MUTYH

gene
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Also known as MYH

Summary

MUTYH (mutY DNA glycosylase, HGNC:7527) is a protein-coding gene on chromosome 1p34.1, encoding Adenine DNA glycosylase (Q9UIF7). Involved in oxidative DNA damage repair.

This gene encodes a DNA glycosylase involved in oxidative DNA damage repair. The enzyme excises adenine bases from the DNA backbone at sites where adenine is inappropriately paired with guanine, cytosine, or 8-oxo-7,8-dihydroguanine, a major oxidatively damaged DNA lesion. The protein is localized to the nucleus and mitochondria. This gene product is thought to play a role in signaling apoptosis by the introduction of single-strand breaks following oxidative damage. Mutations in this gene result in heritable predisposition to colorectal cancer, termed MUTYH-associated polyposis (MAP). Multiple transcript variants encoding different isoforms have been found for this gene.

Source: NCBI Gene 4595 — RefSeq curated summary.

At a glance

  • Gene–disease (curated): familial adenomatous polyposis 2 (Definitive, ClinGen) — +3 more curated relationships
  • GWAS associations: 2
  • Clinical variants (ClinVar): 4,186 total — 184 pathogenic, 150 likely-pathogenic
  • Phenotypes (HPO): 64
  • Druggable target: yes
  • Dosage sensitivity (ClinGen): haploinsufficiency autosomal recessive, triplosensitivity no evidence
  • MANE Select transcript: NM_001048174

Identifiers

Gene identifiers

FieldValue
HGNC IDHGNC:7527
Approved symbolMUTYH
NamemutY DNA glycosylase
Location1p34.1
Locus typegene with protein product
StatusApproved
AliasesMYH
Ensembl geneENSG00000132781
Ensembl biotypeprotein_coding
OMIM604933
Entrez4595

Gene structure

Transcript identifiers

Ensembl transcripts: 110 — 80 protein_coding, 15 nonsense_mediated_decay, 13 retained_intron, 2 protein_coding_CDS_not_defined

ENST00000354383, ENST00000355498, ENST00000372098, ENST00000372104, ENST00000372110, ENST00000372115, ENST00000412971, ENST00000435155, ENST00000448481, ENST00000450313, ENST00000456914, ENST00000461495, ENST00000462387, ENST00000462388, ENST00000466231, ENST00000467459, ENST00000467940, ENST00000470256, ENST00000474703, ENST00000475516, ENST00000476789, ENST00000478796, ENST00000479746, ENST00000481139, ENST00000481571, ENST00000482094, ENST00000483127, ENST00000483642, ENST00000485271, ENST00000485484, ENST00000488731, ENST00000492494, ENST00000525160, ENST00000528013, ENST00000529892, ENST00000529984, ENST00000531105, ENST00000533178, ENST00000534453, ENST00000671856, ENST00000672011, ENST00000672314, ENST00000672593, ENST00000672764, ENST00000672818, ENST00000673134, ENST00000674679, ENST00000710952, ENST00000713749, ENST00000713750, ENST00000713751, ENST00000873954, ENST00000873955, ENST00000873956, ENST00000873957, ENST00000873958, ENST00000873959, ENST00000873960, ENST00000873961, ENST00000873962, ENST00000873963, ENST00000873964, ENST00000873965, ENST00000873966, ENST00000873967, ENST00000873968, ENST00000873969, ENST00000873970, ENST00000938227, ENST00000938228, ENST00000938229, ENST00000938230, ENST00000938231, ENST00000938232, ENST00000938233, ENST00000938234, ENST00000938235, ENST00000938236, ENST00000938237, ENST00000938238, ENST00000938239, ENST00000938240, ENST00000938241, ENST00000938242, ENST00000938243, ENST00000938244, ENST00000938245, ENST00000938246, ENST00000938247, ENST00000946255, ENST00000946256, ENST00000946257, ENST00000946258, ENST00000946259, ENST00000946260, ENST00000946261, ENST00000946262, ENST00000946263, ENST00000946264, ENST00000946265, ENST00000946266, ENST00000946267, ENST00000946268, ENST00000946269, ENST00000946270, ENST00000946271, ENST00000946272, ENST00000946273, ENST00000946274, ENST00000946275

RefSeq mRNA: 32 — MANE Select: NM_001048174 NM_001048171, NM_001048172, NM_001048173, NM_001048174, NM_001128425, NM_001293190, NM_001293191, NM_001293192, NM_001293195, NM_001293196, NM_001350650, NM_001350651, NM_001407069, NM_001407070, NM_001407071, NM_001407072, NM_001407073, NM_001407075, NM_001407077, NM_001407078, NM_001407079, NM_001407080, NM_001407081, NM_001407082, NM_001407083, NM_001407085, NM_001407086, NM_001407087, NM_001407088, NM_001407089, NM_001407091, NM_012222

CCDS: CCDS41321, CCDS41322, CCDS520, CCDS72776, CCDS72777, CCDS90938

Canonical transcript exons

ENST00000456914 — 16 exons

ExonStartEnd
ENSE000017872634533989945339970
ENSE000034616054533309745333170
ENSE000035111894533051645330557
ENSE000035203714532924245329437
ENSE000035220554533291845332959
ENSE000035465414533328545333324
ENSE000035486804533216645332310
ENSE000035701724533142045331556
ENSE000035833914533166145331849
ENSE000036516734533118245331334
ENSE000036649704533202345332086
ENSE000036652384533257445332687
ENSE000036731154533276345332834
ENSE000037028864533239145332488
ENSE000037869284533341345333561
ENSE000042827754533439145334511

Expression profiles

Bgee: expression breadth ubiquitous, 134 present calls, max score 95.55.

FANTOM5 (CAGE): breadth ubiquitous, TPM avg 9.3079 / max 73.7436, expressed in 1755 samples.

