present calls, max score 99.71.
FANTOM5 (CAGE): breadth broad, TPM avg 6.9316 / max 412.0078, expressed in 427 samples.
Highest expression (Bgee): tendon of biceps brachii, synovial joint, periodontal ligament, calcaneal tendon, tendon.
Genetic regulation across tissues (GTEx eQTL / sQTL)
ASPN is an eGene in GTEx v10 — its expression is genetically regulated (eQTL) in 7 tissues and its splicing (sQTL) in 1 (q < 0.05). Strongest associations first; slope = normalized effect of the lead variant’s alternative allele.
8 significant tissue × QTL associations:
| Tissue | QTL | q-value | Slope | Lead variant |
|---|---|---|---|---|
| Heart Atrial Appendage | eqtl | 5.9e-03 | +0.15 | 9:92596168:C:G |
| Esophagus Mucosa | eqtl | 6.4e-03 | +0.16 | 9:92189537:A:G |
| Muscle Skeletal | eqtl | 1.2e-02 | -0.10 | 9:92665540:CTGAG:C |
| Thyroid | eqtl | 1.3e-02 | -0.10 | 9:92517306:A:G |
| Artery Aorta | eqtl | 1.5e-02 | +0.24 | 9:92309812:G:C |
| Esophagus Mucosa | sqtl | 2.9e-02 | -0.94 | 9:91912000:A:ACTC |
| Pancreas | eqtl | 3.6e-02 | +0.37 | 9:92669067:TCTA:T |
| Lung | eqtl | 5.0e-02 | +0.17 | 9:91682051:T:C |
FANTOM5 promoters
5 alternative TSS:
| Promoter ID | TPM avg | Samples expressed |
|---|---|---|
| 101432 | 3.4884 | 362 |
| 101431 | 3.1477 | 303 |
| 101429 | 0.1382 | 71 |
| 101430 | 0.0902 | 50 |
| 101428 | 0.0672 | 33 |
Top tissues by expression
showing 100 of 276 tissues by Bgee expression score (0-100, higher = more expressed):
| Tissue | Anatomy ID | Expression score | Quality |
|---|---|---|---|
| tendon of biceps brachii | UBERON:0008188 | 99.71 | gold quality |
| synovial joint | UBERON:0002217 | 99.70 | gold quality |
| periodontal ligament | UBERON:0008266 | 99.64 | gold quality |
| calcaneal tendon | UBERON:0003701 | 99.63 | gold quality |
| tendon | UBERON:0000043 | 99.14 | gold quality |
| saphenous vein | UBERON:0007318 | 99.06 | gold quality |
| blood vessel layer | UBERON:0004797 | 98.97 | gold quality |
| visceral pleura | UBERON:0002401 | 98.73 | gold quality |
| right coronary artery | UBERON:0001625 | 98.71 | gold quality |
| ascending aorta | UBERON:0001496 | 97.34 | gold quality |
| thoracic aorta | UBERON:0001515 | 97.33 | gold quality |
| vena cava | UBERON:0004087 | 97.03 | gold quality |
| skin of hip | UBERON:0001554 | 97.02 | gold quality |
| descending thoracic aorta | UBERON:0002345 | 96.95 | gold quality |
| gall bladder | UBERON:0002110 | 96.92 | gold quality |
| coronary artery | UBERON:0001621 | 96.16 | gold quality |
| cartilage tissue | UBERON:0002418 | 96.14 | gold quality |
| left coronary artery | UBERON:0001626 | 95.79 | gold quality |
| nipple | UBERON:0002030 | 95.67 | gold quality |
| layer of synovial tissue | UBERON:0007616 | 95.60 | gold quality |
| aorta | UBERON:0000947 | 95.38 | gold quality |
| pleura | UBERON:0000977 | 95.31 | gold quality |
| pylorus | UBERON:0001166 | 95.29 | gold quality |
| decidua | UBERON:0002450 | 94.95 | gold quality |
| myometrium | UBERON:0001296 | 94.86 | gold quality |
| parietal pleura | UBERON:0002400 | 93.94 | gold quality |
| popliteal artery | UBERON:0002250 | 93.88 | gold quality |
| tibial artery | UBERON:0007610 | 93.86 | gold quality |
| superficial temporal artery | UBERON:0001614 | 93.76 | gold quality |
| urethra | UBERON:0000057 | 92.71 | gold quality |
| myocardium | UBERON:0002349 | 92.46 | gold quality |
| heart right ventricle | UBERON:0002080 | 91.95 | gold quality |
| smooth muscle tissue | UBERON:0001135 | 91.16 | gold quality |
| cardiac muscle of right atrium | UBERON:0003379 | 91.08 | gold quality |
| cauda epididymis | UBERON:0004360 | 90.78 | gold quality |
| body of uterus | UBERON:0009853 | 90.31 | gold quality |
| cardia of stomach | UBERON:0001162 | 89.93 | gold quality |
| colonic epithelium | UBERON:0000397 | 89.85 | gold quality |
| trabecular bone tissue | UBERON:0002483 | 89.44 | gold quality |
| mucosa of paranasal sinus | UBERON:0005030 | 89.06 | gold quality |
| endocervix | UBERON:0000458 | 88.68 | gold quality |
| body of tongue | UBERON:0011876 | 88.35 | gold quality |
| left uterine tube | UBERON:0001303 | 87.95 | gold quality |
| apex of heart | UBERON:0002098 | 87.70 | gold quality |
| connective tissue | UBERON:0002384 | 87.13 | gold quality |
| adipose tissue | UBERON:0001013 | 86.76 | gold quality |
| tibia | UBERON:0000979 | 86.71 | gold quality |
| mammalian vulva | UBERON:0000997 | 86.54 | gold quality |
| superior surface of tongue | UBERON:0007371 | 86.38 | gold quality |
| left ventricle myocardium | UBERON:0006566 | 86.36 | gold quality |
| heart | UBERON:0000948 | 86.33 | gold quality |
| trachea | UBERON:0003126 | 86.24 | gold quality |
| liver | UBERON:0002107 | 85.74 | gold quality |
| tongue | UBERON:0001723 | 85.60 | gold quality |
| pericardium | UBERON:0002407 | 85.59 | gold quality |
| thoracic mammary gland | UBERON:0005200 | 85.56 | gold quality |
| adipose tissue of abdominal region | UBERON:0007808 | 85.56 | gold quality |
| gluteal muscle | UBERON:0002000 | 85.43 | gold quality |
| mammary gland | UBERON:0001911 | 85.40 | gold quality |
| peritoneum | UBERON:0002358 | 85.32 | gold quality |
| omental fat pad | UBERON:0010414 | 85.29 | gold quality |