FANTOM5 promoters (4 alternative TSS)

Promoter IDTPM avgSamples expressed
121154.03891471
121123.38261410
121131.6522905
121140.2341109

Top tissues by expression

134 total, by Bgee expression score (0-100, higher = more expressed):

TissueAnatomy IDExpression scoreQuality
cerebellar hemisphereUBERON:000224595.55gold quality
cerebellar cortexUBERON:000212995.53gold quality
right hemisphere of cerebellumUBERON:001489095.51gold quality
cerebellumUBERON:000203795.49gold quality
mucosa of transverse colonUBERON:000499193.00gold quality
granulocyteCL:000009491.94gold quality
right lobe of thyroid glandUBERON:000111991.90gold quality
right uterine tubeUBERON:000130291.56gold quality
left lobe of thyroid glandUBERON:000112091.31gold quality
thyroid glandUBERON:000204691.14gold quality
spleenUBERON:000210691.02gold quality
tibial nerveUBERON:000132390.78gold quality
pituitary glandUBERON:000000790.65gold quality
left ovaryUBERON:000211990.55gold quality
endocervixUBERON:000045890.52gold quality
right ovaryUBERON:000211890.08gold quality
adenohypophysisUBERON:000219690.05gold quality
ectocervixUBERON:001224990.00gold quality
ovaryUBERON:000099289.80gold quality
metanephros cortexUBERON:001053389.67gold quality
body of uterusUBERON:000985389.63gold quality
transverse colonUBERON:000115789.52gold quality
uterine cervixUBERON:000000289.49gold quality
prostate glandUBERON:000236789.31gold quality
small intestine Peyer’s patchUBERON:000345489.31gold quality
lower esophagus mucosaUBERON:003583489.13gold quality
cortex of kidneyUBERON:000122588.98gold quality
C1 segment of cervical spinal cordUBERON:000646988.95gold quality
small intestineUBERON:000210888.61gold quality
primordial germ cell in gonadCL:0000670 ∩ UBERON:000099188.46gold quality

Single-cell (SCXA)

Detected in 2 experiment(s), a significant marker in 1.

ExperimentMarker?Max mean expression
E-ANND-3yes3.20
E-MTAB-7249no21.68

Regulation

Is transcription factor: no

Upstream regulators (CollecTRI, top): MEF2A

Functional genomics

ClinGen dosage: haploinsufficiency 30 (autosomal recessive), triplosensitivity 0 (no evidence). ClinGen Gene Dosage Map

Literature-anchored findings (GeneRIF, showing 40)

  • interaction with mismatch repair proteins MutS homolog 2/MutS homolog 6 (PMID:11801590)
  • Functional interaction of MutY homolog with proliferating cell nuclear antigen in fission yeast (and in human) (PMID:11805113)
  • effect of a single nucleotide polymorphism (SNP) in the MYH gene on the difference in the expression levels of its products (PMID:12056405)
  • Biallelic germline mutations in MYH predispose to multiple colorectal adenoma and somatic G:C–>T:A mutations (PMID:12393807)
  • Germline mutations but not somatic changes at this locus contribute to the pathogenesis of unselected colorectal cancers. (PMID:12707038)
  • OGG1 and MYH function as suppressors for G:C to T:A transversions by 8OHG but not by BPDE in human cells. (PMID:12807753)
  • MutY phosphorylation is defective in human colorectal cancer cell lines with wild-type MutY alleles (PMID:12966098)
  • Biallelic MYH mutations confer susceptibility to colorectal cancer (PMID:14991577)
  • MYH-associated polyposis(MAP) is present in about 20% of Italian FAP/AAPC patients, and in some patients with colorectal adenomas in the general population. Mutation 1395delGGA is a subpolymorphic MYH mutational event in some Caucasian populations. (PMID:14999774)
  • Transversions in KRAS2 or APC are more common in colorectal cancers with single germ-line MYH variants than colorectal cancers with wild-type MYH. (PMID:15034862)
  • patients with MYH-associated adenomatous polyposis were either apparently sporadic cases or had a family history consistent with recessive inheritance (PMID:15188161)
  • data suggest that somatic mutations of base excision repair gene MYH contribute to the development of a sub-set of sporadic gastric cancers (PMID:15273732)
  • MYH mutations cause multiple adenomas of the GI tract and seem to act by increasing the frequency of somatic APC mutations. (PMID:15290654)
  • 3 new mutations (c.340T>C [p.Y114H]; c.503G>A [p.R168H]; and c.1186_1187insGG [p.E396fsX437]) are described. (PMID:15366000)
  • Increased expression of the DNA glycosylase repair enzyme hMYH in A549 cells exposed to O2 and IR leads to improvements in cell survival. (PMID:15450125)
  • Loss of heterozygosity in at least one of four loci in MYH was detected in eight (47%) of 17 colorectal tumors from monoallelic MYH gene mutation carriers but in only two (20%) of 10 colorectal tumors from biallelic MYH gene mutation carriers. (PMID:15523092)
  • Mutation spectrum for MYH by direct DNA sequencing in 219 anonymous North Americans in genetic testing for polyposis colorectal cancer. (PMID:15635083)
  • Pathogenic mechanisms underlying two hMYH polyposis-associated mutations. (PMID:15673720)
  • Germ-line mutations of the MYH gene were studied in Japanese patients with multiple colorectal adenomas. (PMID:15890374)
  • These data provide the strongest evidence to date for a causative role of BER defects in colorectal cancer etiology and show, to our knowledge for the first time, that heterozygous MUTYH mutations predispose to colorectal cancer later in life. (PMID:15931596)
  • normal role of MutYH in the base excision repair of adenines misincorporated opposite 7,8-dihydro-8-oxoguanine in familial adenomatous polyposis (PMID:16042573)
  • there was no significant difference in MYH mutation carrier status between patients with hepatocellular carcinoma, cholangiocarcinoma, and non-cancerous controls (PMID:16292541)
  • Results warrant further study to test the hypothesis of mutations in MMR genes (in particular MSH6) and MUTYH acting together to increase cancer risk. (PMID:16408224)
  • Mutation in MYH may be rarely involved in the pathogenesis of multiple sporadic colorectal adenomas in Korean population. (PMID:16521226)
  • biallelic MUTYH mutations are the underlying genetic basis in a substantial fraction of patients with adenomatous polyposis (PMID:16557584)
  • Our results suggest that hMUTYH might be a useful marker of oxidative stress and that oxidative stress and genomic instability are important in the PD disease process. (PMID:16773329)
  • low-penetrance alleles of MYH are enriched in MMR gene mutation-negative colon cancer families (PMID:16774938)
  • Mutations in the MUTYH gene have been reported to be associated with increased risk of developing colorectal cancer. This study underscores the need for large sample sizes in order to identify small gene effects when the disease allele frequency is low. (PMID:16804517)
  • Mutations in MBD4 are unlikely to be implicated in HPS; MYH mutations should be studied, especially when adenomas occur in the same patient. (PMID:16831587)
  • Patients with biallelic MYH mutations showed disappearance of staining from the nucleus, and segregation of immunoreactivity in the cytoplasm, both in neoplastic and surrounding healthy mucosa. (PMID:16890597)
  • Colorectal cancer has an important genetic component. Colorectal polyposis associated with mutations in the MYH gene is an autosomal recessive syndrome characterized by the development of colorectal adenomas and cancer. (PMID:16938257)
  • Results show high frequency of MUTYH mutations in patients with multiple polyposis. (PMID:16941501)
  • Biallelic germline mutation of MYH in colorectal cancer also demonstrated microsatellite instability as a result of biallelic hypermethylation of the MLH1 promoter. (PMID:17031395)
  • MSH6/MUTYH heterozygote mutation carriers display a predominant HNPCC molecular tumour phenotype, with microsatellite instability and underrepresentation of G>T transversions. (PMID:17039270)
  • characterization of one newly identified MYH-associated polyposis MYH missense mutation (R231L) that lies adjacent to the putative hMSH6 binding domain; the mutant protein has severe defects in A/GO binding & adenine glycosylase activities (PMID:17081686)
  • MYH mutations are unlikely to contribute to prostate cancer risk. (PMID:17219200)
  • germline MYH mutations (by dHPLCO) in 20 clinic-based multiple adenoma patients who were adenomatous polyposis coli (APC) mutation-negative. (PMID:17219385)
  • Two novel mutations of MYH and a novel OGG1 polymorphism seemed to be associated with multiple colorectal adenomas in Korean families. (PMID:17252231)
  • the presence of germline mutations in the MUTYH genes in attenuated familial adenomatous polyposis. (PMID:17489848)
  • No germline mutations in MUTYH in Multiple colorectal adenoma. (PMID:17505512)