| subcutaneous adipose tissue | UBERON:0002190 | 85.13 | gold quality |
| cardiac atrium | UBERON:0002081 | 85.05 | gold quality |
| triceps brachii | UBERON:0001509 | 84.99 | gold quality |
| muscle layer of sigmoid colon | UBERON:0035805 | 84.71 | gold quality |
| mammary duct | UBERON:0001765 | 84.58 | gold quality |
| primordial germ cell in gonad | CL:0000670 ∩ UBERON:0000991 | 84.36 | gold quality |
| biceps brachii | UBERON:0001507 | 84.24 | gold quality |
| rectum | UBERON:0001052 | 84.14 | gold quality |
| right atrium auricular region | UBERON:0006631 | 83.93 | gold quality |
| cardiac ventricle | UBERON:0002082 | 83.81 | gold quality |
| heart left ventricle | UBERON:0002084 | 83.50 | gold quality |
| epithelium of mammary gland | UBERON:0003244 | 83.20 | gold quality |
| right lobe of liver | UBERON:0001114 | 83.17 | gold quality |
| skeletal muscle tissue of biceps brachii | UBERON:0004502 | 82.95 | gold quality |
| jejunum | UBERON:0002115 | 82.79 | gold quality |
| uterus | UBERON:0000995 | 82.78 | gold quality |
| renal medulla | UBERON:0000362 | 82.53 | gold quality |
| fundus of stomach | UBERON:0001160 | 82.34 | gold quality |
| right lung | UBERON:0002167 | 82.12 | gold quality |
| lower esophagus muscularis layer | UBERON:0035833 | 81.83 | gold quality |
| lower esophagus | UBERON:0013473 | 81.78 | gold quality |
| penis | UBERON:0000989 | 81.46 | gold quality |
| dorsal root ganglion | UBERON:0000044 | 81.39 | gold quality |
| ectocervix | UBERON:0012249 | 81.10 | gold quality |
| pharyngeal mucosa | UBERON:0000355 | 80.95 | gold quality |
| lung | UBERON:0002048 | 80.65 | gold quality |
| muscle tissue | UBERON:0002385 | 80.35 | gold quality |
| uterine cervix | UBERON:0000002 | 80.30 | gold quality |
| male germ line stem cell (sensu Vertebrata) in testis | CL:0000089 ∩ UBERON:0000473 | 80.17 | gold quality |
| esophagogastric junction muscularis propria | UBERON:0035841 | 79.73 | gold quality |
| thyroid gland | UBERON:0002046 | 79.45 | gold quality |
| intestine | UBERON:0000160 | 79.40 | gold quality |
| large intestine | UBERON:0000059 | 79.31 | gold quality |
| jejunal mucosa | UBERON:0000399 | 79.28 | gold quality |
| tibial nerve | UBERON:0001323 | 79.24 | gold quality |
| duodenum | UBERON:0002114 | 79.24 | gold quality |
| fallopian tube | UBERON:0003889 | 79.20 | gold quality |
| colon | UBERON:0001155 | 78.94 | gold quality |
| caecum | UBERON:0001153 | 78.71 | gold quality |
Single-cell (SCXA)
Detected in 9 experiment(s), a significant marker in 8.
| Experiment | Marker? | Max mean expression |
|---|---|---|
| E-MTAB-8322 | yes | 2937.61 |
| E-CURD-126 | yes | 1732.07 |
| E-HCAD-10 | yes | 32.64 |
| E-MTAB-10287 | yes | 26.47 |
| E-MTAB-8410 | yes | 17.55 |
| E-MTAB-10042 | yes | 9.00 |
| E-MTAB-10553 | yes | 6.33 |
| E-GEOD-124858 | no | 78.88 |
| E-ANND-3 | no | 0.00 |
HPA expression
RNA tissue specificity: Tissue enhanced
showing 60 of 77 HPA tissues / cells by nTPM:
| Tissue / cell | Axis | nTPM | Protein (IHC) |
|---|---|---|---|
| Smooth muscle | tissue | 103.1 | not detected |
| Heart muscle | tissue | 89.2 | not detected |
| Endometrium 1 | tissue | 65.1 | not detected |
| Gallbladder | tissue | 61.7 | not detected |
| Cervix | tissue | 38.4 | not detected |
| Liver | tissue | 38.4 | not detected |
| Adipose tissue | tissue | 27.7 | low |
| Spinal cord | tissue | 19.6 | |
| Tongue | tissue | 18.5 | |
| Small intestine | tissue | 16.6 | not detected |
| Lung | tissue | 13.5 | not detected |
| Pancreas | tissue | 12.6 | not detected |
| Urinary bladder | tissue | 12.5 | not detected |
| Skin 1 | tissue | 11.4 | not detected |
| Breast | tissue | 11.1 | low |
| Seminal vesicle | tissue | 11.0 | not detected |
| Rectum | tissue | 10.6 | not detected |
| Colon | tissue | 10.5 | not detected |
| Kidney | tissue | 10.5 | not detected |
| Substantia nigra | tissue | 10.3 | |
| Superior colliculi | tissue | 9.8 | |
| Esophagus | tissue | 9.5 | not detected |
| Medulla oblongata | tissue | 9.5 | |
| Epididymis | tissue | 9.1 | not detected |
| Olfactory bulb | tissue | 9.1 | |
| Duodenum | tissue | 9.0 | not detected |
| Ovary | tissue | 8.8 | not detected |
| Cerebellum | tissue | 8.3 | not detected |
| Thyroid gland | tissue | 8.3 | not detected |
| Basal ganglia | tissue | 8.0 | not detected |
| Cerebral cortex | tissue | 7.9 | not detected |
| Corpus callosum | tissue | 7.9 | |
| Periaqueductal gray | tissue | 7.9 | |
| Insular cortex | tissue | 7.9 | |
| Amygdala | tissue | 7.8 | |
| Midbrain | tissue | 7.6 | |
| Retrosplenial and cingulate cortex | tissue | 7.6 | |
| Temporal cortex | tissue | 7.6 | |
| Putamen | tissue | 7.4 | |
| Ventral forebrain | tissue | 7.4 | |
| Retrosplenial cortex | tissue | 7.4 | |
| Skeletal muscle | tissue | 7.3 | not detected |
| Adrenal gland | tissue | 7.1 | not detected |
| Septum | tissue | 7.0 | |
| Hippocampal formation | tissue | 6.9 | |
| Entorhinal cortex | tissue | 6.9 | |
| Thalamus | tissue | 6.7 | |
| Prefrontal cortex | tissue | 6.6 | |
| Somatosensory cortex | tissue | 6.6 | |
| Motor cortex | tissue | 6.5 | |
| Fallopian tube | tissue | 6.5 | not detected |
| Occipital cortex | tissue | 6.5 | |
| Pons | tissue | 6.3 | |
| Stomach 1 | tissue | 6.2 | not detected |
| Hypothalamus | tissue | 5.9 | |
| Appendix | tissue | 5.4 | not detected |
| Tonsil | tissue | 5.2 | not detected |
| Vagina | tissue | 5.1 | not detected |
| Placenta | tissue | 4.0 | not detected |
| Prostate | tissue | 3.9 | not detected |
Brain sub-regions (HPA Brain Atlas): detected in 190; highest nTPM — Blood vessel (129.3), Dorsal spinal cord (19.6), Ventral spinal cord (13.5), White matter (7.9), Ventral hippocampus (6.9).
Regulation
Is transcription factor: no
Upstream regulators (CollecTRI, top): SMAD3, SP1
miRNA regulators (miRDB)
Targeting ASPN by miRDB confidence (max_score; target_count = how many genes the miRNA targets in total — lower means more specific).
showing 30 of 64 miRNAs:
| miRNA | Max score | Avg score | miRNA target_count |
|---|---|---|---|
| HSA-MIR-3120-5P | 100.00 | 65.56 | 965 |
| HSA-MIR-5011-5P | 100.00 | 83.46 | 5820 |
| HSA-MIR-3924 | 100.00 | 72.09 | 2394 |
| HSA-MIR-5692B | 100.00 | 71.32 | 2622 |
| HSA-MIR-5692C | 100.00 | 71.32 | 2622 |
| HSA-MIR-186-5P | 99.99 | 70.83 | 3707 |
| HSA-MIR-371B-5P | 99.99 | 75.34 | 4759 |
| HSA-MIR-373-5P | 99.98 | 75.36 | 4753 |
| HSA-MIR-616-5P | 99.98 | 75.58 | 4775 |
| HSA-MIR-6888-3P | 99.97 | 65.95 | 1170 |
| HSA-MIR-3658 | 99.96 | 73.87 | 4379 |
| HSA-MIR-4267 | 99.96 | 66.53 | 2368 |
| HSA-MIR-23A-3P | 99.95 | 74.24 | 3163 |
| HSA-MIR-23B-3P | 99.95 | 74.24 | 3163 |
| HSA-MIR-23C | 99.95 | 73.92 | 3192 |
| HSA-MIR-101-3P | 99.94 | 75.03 | 2230 |
| HSA-MIR-144-3P | 99.94 | 73.98 | 2698 |
| HSA-MIR-9983-3P | 99.94 | 71.48 | 3631 |
| HSA-MIR-1297 | 99.91 | 73.41 | 3162 |
| HSA-MIR-129-5P | 99.88 | 70.26 | 3273 |
| HSA-MIR-182-5P | 99.87 | 74.03 | 2589 |
| HSA-MIR-369-3P | 99.85 | 70.52 | 2264 |
| HSA-MIR-6715A-3P | 99.83 | 68.05 | 1473 |
| HSA-MIR-3133 | 99.81 | 70.92 | 3506 |
| HSA-MIR-4639-5P | 99.81 | 67.37 | 1028 |
| HSA-MIR-4694-3P | 99.79 | 69.53 | 2640 |
| HSA-MIR-26A-5P | 99.78 | 73.52 | 2303 |
| HSA-MIR-26B-5P | 99.78 | 73.51 | 2305 |
| HSA-MIR-548AG | 99.77 | 69.25 | 1492 |
| HSA-MIR-200A-5P | 99.76 | 69.10 | 949 |
Functional genomics
gnomAD constraint: pLI 4.68e-09, LOEUF 1.53, missense Z 1.27 — population loss-of-function intolerance (pLI ≥ 0.9 = LoF-intolerant; lower LOEUF = more constrained). gnomAD
Regional missense constraint (gnomAD)
ENST00000375544 splits into 3 regions with different missense tolerance; 1 is missense-constrained (≈4% of the expected missense variation). Missense variants in a constrained region (low observed/expected) are more likely to be pathogenic. gnomAD
| Region (GRCh38) | Missense obs / exp | o/e | Constrained |
|---|---|---|---|
| 9:92,457,291–92,474,739 | 336 / 379.3 | 0.89 | no |
| 9:92,474,740–92,474,786 | 4 / 19.0 | 0.21 | yes (p 5.7e-04) |
| 9:92,474,787–92,474,897 | 41 / 42.8 | 0.96 | no |
Literature-anchored findings (GeneRIF, showing 40)
- these findings provide another functional link between extracellular matrix proteins, TGF-beta activity and disease, suggesting new therapeutic strategies for osteoarthritis. (PMID:15640800)
- No significant differences were observed in any of the multiple comparisons performed in osteoarthritis and controls (PMID:16542493)
- expression may be associated with the process of cytodifferentiation of periodontal ligament cells (PMID:16632759)
- Association of the D14 allele with knee osteoarthritis susceptibility in Han Chinese. (PMID:17024313)
- the association of the ASPN D14 allele and knee OA has global relevance [meta-analysis] (PMID:17517696)
- This study further highlighted the significance of asporin in osteoarthritis. (PMID:17603749)
- Characterization of the human ASPN promoter region revealed a region from -126 to -82 that is sufficient for full promoter activity; however, TGF-beta1 failed to increase activity through the ASPN promoter. (PMID:17804408)
- describe mechanisms for asporin function and regulation in human articular cartilage; asporin blocks chondrogenesis and inhibits TGF-beta1-induced expression of matrix genes and the resulting chondrocyte phenotypes. (PMID:17827158)
- The frequency of the aspartic acid repeat polymorphism was examined. These results suggest that asporin may play a role in OA susceptibility of the knee in the Korean female population. (PMID:18178444)
- ASPN is a lumbar-disc degeneration (LDD) gene in Asians, and common risk factors may be considered for osteoarthritis and LDD. (PMID:18304494)
- Asporin is up-regulated in disease states. It binds to various growth factors, including TGF-beta and BMP-2, and negatively regulates their activity. By inhibiting binding of TGF-beta1 to its type II receptor, asporin forms a functional feedback loop. (PMID:18336287)
- These data suggest that polymorphisms within ASPN are not a major influence in susceptibility to hand or knee OA in US Caucasians. (PMID:18434216)
- In the discs of Caucasian subjects there was greatest expression of asporin in the more degenerate human discs in vivo. (PMID:19327154)
- Asporin has a role in osteoblast-driven collagen biomineralization activity. (PMID:19589127)