Cross-species orthologs

3 orthologs

OrganismSymbolGene ID
danio_reriomutyhENSDARG00000074889
mus_musculusMutyhENSMUSG00000028687
rattus_norvegicusMutyhENSRNOG00000017887

Paralogs (1): NTHL1 (ENSG00000065057)

Protein

Protein identifiers

Adenine DNA glycosylaseQ9UIF7 (reviewed: Q9UIF7)

Alternative names: MutY homolog

All UniProt accessions (25): Q9UIF7, A0A5F9ZHI2, A0A5F9ZI14, A0A5F9ZI60, A0A6Q8PF38, A0AAQ5BGW7, E5KP25, E5KP26, E5KP27, E5KP28, E9PI11, E9PIW5, E9PKM9, E9PLT4, E9PM53, E9PMH1, E9PNY0, E9PP30, E9PP34, H0YCA8, H0YCY5, H0YEI2, H0YER6, Q5T413, Q5T418

UniProt curated annotations — full annotation on UniProt →

Function. Involved in oxidative DNA damage repair. Initiates repair of AoxoG to CG by removing the inappropriately paired adenine base from the DNA backbone. Possesses both adenine and 2-OH-A DNA glycosylase activities.

Subcellular location. Nucleus. Mitochondrion.

Disease relevance. Familial adenomatous polyposis 2 (FAP2) [MIM:608456] A condition characterized by the development of multiple colorectal adenomatous polyps, benign neoplasms derived from glandular epithelium. Some affected individuals may develop colorectal carcinoma. The disease is caused by variants affecting the gene represented in this entry. Gastric cancer (GASC) [MIM:613659] A malignant disease which starts in the stomach, can spread to the esophagus or the small intestine, and can extend through the stomach wall to nearby lymph nodes and organs. It also can metastasize to other parts of the body. The term gastric cancer or gastric carcinoma refers to adenocarcinoma of the stomach that accounts for most of all gastric malignant tumors. Two main histologic types are recognized, diffuse type and intestinal type carcinomas. Diffuse tumors are poorly differentiated infiltrating lesions, resulting in thickening of the stomach. In contrast, intestinal tumors are usually exophytic, often ulcerating, and associated with intestinal metaplasia of the stomach, most often observed in sporadic disease. The gene represented in this entry may be involved in disease pathogenesis. Somatic mutations contribute to the development of a sub-set of sporadic gastric cancers in carriers of Helicobacter pylori.

Cofactor. Binds 1 [4Fe-4S] cluster. The cluster does not appear to play a role in catalysis, but is probably involved in the proper positioning of the enzyme along the DNA strand.

Similarity. Belongs to the Nth/MutY family.

Isoforms (6)

UniProt IDNamesCanonical?
Q9UIF7-1Alpha-1yes
Q9UIF7-2Alpha-2
Q9UIF7-3Alpha-3
Q9UIF7-4Beta-1
Q9UIF7-5Gamma-2
Q9UIF7-6Gamma-3

RefSeq proteins (32): NP_001041636, NP_001041637, NP_001041638, NP_001041639, NP_001121897, NP_001280119, NP_001280120, NP_001280121, NP_001280124, NP_001280125, NP_001337579, NP_001337580, NP_001393998, NP_001393999, NP_001394000, NP_001394001, NP_001394002, NP_001394004, NP_001394006, NP_001394007, NP_001394008, NP_001394009, NP_001394010, NP_001394011, NP_001394012, NP_001394014, NP_001394015, NP_001394016, NP_001394017, NP_001394018, NP_001394020, NP_036354 (=MANE)

Domains & families (InterPro)

IDNameType
IPR000086NUDIX_hydrolase_domDomain
IPR000445HhH_motifConserved_site
IPR003265HhH-GPD_domainDomain
IPR003651Endonuclease3_FeS-loop_motifConserved_site
IPR004035Endouclease-III_FeS-bd_BSBinding_site
IPR004036Endonuclease-III-like_CS2Conserved_site
IPR011257DNA_glycosylaseHomologous_superfamily
IPR015797NUDIX_hydrolase-like_dom_sfHomologous_superfamily
IPR023170HhH_base_excis_CHomologous_superfamily
IPR029119MutY_CDomain
IPR044298MIG/MutYFamily

Pfam: PF00633, PF00730, PF14815

UniProt features (110 total): sequence variant 60, helix 22, strand 11, binding site 4, splice variant 3, turn 2, mutagenesis site 2, chain 1, domain 1, region of interest 1, short sequence motif 1, active site 1, site 1

Structure

Experimental structures (PDB)

3 structures.