- The ratio of Asporin to TGF-beta1 (transforming growth factor-beta1) mRNA in patients with severe cartilage damage was higher than that in osteoartritis patients with mild cartilage damage (PMID:19997821)
- Association of an asporin repeat polymorphism with ankylosing spondylitis in Han Chinese population: a case-control study, is reported. (PMID:20144272)
- Our results show an obvious association between the D repeat polymorphism of ASPN and Developmental dysplasia of the hip (PMID:21329514)
- ASPN plays positive roles in the mineralization of dental pulp stem cells and predentin to dentin. (PMID:21413025)
- Data indicate that the expression of ASPN gene is finely regulated in cartilage and suggest a major role of Sp1. (PMID:21528154)
- mir-101 and mir-21 target PLAP-1 to regulate its expression during osteogenic differentiation of PDLCs. (PMID:22367347)
- Asporin is associated with hand osteoarthritis progression. (PMID:23357225)
- polymorphisms within the ASPN gene could influence knee osteoarthritis susceptibility (PMID:23733110)
- A meta-analysis suggest that the D-repeat of asporin gene (ASPN) may not be a major susceptibility locus in the Caucasian and Asian populations with knee osteoarthritis. (PMID:23942062)
- The asporin-encoding gene is a promising candidate as a susceptibility gene for osteoarthritis and degenerative disc disease. [Review] (PMID:24003854)
- Our data suggest that the D15 asporin allele could be considered a knee osteoarthritis risk allele significant only for women in the Iranian population. (PMID:24078942)
- This meta-analysis shows that the ASPN D14, D13, and D15 alleles are not associated with the development of osteoarthritis in Europeans and Asians. [Meta-Analysis] (PMID:24306268)
- Asporin may represent a new therapeutic target molecule for the development of drugs aimed at manipulating the cancer microenvironment. (PMID:24441039)
- D14-PLAP-1 suppressed BMP-2 signal transduction more efficiently than D13-PLAP-1; stronger affinity of D14-PLAP-1 protein to BMP-2 compared with D13-PLAP-1 protein. D repeat polymorphism of PLAP-1/asporin has influence on functions of PDL cells. (PMID:24453179)
- Our results showed that ASPN rs13301537 T to C change and variant C genotype may contribute to knee OA risk in a Chinese Han population. (PMID:25030405)
- Osteomodulin, osteoglycin, and asporin appear to be distinctly regulated in osteoarthritis labrum compared to OA cartilage. (PMID:25371314)
- Collectively, our findings indicate that ASPN is upregulated and plays an oncogenic role in gastric cancer progression and metastasis by influencing the EGFR signaling pathway. (PMID:25673058)
- this is the first case-control study in Mexican women that suggests that menopause and the D-repeat polymorphism in the ASPN gene are associated with knee OA (PMID:26016288)
- To test the associations of ASPN variations with risk of subsequent oncologic outcomes. (PMID:26446945)
- Suggest that the D14 allele of the ASPN polymorphism could exert an influence on primary osteoarthritis of the knee etiology in a Mexican Mestizo population. (PMID:26620055)
- we found that asporin can be downregulated by bone morphogenetic protein 4 in Hs578T cells and its upregulation may be facilited by serum-free cultivation or by three dimensional growth (PMID:27409832)
- higher expression of asporin was noticed in CRC tissues and it was correlated with later clinical stage of the patients. Asporin promoted the migration and invasion of the tumor cells partially through an EGFR/Src/cortactin- signaling pathway. (PMID:27705916)
- High ASPN expression in stroma is associated with prostate cancer progression. (PMID:28152543)
- Asporin promotes epithelial mesenchymal transformation, invasion, and migration of pancreatic cancer cellss by activating CD44-AKT/ERK-NF-kappaB pathway in paracrine and autocrine manner. (PMID:28400334)
- our study provides evidence that asporin is an important risk factor in intervertebral disc degeneration. The identification of the intrinsic expression mechanisms of asporin provides further understanding of disc degeneration. (PMID:28646230)
- ASPN D-repeat polymorphism is not associated with an increased Knee Osteoarthritis risk. (PMID:28889984)
Cross-species orthologs
3 orthologs
| Organism | Symbol | Gene ID |
|---|---|---|
| danio_rerio | aspn | ENSDARG00000002192 |
| mus_musculus | Aspn | ENSMUSG00000021388 |
| rattus_norvegicus | Aspn | ENSRNOG00000015410 |
Paralogs (22): DCN (ENSG00000011465), RTN4R (ENSG00000040608), FLRT3 (ENSG00000125848), FLRT1 (ENSG00000126500), LRRC4 (ENSG00000128594), LRRC4B (ENSG00000131409), PODNL1 (ENSG00000132000), LRTM1 (ENSG00000144771), LRRC4C (ENSG00000148948), LRRTM1 (ENSG00000162951), LRRC15 (ENSG00000172061), PODN (ENSG00000174348), LRRTM4 (ENSG00000176204), BGN (ENSG00000182492), LRRC19 (ENSG00000184434), FLRT2 (ENSG00000185070), GP1BA (ENSG00000185245), RTN4RL1 (ENSG00000185924), RTN4RL2 (ENSG00000186907), NYX (ENSG00000188937), LRRC66 (ENSG00000188993), LRRTM3 (ENSG00000198739)
Mouse-model phenotypes
Observed phenotypes of the mouse ortholog (MGI:1913945) from MGI (Alliance of Genome Resources) — knockout/mutant phenotypes, ranked by annotation count. 11 distinct phenotype terms.
| Mouse phenotype (MP) | Records |
|---|---|
| abnormal lens morphology | 1 |
| abnormal retina morphology | 1 |
| increased circulating HDL cholesterol level | 1 |
| abnormal skin morphology | 1 |
| decreased mean corpuscular volume | 1 |
| abnormal vitreous body morphology | 1 |
| abnormal auditory brainstem response | 1 |
| increased circulating cholesterol level | 1 |
| abnormal skin tensile strength | 1 |
| abnormal cutaneous collagen fibril morphology | 1 |
| abnormal glycosaminoglycan level | 1 |
Additional cross-species homologs
Sequence homologs in species beyond Ensembl Compara’s model organisms, by Diamond local protein alignment (% sequence identity; best hit per species). Lower-identity rows are more distant homologs. The matched accessions’ gene symbols aren’t in biobtree yet, so each row shows the UniProt accession.
| Organism | UniProt | Identity | Method |
|---|---|---|---|
| Pan troglodytes | Q5R1V9 | 100.0% | Diamond |
| Macaca fascicularis | Q9BGP6 | 100.0% | Diamond |
| Ovis aries | O46390 | 99.5% | Diamond |
| Bos taurus | P21809 | 99.5% | Diamond |
| Oryctolagus cuniculus | O46377 | 99.3% | Diamond |
| Equus caballus | O46403 | 99.3% | Diamond |
| Sus scrofa | Q9GKQ6 | 99.3% | Diamond |
| Canis lupus familiaris | O02678 | 97.8% | Diamond |
| Gallus gallus | P28675 | 97.5% | Diamond |
| Coturnix japonica | Q9DE68 | 97.5% | Diamond |
| Xenopus laevis | Q9IB75 | 85.9% | Diamond |
| Caenorhabditis elegans | G5EFX6 | 54.9% | Diamond |
| Branchiostoma floridae | C3YZ59 | 44.3% | Diamond |
Genomic neighbors (locus context)
Genes flanking this one on the chromosome (NCBI/Entrez gene neighborhood). Positional context only — some neighbors share regulatory elements (bidirectional promoters, antisense/overlapping transcripts), but chromosomal adjacency is not itself a functional relationship (see Interactions for that).
| Symbol | Type | Entrez |
|---|---|---|
| MIR4670 | ncRNA | 100616351 |
| ECM2 | protein-coding | 1842 |
| CENPP | protein-coding | 401541 |
| IPPK | protein-coding | 64768 |
| OMD | protein-coding | 4958 |
| OGN | protein-coding | 4969 |
| NOL8 | protein-coding | 55035 |
| SNORA84 | snoRNA | 100124534 |
| MIR3651 | ncRNA | 100500918 |
| IARS1 | protein-coding | 3376 |
Protein
Protein identifiers
Asporin — Q9BXN1 (reviewed: Q9BXN1)
Alternative names: Periodontal ligament-associated protein 1
All UniProt accessions (4): A0A494C084, A0A494C1J0, Q9BXN1, Q5TBF2
UniProt curated annotations — full annotation on UniProt →
Function. Negatively regulates periodontal ligament (PDL) differentiation and mineralization to ensure that the PDL is not ossified and to maintain homeostasis of the tooth-supporting system. Inhibits BMP2-induced cytodifferentiation of PDL cells by preventing its binding to BMPR1B/BMP type-1B receptor, resulting in inhibition of BMP-dependent activation of SMAD proteins. Critical regulator of TGF-beta in articular cartilage and plays an essential role in cartilage homeostasis and osteoarthritis (OA) pathogenesis. Negatively regulates chondrogenesis in the articular cartilage by blocking the TGF-beta/receptor interaction on the cell surface and inhibiting the canonical TGF-beta/Smad signal. Binds calcium and plays a role in osteoblast-driven collagen biomineralization activity.
Subunit / interactions. Interacts with TGFB1, TGFB2 and TGFB3. DCN, BGN, and FMOD inhibit binding to TGFB1. Interacts with BMP2. Interacts in vitro with type II collagen. Interacts with type I collagen. DCN can inhibit collagen binding.
Subcellular location. Secreted. Extracellular space. Extracellular matrix.
Tissue specificity. Higher levels in osteoarthritic articular cartilage, aorta, uterus. Moderate expression in small intestine, heart, liver, bladder, ovary, stomach, and in the adrenal, thyroid, and mammary glands. Low expression in trachea, bone marrow, and lung. Colocalizes with TGFB1 in chondrocytes within osteoarthritic (OA) lesions of articular cartilage.