PDBMethodResolution (Å)
8FAYX-RAY DIFFRACTION1.91
3N5NX-RAY DIFFRACTION2.3
1X51SOLUTION NMR

Predicted structure (AlphaFold)

ModelpLDDTFraction very-high
AF-Q9UIF7-F179.620.61

Functional residue map

Curated UniProt residues grouped by drug-discovery relevance — catalytic, ligand-binding, modification, and mutation-validated positions. Source: UniProtKB sequence features.

Catalytic / active sites (2): 131 (proton donor/acceptor); 233 (transition state stabilizer)

Ligand- & substrate-binding residues (4): 287; 294; 297; 303

Mutagenesis-validated functional residues (2):

PositionPhenotype
121does not affect dna glycosylase activity. does not affect function in dna repair.
233loss of dna glycosylase activity.

Function

Pathways and Gene Ontology

Reactome pathways

5 pathways

IDPathway
R-HSA-110330Recognition and association of DNA glycosylase with site containing an affected purine
R-HSA-110331Cleavage of the damaged purine
R-HSA-110357Displacement of DNA glycosylase by APEX1
R-HSA-9608287Defective MUTYH substrate binding
R-HSA-9608290Defective MUTYH substrate processing

MSigDB gene sets: 297 (showing top): MORF_ATRX, GRAESSMANN_APOPTOSIS_BY_DOXORUBICIN_DN, GRAESSMANN_RESPONSE_TO_MC_AND_DOXORUBICIN_DN, KAUFFMANN_DNA_REPAIR_GENES, MUELLER_PLURINET, GOBP_DNA_MODIFICATION, MORF_PPP5C, BLALOCK_ALZHEIMERS_DISEASE_UP, chr1p34, GOBP_DNA_DAMAGE_RESPONSE, SPIELMAN_LYMPHOBLAST_EUROPEAN_VS_ASIAN_UP, GOBP_MISMATCH_REPAIR, FISCHER_DREAM_TARGETS, REACTOME_DNA_REPAIR, MODULE_568

GO Biological Process (7): DNA repair (GO:0006281), base-excision repair (GO:0006284), mismatch repair (GO:0006298), depurination (GO:0045007), negative regulation of necroptotic process (GO:0060546), response to stress (GO:0006950), DNA damage response (GO:0006974)

GO Molecular Function (14): purine-specific mismatch base pair DNA N-glycosylase activity (GO:0000701), DNA N-glycosylase activity (GO:0019104), oxidized purine DNA binding (GO:0032357), MutSalpha complex binding (GO:0032407), 8-oxo-7,8-dihydroguanine DNA N-glycosylase activity (GO:0034039), adenine/guanine mispair binding (GO:0035485), metal ion binding (GO:0046872), 4 iron, 4 sulfur cluster binding (GO:0051539), DNA binding (GO:0003677), catalytic activity (GO:0003824), protein binding (GO:0005515), hydrolase activity (GO:0016787), hydrolase activity, acting on glycosyl bonds (GO:0016798), iron-sulfur cluster binding (GO:0051536)

GO Cellular Component (3): nucleus (GO:0005634), nucleoplasm (GO:0005654), mitochondrion (GO:0005739)

Reactome top-level categories

Rollup of top-3 pathways:

CategoryPathways
Depurination2
Defective Base Excision Repair Associated with MUTYH2
Resolution of Abasic Sites (AP sites)1

GO top-level categories

Rollup of top GO terms by namespace:

CategoryTerms
DNA repair2
intracellular membrane-bounded organelle2
DNA metabolic process1
DNA damage response1
base-excision repair, AP site formation1
DNA modification1
regulation of necroptotic process1
negative regulation of programmed necrotic cell death1
necroptotic process1
response to stimulus1
cellular response to stress1
mismatch base pair DNA N-glycosylase activity1
hydrolase activity, hydrolyzing N-glycosyl compounds1
catalytic activity, acting on DNA1
oxidized DNA binding1
mismatch repair complex binding1
oxidized purine nucleobase lesion DNA N-glycosylase activity1
mismatched DNA binding1
cation binding1
iron-sulfur cluster binding1
nucleic acid binding1
molecular_function1
binding1
catalytic activity1
hydrolase activity1
metal cluster binding1
nuclear lumen1
cellular anatomical structure1
cytoplasm1

Protein interactions and networks

STRING

1726 interactions, top by confidence (×1000):

Protein AProtein BPartner UniProtScore
MUTYHMSH6P52701976
MUTYHOGG1P78554971
MUTYHNUDT1P36639927
MUTYHMLH1P40692914
MUTYHPMS2P54278896
MUTYHMSH2P43246892
MUTYHRAD9AQ99638891
MUTYHAPEX1P27695870
MUTYHPOLD1P28340868
MUTYHMLH3P49751863
MUTYHNTHL1P78549862
MUTYHHUS1O60921819
MUTYHTDGQ13569815
MUTYHPMS1P54277813
MUTYHMSH3P20585810

IntAct

39 interactions, top by confidence:

ABTypeScore
MUTYHAKT1psi-mi:“MI:2364”(proximity)0.470
MUTYHAKT1psi-mi:“MI:0915”(physical association)0.470
MUTYHAPEX1psi-mi:“MI:0407”(direct interaction)0.440
MUTYHPOLLpsi-mi:“MI:0407”(direct interaction)0.440
MUTYHMSH2psi-mi:“MI:0407”(direct interaction)0.440
BAATMUTYHpsi-mi:“MI:0915”(physical association)0.370
MSANTD3MUTYHpsi-mi:“MI:0915”(physical association)0.370
MUTYHTSTD2psi-mi:“MI:0915”(physical association)0.370
MUTYHCYLC2psi-mi:“MI:0915”(physical association)0.370
FANCCMUTYHpsi-mi:“MI:0915”(physical association)0.370
HRASMUTYHpsi-mi:“MI:0915”(physical association)0.370
MUTYHSEC61Bpsi-mi:“MI:0915”(physical association)0.370
MUTYHSMAD1psi-mi:“MI:0915”(physical association)0.370
TDRD7MUTYHpsi-mi:“MI:0915”(physical association)0.370
MUTYHXPApsi-mi:“MI:0915”(physical association)0.370
NME4PMPCBpsi-mi:“MI:0914”(association)0.350
NME4NDUFAB1psi-mi:“MI:0914”(association)0.350
FBXW7MUTYHpsi-mi:“MI:2364”(proximity)0.270
SMAD4MUTYHpsi-mi:“MI:2364”(proximity)0.270
MUTYHSMARCA4psi-mi:“MI:2364”(proximity)0.270
SMARCA4MUTYHpsi-mi:“MI:2364”(proximity)0.270
SPOPMUTYHpsi-mi:“MI:2364”(proximity)0.270
MUTYHSPOPpsi-mi:“MI:2364”(proximity)0.270

BioGRID (50): AGTRAP (Two-hybrid), MUTYH (Affinity Capture-MS), MUTYH (Affinity Capture-MS), MUTYH (Two-hybrid), SIRT6 (Affinity Capture-Western), MUTYH (Affinity Capture-Western), Sirt6 (Reconstituted Complex), SIRT6 (Reconstituted Complex), RAD9A (Co-localization), RAD9A (Affinity Capture-Western), RAD9A (Reconstituted Complex), MUTYH (Affinity Capture-Western), MUTYH (Affinity Capture-Western), MUTYH (Affinity Capture-Western), MUTYH (Affinity Capture-Western)

ESM2 similar proteins: A0A1D6LAG9, A2RTX5, A6QLY4, A6QNM8, A7M7B9, A9S0B8, A9VB27, B9DFZ0, C1BM18, E2RDZ6, F4JCQ3, G3X8U3, O35980, O70157, O75879, P13051, P36776, P54137, P78549, P97931, Q09907, Q0V9S0, Q13472, Q2KID2, Q4KM92, Q4R380, Q59HJ6, Q5ZKD7, Q640B4, Q7SXA9, Q80UN9, Q80VY9, Q8BLY2, Q8BYM8, Q8CGK3, Q8K582, Q8R5G2, Q8SRB8, Q924S5, Q99JT1

Diamond homologs: A0R567, F4JRF4, O31584, P17802, P39788, P44320, P46230, P57617, P73715, P83847, P9WQ08, P9WQ09, Q05869, Q10159, Q58030, Q7LX22, Q89A45, Q8R5G2, Q99P21, Q9UIF7, Q9YDP0, Q8K926, Q9SIC4, B9DFZ0, P57219, P0AB83, P0AB84, P29588, P44319, Q9WYK0, Q89AW4, Q8KA16, P46303, Q4UK93, P54137, C8VC05, O83754, Q08214, Q0IGK1, Q9Z2D7

SIGNOR signaling

4 interactions.

AEffectBMechanism
MUTYHup-regulatesATRbinding
MUTYHup-regulatesCHEK1
MUTYHup-regulatesTOPBP1binding
MUTYHup-regulatesBase-excision_repair

Enriched among interaction partners

Reactome pathways and GO biological processes over-represented among this gene’s 27 IntAct physical interaction partners (hypergeometric vs the genome-wide background, BH-FDR, gene-set size 15–500, ranked by fold). A functional readout of the neighbourhood — distinct from this gene’s own memberships above, and biased toward well-studied / hub proteins, so read it as themes rather than proof.

GO biological processes:

GO termPartnersFoldFDR
positive regulation of miRNA transcription558.1×1e-05
positive regulation of ERK1 and ERK2 cascade517.0×1e-03
DNA repair512.8×3e-03
negative regulation of cell population proliferation58.4×1e-02

Disease & clinical

Clinical variants and AI predictions

ClinVar

4186 variants total. Per-class counts are floors (≥ shown; pagination cap):

ClassificationCount (floor)
Pathogenic184
Likely pathogenic150
Uncertain significance1900
Likely benign1038
Benign108

Top pathogenic / likely-pathogenic (30)

Variant IDHGVSClassification
1045946NM_001048174.2(MUTYH):c.764_772del (p.Met255_Gly258delinsArg)Pathogenic
1050536NM_001048174.2(MUTYH):c.1393-51_*2delPathogenic
1068517NM_001048174.2(MUTYH):c.811C>T (p.Gln271Ter)Pathogenic
1069525NM_001048174.2(MUTYH):c.775dup (p.Ala259fs)Pathogenic
1070115NM_001048174.2(MUTYH):c.507del (p.Gly171fs)Pathogenic
1070581NM_001048174.2(MUTYH):c.148C>T (p.Gln50Ter)Pathogenic
1072128NM_001048174.2(MUTYH):c.1425del (p.Thr476fs)Pathogenic
1075894NM_001048174.2(MUTYH):c.310dup (p.Val104fs)Pathogenic
1076845NM_001048174.2(MUTYH):c.376_377del (p.Gln126fs)Pathogenic
127835NM_001048174.2(MUTYH):c.928C>T (p.Gln310Ter)Pathogenic
1352487NM_001048174.2(MUTYH):c.409del (p.Ala137fs)Pathogenic
1356072NM_001128425.2(MUTYH):c.177_178insCA (p.Glu60fs)Pathogenic
1364709NM_001048174.2(MUTYH):c.924_925del (p.Gly309fs)Pathogenic
1368442NM_001048174.2(MUTYH):c.541C>T (p.Gln181Ter)Pathogenic
1374111NM_001048174.2(MUTYH):c.779_780del (p.Thr260fs)Pathogenic
1395788NM_001048174.2(MUTYH):c.136del (p.Glu46fs)Pathogenic
1408238NM_001048174.2(MUTYH):c.1276C>T (p.Gln426Ter)Pathogenic
140827NM_001048174.2(MUTYH):c.205C>T (p.Arg69Ter)Pathogenic
140876NM_001048174.2(MUTYH):c.856C>T (p.Gln286Ter)Pathogenic
141379NM_001048174.2(MUTYH):c.49del (p.Ala17fs)Pathogenic
142604NM_001048174.2(MUTYH):c.1130C>T (p.Pro377Leu)Pathogenic
143003NM_001048174.2(MUTYH):c.655C>T (p.Arg219Ter)Pathogenic
1436665NM_001048174.2(MUTYH):c.300T>A (p.Tyr100Ter)Pathogenic
1441468NM_001048174.2(MUTYH):c.685del (p.Val230fs)Pathogenic
1452003NM_001048174.2(MUTYH):c.1160_1167dup (p.Lys390fs)Pathogenic
1454604NM_001048174.2(MUTYH):c.1185del (p.Glu395fs)Pathogenic
1455088NM_001048174.2(MUTYH):c.228C>G (p.Tyr76Ter)Pathogenic
1455631NM_001048174.2(MUTYH):c.684_702dup (p.Trp235fs)Pathogenic
1459595NM_001048174.2(MUTYH):c.627del (p.Asn210fs)Pathogenic
156509NM_001048174.2(MUTYH):c.1087C>T (p.Gln363Ter)Pathogenic

SpliceAI

2163 predictions. Top by Δscore:

VariantEffectΔscore
1:45329437:CCTG:Cacceptor_gain1.0000
1:45331222:T:TAdonor_gain1.0000
1:45331416:TTA:Tdonor_loss1.0000
1:45331417:TACCT:Tdonor_loss1.0000
1:45331418:A:ACdonor_gain1.0000
1:45331418:AC:Adonor_gain1.0000
1:45331418:ACCT:Adonor_gain1.0000
1:45331418:ACCTC:Adonor_gain1.0000
1:45331419:C:CTdonor_gain1.0000
1:45331419:CC:Cdonor_gain1.0000
1:45331419:CCT:Cdonor_gain1.0000
1:45331419:CCTC:Cdonor_gain1.0000
1:45331419:CCTCC:Cdonor_gain1.0000
1:45331552:CAGAC:Cacceptor_gain1.0000
1:45331553:AGAC:Aacceptor_gain1.0000
1:45331554:GAC:Gacceptor_gain1.0000
1:45331555:AC:Aacceptor_gain1.0000
1:45331556:CC:Cacceptor_gain1.0000
1:45331557:C:CCacceptor_gain1.0000
1:45332164:A:ACdonor_gain1.0000
1:45332165:C:CCdonor_gain1.0000
1:45332165:CT:Cdonor_gain1.0000
1:45332165:CTCT:Cdonor_gain1.0000
1:45332168:T:Adonor_gain1.0000
1:45332246:G:Cdonor_gain1.0000
1:45332308:CCC:Cacceptor_gain1.0000
1:45332309:CC:Cacceptor_gain1.0000
1:45332309:CCC:Cacceptor_gain1.0000
1:45332310:CC:Cacceptor_gain1.0000
1:45332758:CTTA:Cdonor_loss1.0000

AlphaMissense

0 scored. Top likely-pathogenic:

dbSNP variants (sampled 300 via entrez): RS1000047665 (1:45336022 A>G), RS1000260695 (1:45329414 G>A), RS1000609513 (1:45331010 G>A), RS1000623040 (1:45330159 G>C), RS1001144609 (1:45339009 C>T), RS1001379309 (1:45334630 A>C), RS1001390252 (1:45330624 C>T), RS1001416500 (1:45330397 C>T), RS1001667829 (1:45336118 C>T), RS1002437652 (1:45332754 T>C), RS1002637086 (1:45342032 G>A), RS1002936745 (1:45337865 G>T), RS1002995018 (1:45342425 G>A,C), RS1003048107 (1:45336349 C>T), RS1003275266 (1:45338190 T>C)

Disease associations

OMIM: gene MIM:604933 | disease phenotypes: MIM:608456, MIM:613659, MIM:132600, MIM:175100, MIM:114500, MIM:614969, MIM:120435, MIM:114480, MIM:167000, MIM:607259, MIM:155255, MIM:608089

GenCC curated gene-disease

DiseaseClassificationInheritance
familial adenomatous polyposis 2DefinitiveAutosomal recessive

ClinGen Gene-Disease Validity (6)

Expert-panel classifications — Definitive > Strong > Moderate > Limited > Disputed > Refuted.

DiseaseClassificationInheritance
familial ovarian cancerDisputedAR
familial ovarian cancerDisputedAD
familial adenomatous polyposis 2DefinitiveAR
hereditary breast carcinomaDisputedAR
colorectal cancerDisputedAD
hereditary breast carcinomaRefutedAD

Mondo (36): familial adenomatous polyposis 2 (MONDO:0012041), hereditary neoplastic syndrome (MONDO:0015356), gastric cancer (MONDO:0001056), colon carcinoma (MONDO:0002032), hereditary breast ovarian cancer syndrome (MONDO:0003582), breast carcinoma (MONDO:0004989), polyp of large intestine (MONDO:0021392), medulloblastoma SHH activated and TP53 wild-type (MONDO:0956965), pilomatrixoma (MONDO:0007564), gastric neoplasm (MONDO:0021085), familial adenomatous polyposis 1 (MONDO:0021056), diffuse midline glioma, H3 K27-altered (MONDO:1060171), hepatoblastoma (MONDO:0018666), colorectal cancer (MONDO:0005575), familial colorectal cancer (MONDO:0023113)

Orphanet (21): Attenuated familial adenomatous polyposis (Orphanet:220460), MUTYH-related polyposis (Orphanet:247798), Inherited cancer-predisposing syndrome (Orphanet:140162), Hereditary breast and/or ovarian cancer syndrome (Orphanet:145), Pilomatrixoma (Orphanet:91414), Hepatoblastoma (Orphanet:449), Pontocerebellar hypoplasia type 7 (Orphanet:284339), Familial colorectal cancer Type X (Orphanet:440437), Retinoblastoma (Orphanet:790), Lynch syndrome (Orphanet:144), Hereditary breast cancer (Orphanet:227535), Rare ovarian cancer (Orphanet:213500), Familial adenomatous polyposis (Orphanet:733), Spastic paraplegia type 7 (Orphanet:99013), Anaplastic/large cell medulloblastoma (Orphanet:251855)

HPO phenotypes

64 total (30 of 64 shown, HPO-id order):