Post-translational modifications. There is no serine/glycine dipeptide sequence expected for the attachment of O-linked glycosaminoglycans and this is probably not a proteoglycan. The O-linked polysaccharide on 54-Ser is probably the mucin type linked to GalNAc. The N-linked glycan at Asn-282 is composed of variable structures of GlcNAc, mannose, fucose, HexNAc and hexose.
Disease relevance. Osteoarthritis 3 (OS3) [MIM:607850] A degenerative disease of the joints characterized by degradation of the hyaline articular cartilage and remodeling of the subchondral bone with sclerosis. Clinical symptoms include pain and joint stiffness often leading to significant disability and joint replacement. Disease susceptibility is associated with variants affecting the gene represented in this entry. Susceptibility to osteoarthritis is conferred by a triplet repeat expansion polymorphism. ASPN allele having 14 aspartic acid repeats in the N-terminal region of the protein (D14), is overrepresented relative to the common allele having 13 aspartic acid repeats (D13). The frequency of the D14 allele increases with disease severity. The D14 allele is also overrepresented in individuals with hip osteoarthritis. Intervertebral disc disease (IDD) [MIM:603932] A common musculo-skeletal disorder caused by degeneration of intervertebral disks of the lumbar spine. It results in low-back pain and unilateral leg pain. Disease susceptibility is associated with variants affecting the gene represented in this entry. Susceptibility to intervertebral disk disease, particularly lumbar disk degeneration, is conferred by a triplet repeat expansion polymorphism. ASPN allele having 14 aspartic acid repeats in the N-terminal region of the protein (D14), is associated with the disorder in some populations.
Domain organisation. The LRR 5 repeat can inhibit BMP2-induced cytodifferentiation and may be involved in the interaction with BMP2. The repeats LRR 10, LRR 11 and LRR 12 are involved in binding type I collagen. The poly-Asp region is involved in binding calcium.
Induction. By TGFB1.
Polymorphism. The poly-Asp region of ASPN is polymorphic and ranges at least from 11 to 17 Asp.
Similarity. Belongs to the small leucine-rich proteoglycan (SLRP) family. SLRP class I subfamily.
RefSeq proteins (2): NP_001180264, NP_060150* (*=MANE)
Domains & families (InterPro)
| ID | Name | Type |
|---|---|---|
| IPR000372 | LRRNT | Domain |
| IPR001611 | Leu-rich_rpt | Repeat |
| IPR003591 | Leu-rich_rpt_typical-subtyp | Repeat |
| IPR016352 | SLRP_I_decor/aspor/byglycan | Family |
| IPR032675 | LRR_dom_sf | Homologous_superfamily |
| IPR050333 | SLRP | Family |
Pfam: PF01462, PF13855
UniProt features (24 total): repeat 11, disulfide bond 3, region of interest 2, glycosylation site 2, signal peptide 1, propeptide 1, compositionally biased region 1, chain 1, sequence conflict 1, domain 1
Structure
Predicted structure (AlphaFold)
| Model | pLDDT | Fraction very-high |
|---|---|---|
| AF-Q9BXN1-F1 | 85.71 | 0.77 |
Human Protein Atlas
Protein class: Predicted secreted proteins, Predicted intracellular proteins, Plasma proteins, Disease related genes, Human disease related genes
Protein evidence: Evidence at protein level
Subcellular location (HPA, imaging): nucleoplasm; cytosol
Antibody reliability (HPA): IH approved · IF uncertain
Functional residue map
Curated UniProt residues grouped by drug-discovery relevance — catalytic, ligand-binding, modification, and mutation-validated positions. Source: UniProtKB sequence features.
Disulfide bonds (3)
| Type | Positions |
|---|---|
| Disulfide bond | 75–81, 79–88, 333–366 |
Glycosylation sites (2)
| Type | Positions |
|---|---|
| O-linked (galnac…) serine | 55 |
| N-linked (glcnac…) asparagine | 282 |
Function
Pathways and Gene Ontology
Reactome pathways
0 curated (TAS) of 2; 0 disease pathways. Curated-first; evidence = TAS (manually curated) vs IEA (electronic inference).
2 pathways:
| ID | Pathway | Evidence |
|---|---|---|
| R-HSA-3000178 | ECM proteoglycans | — |
| R-HSA-1474244 | Extracellular matrix organization | — |
MSigDB gene sets: 173 (showing top):
TURASHVILI_BREAST_LOBULAR_CARCINOMA_VS_DUCTAL_NORMAL_UP, GOBP_REGULATION_OF_CELLULAR_RESPONSE_TO_GROWTH_FACTOR_STIMULUS, MODULE_418, SMID_BREAST_CANCER_RELAPSE_IN_LUNG_DN, GAUSSMANN_MLL_AF4_FUSION_TARGETS_E_UP, GOBP_TOOTH_MINERALIZATION, TURASHVILI_BREAST_CARCINOMA_DUCTAL_VS_LOBULAR_DN, GOBP_ANIMAL_ORGAN_MORPHOGENESIS, GOBP_BONE_MINERALIZATION, GOBP_REGULATION_OF_TRANSMEMBRANE_RECEPTOR_PROTEIN_SERINE_THREONINE_KINASE_SIGNALING_PATHWAY, NF1_Q6_01, GOBP_RESPONSE_TO_TRANSFORMING_GROWTH_FACTOR_BETA, GOMF_EXTRACELLULAR_MATRIX_STRUCTURAL_CONSTITUENT, SCHAEFFER_PROSTATE_DEVELOPMENT_6HR_UP, SCHAEFFER_PROSTATE_DEVELOPMENT_12HR_UP
GO Biological Process (5): bone mineralization (GO:0030282), negative regulation of transforming growth factor beta receptor signaling pathway (GO:0030512), negative regulation of tooth mineralization (GO:0070171), response to fluoride (GO:1902617), biomineral tissue development (GO:0031214)
GO Molecular Function (3): calcium ion binding (GO:0005509), protein binding (GO:0005515), extracellular matrix structural constituent conferring compression resistance (GO:0030021)
GO Cellular Component (3): extracellular matrix (GO:0031012), cell projection (GO:0042995), gel phase of interstitial matrix (GO:0140150)
Reactome top-level categories
1 top-level categories:
| Category | Pathways |
|---|---|
| Extracellular matrix organization | 1 |
GO top-level categories
18 GO namespaces:
| Category | Terms |
|---|---|
| external encapsulating structure | 2 |
| ossification | 1 |
| biomineral tissue development | 1 |
| animal gross anatomical part developmental process | 1 |
| transforming growth factor beta receptor signaling pathway | 1 |
| regulation of transforming growth factor beta receptor signaling pathway | 1 |
| negative regulation of transmembrane receptor protein serine/threonine kinase signaling pathway | 1 |
| tooth mineralization | 1 |
| negative regulation of biomineral tissue development | 1 |
| regulation of tooth mineralization | 1 |
| response to chemical | 1 |
| tissue development | 1 |
| animal organ development | 1 |
| metal ion binding | 1 |
| binding | 1 |
| extracellular matrix structural constituent | 1 |
| cellular anatomical structure | 1 |
| interstitial matrix | 1 |
Experimentally-supported GO annotations
GO terms backed by direct experimental evidence (ECO experimental codes) — 4 of 12 annotations. The rest are phylogenetic / computational / electronic (IEA).