HPOTerm
HP:0000007Autosomal recessive inheritance
HP:0000505Visual impairment
HP:0000708Atypical behavior
HP:0000716Depression
HP:0000737Irritability
HP:0000738Hallucinations
HP:0000739Anxiety
HP:0001123Visual field defect
HP:0001250Seizure
HP:0001252Hypotonia
HP:0001260Dysarthria
HP:0001276Hypertonia
HP:0001288Gait disturbance
HP:0001371Flexion contracture
HP:0001402Hepatocellular carcinoma
HP:0001442Typified by somatic mosaicism
HP:0001824Weight loss
HP:0002017Nausea and vomiting
HP:0002019Constipation
HP:0002024Malabsorption
HP:0002027Abdominal pain
HP:0002076Migraine
HP:0002167Abnormal speech pattern
HP:0002239Gastrointestinal hemorrhage
HP:0002354Memory impairment
HP:0002376Developmental regression
HP:0002516Increased intracranial pressure
HP:0002671Basal cell carcinoma
HP:0002893Pituitary adenoma
HP:0002894Neoplasm of the pancreas

GWAS associations

2 associations (top):

StudyTraitp-value
GCST008573_5Composite immunoglobulin trait (IgA/IgM)1.000000e-08
GCST010726_80Periventricular white matter hyperintensities4.000000e-06

EFO canonical traits (1, from GWAS)

EFO IDTrait name
EFO:0005665white matter hyperintensity measurement

MeSH disease descriptors (14)

DescriptorNameTree numbers
D003110Colonic NeoplasmsC04.588.274.476.411.307.180; C06.301.371.411.307.180; C06.405.249.411.307.180; C06.405.469.158.356.180; C06.405.469.491.307.180
D004806EpendymomaC04.557.465.625.600.380.290; C04.557.470.670.380.290; C04.557.580.625.600.380.290
D018197HepatoblastomaC04.557.435.380
D061325Hereditary Breast and Ovarian Cancer SyndromeC04.588.180.483; C04.588.322.455.431; C04.700.517; C12.050.351.500.056.630.705.431; C12.050.351.937.418.685.431; C12.100.250.056.630.705.431; C12.900.418.685.431; C16.320.700.517; C17.800.090.500.483; C19.344.410.431; C19.391.630.705.431
D008527MedulloblastomaC04.557.465.625.600.380.515; C04.557.465.625.600.590.500; C04.557.470.670.380.515; C04.557.470.670.590.500; C04.557.580.625.600.380.515; C04.557.580.625.600.590.500
D009386Neoplastic Syndromes, HereditaryC04.700; C16.320.700
D010051Ovarian NeoplasmsC04.588.322.455; C12.050.351.500.056.630.705; C12.050.351.937.418.685; C12.100.250.056.630.705; C12.900.418.685; C19.344.410; C19.391.630.705
D018296PilomatrixomaC04.557.470.565.625
D012175RetinoblastomaC04.557.465.625.600.725; C04.557.470.670.725; C04.557.580.625.600.725; C04.588.364.818.760; C11.270.862; C11.319.475.760; C11.768.717.760
D013274Stomach NeoplasmsC04.588.274.476.767; C06.301.371.767; C06.405.249.767; C06.405.748.789
C562840Breast Cancer, Familial (supp.)
C563924Colorectal Adenomatous Polyposis, Autosomal Recessive (supp.)
C537261Lynch syndrome I (site-specific colonic cancer) (supp.)
C564599Spastic Paraplegia 7, Autosomal Recessive (supp.)

Drugs & pharmacology

Drug and pharmacology data

Is drug target: yes

ChEMBL targets (1): CHEMBL5723574 (SINGLE PROTEIN)

PharmGKB: 1 entry (VIP=true, CPIC=false)

PharmGKB clinical annotations

2 annotations.

VariantTypeLevelDrugsPhenotypes
rs3219484Toxicity3cisplatin;cyclophosphamideOvarian Neoplasms
rs3219489Efficacy3cisplatin;fluorouracil;radiotherapyCarcinoma;Squamous Cell;Progression-free survival

PharmGKB variants

2 variants.

VariantGenesLevelScore#Clin annotsDrugs
rs3219484MUTYH33.001cisplatin;cyclophosphamide
rs3219489MUTYH33.751cisplatin;fluorouracil;radiotherapy

CTD chemical–gene interactions

46 total (human), top 30 by PubMed support.

ChemicalActions (top 5)PubMed papers
bisphenol Adecreases expression, decreases methylation2
Air Pollutantsaffects cotreatment, increases abundance, increases oxidation, decreases expression2
Phenylmercuric Acetateaffects cotreatment, decreases expression2
Particulate Matteraffects cotreatment, decreases expression, increases abundance2
aristolochic acid Iincreases expression1
FR900359decreases phosphorylation1
bisphenol Fdecreases expression1
myristicindecreases expression1
alpha-pineneaffects cotreatment, increases oxidation, increases abundance1
pirinixic acidincreases expression, affects binding, increases activity1
beta-lapachoneincreases expression1
cobaltous chloridedecreases expression1
potassium bromatedecreases expression1
methacrylaldehydeaffects cotreatment, increases oxidation, increases abundance1
beta-methylcholineaffects expression1
di-n-butylphosphoric acidaffects expression1
perfluorooctane sulfonic acidincreases expression1
perfluoro-n-nonanoic acidincreases expression1
pinostrobinincreases expression1
4-(5-benzo(1,3)dioxol-5-yl-4-pyridin-2-yl-1H-imidazol-2-yl)benzamideaffects cotreatment, decreases expression1
dorsomorphinaffects cotreatment, decreases expression1
bisphenol Sdecreases expression1
jinfukangaffects cotreatment, increases expression1
Bortezomibdecreases expression1
Arsenic Trioxideaffects activity1
Acroleinaffects cotreatment, increases oxidation, increases abundance1
Ethanoldecreases expression1
Arsenicaffects methylation1
Benzo(a)pyrenedecreases methylation, increases methylation1
Carbon Tetrachloridedecreases expression1

ChEMBL screening assays

1 unique, capped per target: 1 functional

Representative assays (with source publication via chembl_document):

Assay IDTypeDescriptionSource paper
CHEMBL5665446FunctionalInhibition of MUTYH by quantifying inhibition of MUTYH-mediated cleavage and dissociation of quenched duplex DNA oligonucleotides, measured as fluorescence at 594 nm. To generate a functional strand incision and increase turn-over this assaEnzyme Inhibitor Single Concentration assay results for EUbOPEN Chemogenomics Library

Cellosaurus cell lines

5 cell lines: 5 cancer cell line

First 10 cell lines (id-ordered, not curated):

CellosaurusNameCategorySex
CVCL_A1TTJIL-2266Cancer cell lineFemale
CVCL_B6PTJacketCancer cell lineMale
CVCL_E0IJUbigene HeLa MUTYH KOCancer cell lineFemale
CVCL_SZ48HAP1 MUTYH (-) 1Cancer cell lineMale
CVCL_SZ49HAP1 MUTYH (-) 2Cancer cell lineMale

Clinical trials (associated diseases)

300 trials via MONDO — disease-level, not drug-specific.