4 experimentally-supported GO terms:
| GO term | NS | Evidence |
|---|---|---|
| bone mineralization | BP | direct assay |
| negative regulation of transforming growth factor beta receptor signaling pathway | BP | direct assay |
| extracellular matrix | CC | direct assay |
| calcium ion binding | MF | direct assay |
Protein interactions and networks
STRING
showing 15 of 1,402 interactions by confidence (×1000):
| Protein A | Protein B | Partner UniProt | Score |
|---|---|---|---|
| ASPN | MATN3 | O15232 | 902 |
| ASPN | FRZB | Q92765 | 894 |
| ASPN | CTDSP2 | O14595 | 850 |
| ASPN | CILP | O75339 | 834 |
| ASPN | HDAC11 | Q96DB2 | 796 |
| ASPN | GBA1 | P04062 | 759 |
| ASPN | GDF5 | P43026 | 759 |
| ASPN | COL11A1 | P12107 | 751 |
| ASPN | HDAC8 | Q9BY41 | 721 |
| ASPN | CTRB2 | Q6GPI1 | 718 |
| ASPN | CTRB1 | P17538 | 718 |
| ASPN | HDAC3 | O15379 | 700 |
| ASPN | HDAC2 | Q92769 | 699 |
| ASPN | HDAC1 | Q13547 | 696 |
| ASPN | THBS2 | P35442 | 673 |
IntAct
Human interaction partners of ASPN in IntAct, one row per partner (best MIscore; records = supporting IntAct interaction records).
1 partners by confidence:
| Partner | Interaction type | MIscore | Records |
|---|---|---|---|
| ITIH2 | association | 0.350 | 1 |
BioGRID (7 interactions; top human partners by supporting records): PSMD2 (Affinity Capture-Western; 2 records), ITIH2 (Affinity Capture-MS), RPL37A (Cross-Linking-MS (XL-MS)), SELM (Affinity Capture-MS), TRPC6 (Positive Genetic)
Disease & clinical
Genetic variants
Variant evidence for ASPN: 42 ClinVar records (2 pathogenic / likely pathogenic); 3 GWAS associations. Per-variant detail is on Sugi Variant.
ClinVar
42 variants total. Per-class counts are floors (≥ shown; pagination cap):
| Classification | Count (floor) |
|---|---|
| Pathogenic | 2 |
| Likely pathogenic | 0 |
| Uncertain significance | 22 |
| Likely benign | 4 |
| Benign | 7 |
Top pathogenic / likely-pathogenic (2)
Showing all 2 pathogenic / likely-pathogenic ClinVar records, ranked by ClinVar review status (expert panel → multiple submitters → single submitter), then by number of submitting labs.
| Variant ID | HGVS | Classification | Review | Submitters |
|---|---|---|---|---|
| 1073961 | NC_000009.11:g.(?95007241)(95237179_?)del | Pathogenic | criteria provided, single submitter | 1 |
| 2425154 | NC_000009.11:g.(?94485944)(95527026_?)del | Pathogenic | criteria provided, single submitter | 1 |
Per-variant reference — Sugi Variant
Explore ASPN’s pathogenic and likely-pathogenic variants individually — each with its ClinVar classification and conditions, applied ACMG criteria (ClinGen expert panel, where curated), the calibrated in-silico predictors (AlphaMissense, REVEL, SaProt, conservation), gnomAD frequency, and the predictor-disagreement QC signal — on Sugi Variant.
AlphaMissense
890 missense substitutions predicted likely pathogenic (of 2,534 scored), across 223 residues. Top 20 hotspot residues, ranked by the number of likely-pathogenic substitutions (of those reachable by a single-nucleotide change), then by mean score:
| Residue | Likely-pathogenic substitutions | Mean am_pathogenicity | Max am_pathogenicity |
|---|---|---|---|
| N181 | 8 | 0.995 | 0.999 |
| N112 | 8 | 0.990 | 0.999 |
| N136 | 8 | 0.986 | 0.998 |
| N160 | 8 | 0.986 | 0.998 |
| N275 | 8 | 0.979 | 0.996 |
| N299 | 8 | 0.973 | 0.995 |
| N251 | 8 | 0.971 | 0.996 |
| D108 | 8 | 0.962 | 0.992 |
| N205 | 8 | 0.957 | 0.997 |
| N352 | 8 | 0.957 | 0.995 |
| N322 | 8 | 0.954 | 0.995 |
| F217 | 8 | 0.933 | 0.985 |
| D90 | 8 | 0.931 | 0.985 |
| F191 | 8 | 0.925 | 0.992 |
| F364 | 8 | 0.919 | 0.976 |
| F332 | 8 | 0.918 | 0.993 |
| F146 | 8 | 0.912 | 0.989 |
| D249 | 8 | 0.906 | 0.978 |
| S348 | 8 | 0.884 | 0.992 |
| D260 | 8 | 0.881 | 0.955 |
HPA cancer prognostics
RNA cancer specificity: Cancer enhanced (Breast Invasive Carcinoma)
Human Protein Atlas survival analysis — favorable = higher expression predicts better survival.
5 prognostic cancer types:
| Cancer | Prognostic | p-value |
|---|---|---|
| Kidney Renal Papillary Cell Carcinoma (TCGA) | unfavorable | 2.46e-05 |
| Ovary Serous Cystadenocarcinoma (validation) | unfavorable | 0.000124 |
| Stomach Adenocarcinoma (TCGA) | unfavorable | 0.000254 |
| Kidney Chromophobe (TCGA) | unfavorable | 0.000258 |
| Bladder Urothelial Carcinoma (TCGA) | favorable | 0.000589 |
Disease associations
OMIM: gene MIM:608135 | disease phenotypes:
GenCC curated gene-disease
1 curated gene-disease records:
| Disease | Classification | Inheritance | Records |
|---|---|---|---|
| osteoarthritis susceptibility 3 | Limited | Autosomal dominant |
Mondo (1): osteoarthritis susceptibility 3 (MONDO:0011923)
HPO phenotypes
6 phenotypes (HPO-id order):
| HPO | Term |
|---|---|
| HP:0000006 | Autosomal dominant inheritance |
| HP:0001387 | Joint stiffness |
| HP:0002758 | Osteoarthritis |
| HP:0002829 | Arthralgia |
| HP:0006226 | Osteoarthritis of the first carpometacarpal joint |
| HP:0006233 | Osteoarthritis of the distal interphalangeal joint |
GWAS associations
3 associations:
| Study | Trait | p-value |
|---|---|---|
| GCST010725_3 | Malaria | 6e-6 |
| GCST010725_70 | Malaria | 6e-6 |
| GCST010725_91 | Malaria | 9e-6 |
Drugs & pharmacology
Drug and pharmacology data
Is drug target: no
PharmGKB: 1 entry (CPIC guideline: no)
CTD chemical–gene interactions
15 total (human), top 15 by PubMed support.
| Chemical | Actions (top 5) | PubMed papers |
|---|---|---|
| methylmercuric chloride | increases expression | 2 |
| Estradiol | decreases expression, affects expression, affects cotreatment | 2 |
| Progesterone | affects cotreatment, decreases expression, increases expression | 2 |
| testosterone enanthate | affects expression | 1 |
| bisphenol A | affects cotreatment, increases expression | 1 |
| triadimefon | decreases expression | 1 |
| CGP 52608 | affects binding, increases reaction | 1 |
| entinostat | increases expression | 1 |
| incobotulinumtoxinA | increases expression | 1 |
| Calcitriol | decreases expression | 1 |
| Dexamethasone | affects cotreatment, increases expression, decreases expression | 1 |
| Doxorubicin | decreases expression | 1 |
| Indomethacin | affects cotreatment, increases expression, decreases expression | 1 |
| Valproic Acid | decreases expression | 1 |
| 1-Methyl-3-isobutylxanthine | decreases expression, affects cotreatment, increases expression | 1 |
Clinical trials (associated diseases)
Via MONDO — disease-level, not drug-specific.
15 trials:
| NCT | Phase | Status | Title |
|---|---|---|---|
| NCT03414970 | Phase 3 | ACTIVE_NOT_RECRUITING | Hypofractionated Radiation Therapy After Mastectomy in Preventing Recurrence in Patients With Stage IIa-IIIa Breast Cancer |
| NCT06113055 | Phase 2 | UNKNOWN | Hereditary Sensory Neuropathy Serine Trial |
| NCT00461344 | Phase 2 | TERMINATED | Docetaxel + Doxorubicin as Neoadjuvant Chemotherapy in Patients With Breast Cancer |
| NCT07499999 | Phase 2 | NOT_YET_RECRUITING | Randomized Double-Blind Phase II Trial of Baby Exemestane Versus Baby Tamoxifen in Post-Menopausal Women at High Risk for Breast Cancer |
| NCT02134496 | Not specified | COMPLETED | PACU Discharge Without Motorfunction Assessment After Spinal Anaesthesia |
| NCT01733407 | Phase 1/2 | COMPLETED | L-Serine Supplementation in Hereditary Sensory Neuropathy Type 1 |
| NCT00637364 | Phase 1/2 | SUSPENDED | High Intensity Focused Ultrasound Tumor Treatment for Pancreatic Cancer Pain |
| NCT02779855 | Phase 1/2 | COMPLETED | Talimogene Laherparepvec in Combination With Neoadjuvant Chemotherapy in Triple Negative Breast Cancer |
| NCT01753908 | Early Phase 1 | COMPLETED | Broccoli Sprout Extract in Treating Patients With Breast Cancer |
| NCT01796041 | Early Phase 1 | COMPLETED | Intraoperative Imaging of Breast Cancer With Indocyanine Green |
| NCT07628634 | Early Phase 1 | RECRUITING | Feasibility Study on the Effect of a Methionine-Reduced Diet on Serum Levels in Pts w/ Solid Tumors |
| NCT01208974 | Not specified | COMPLETED | Nipple-Areola Complex (NAC) Irradiation After Nipple-Sparing Mastectomy and Reconstruction |
| NCT01875198 | Not specified | TERMINATED | Oncologic Impact of Splenectomy-omitting Radical Pancreatectomy in Well-selected Left-sided Pancreatic Cancer |
| NCT03543397 | Not specified | UNKNOWN | MRI in Ductal Carcinoma in Situ (DCIS) |
| NCT03834532 | Not specified | COMPLETED | Living Well After Breast Surgery |
Related Atlas pages
- Associated diseases: osteoarthritis susceptibility 3
- Disease cohort memberships (association, not causation — diseases whose associated-gene cohort lists this gene; a subset are also under Associated diseases): breast ductal adenocarcinoma, lumbar disk degeneration, susceptibility to, osteoarthritis susceptibility 3