TrialPhaseStatusTitle
NCT00365508PHASE4COMPLETEDCounseling and Nicotine Replacement Therapy in Helping Adult Smokers Quit Smoking
NCT00558155PHASE4COMPLETEDThe Impact of Immunostimulating Nutrition on the Outcome of Surgery
NCT00576940PHASE4COMPLETEDStandard and Immunostimulating Enteral Nutrition in Surgical Patients
NCT00666978PHASE4COMPLETEDHealth Education Counseling With or Without Bupropion in Helping African Americans Stop Smoking
NCT01038154PHASE4UNKNOWNStudy to Evaluate the Efficacy of Pravastatin on Survival and Recurrence of Advanced Gastroesophageal Cancer
NCT01234272PHASE4COMPLETEDComparison of the Analgesic Effect Between Intrathecal Morphine and IV-fentanyl Patient Controlled Analgesia (ITM-IVPCA) and Epidural PCA (PCEA) in Patients Undergoing Gastrectomy -Randomized Allocation Study-
NCT01260194PHASE4TERMINATEDA Study of Herceptin (Trastuzumab) in Combination With Standard Chemotherapy in Patients With HER Positive Metastatic Gastric Cancer
NCT01271582PHASE4UNKNOWNInvestigation of Association Between UGT1A1 Polymorphisms and Irinotecan Toxicity in Korean Patients
NCT01401075PHASE4COMPLETEDRCT With Adjuvant Mistletoe Treatment in Gastric Cancer Patients
NCT01471756PHASE4COMPLETEDImproving Complete Endoscopic Mucosal Resection (EMR) of Colorectal Neoplasia
NCT01766765PHASE4UNKNOWNEarly Jejunostomy Nutrition Minimizes Time to Chemotherapy
NCT01910948PHASE4UNKNOWNPerioperative Application of Omega-3 Polyunsaturated Fatty Acids in Gastric Cancer Patients
NCT01927328PHASE4UNKNOWNIron Replacement in Oesophagogastric Neoplasia
NCT01962272PHASE4COMPLETEDThe Effect of Nutritional Counseling for Cancer Patients
NCT01962376PHASE4UNKNOWNPreoperative Chemotherapy With Bevacizumab For Potentially Resectable Gastric Cancer With Liver Metastasis
NCT02047994PHASE4RECRUITINGMulticentric Randomized Study of H. Pylori Eradication and Pepsinogen Testing for Prevention of Gastric Cancer Mortality
NCT02235246PHASE4COMPLETEDThe Effect of Perioperative Intravenous Magnesium on Pain After Endoscopic Submucosal Dissection for Gastric Neoplasm: Prospective Randomized Double-blind Placebo Controlled Study
NCT02366819PHASE4SUSPENDEDGenetic Analysis-Guided Irinotecan Hydrochloride Dosing of mFOLFIRINOX in Treating Patients With Locally Advanced Gastroesophageal or Stomach Cancer
NCT02401971PHASE4UNKNOWNIrinotecan Plus Thalidomide in Second Line Advanced Gastric Cancer
NCT02458573PHASE4COMPLETEDComparison of the Effects of Continuous Epidural Analgesia and Continuous Intravenous Analgesia on Postoperative Bowel Movement in Patients Undergoing Laparoscopic Gastrectomy
NCT02638584PHASE4COMPLETEDEffects of Ilaprazole on Ulcer Healing Rate and Prevention of Gastrointestinal Bleeding in the Patients Undergone ESD.
NCT02776527PHASE4UNKNOWNA Clinical Trial of Maintenance Treatment of Apatinib in Advanced Gastric Cancer Patients Have Completed Postoprative Adjuvant Chemotherapy
NCT03384511PHASE4COMPLETEDThe Use of 18F-ALF-NOTA-PRGD2 PET/CT Scan to Predict the Efficacy and Adverse Events of Apatinib in Malignancies.
NCT03550482PHASE4COMPLETEDOncoxin® and Quality of Life in Cancer Patients
NCT03609892PHASE4COMPLETEDHelicobacter Rescue Therapy With Berberine Plus Amoxicillin Quadruple Therapy Versus Tetracycline Plus Furazolidone Quadruple Therapy
NCT03642093PHASE4UNKNOWNHOPE - A Study to Evaluate the Effect of a Prehabilitation Program on GI Cancer Patients Planning to Undergo Surgery
NCT03733639PHASE4UNKNOWNTisseel® as a Reinforcement of Esophagojejunal Anastomoses
NCT04168346PHASE4NOT_YET_RECRUITINGPreoperative Intravenous Iron Therapy in Patients With Gastric Cancer
NCT04209933PHASE4COMPLETEDHelicobacter Pylori Eradication With Different Bismuth Quadruple Therapies
NCT04591028PHASE4WITHDRAWNA Study to Evaluate Indocyanine Green Lymphangiography to Improve Lymphadenectomy in Gastric Cancer Patients
NCT04607057PHASE4UNKNOWNSupplemental Parenteral Nutrition During Postgastrectomy in Nutritionally at Risk Patient
NCT04660123PHASE4COMPLETEDA Real World Study of Bismuth Colloidal Pectin Granules Quadruple Therapy for H. Pylori Eradication
NCT04678492PHASE4COMPLETEDHelicobacter Rescue Therapy With High-dose Esomeprazole and Amoxicillin Dual Therapy Versus Bismuth-containing Quadruple Therapy
NCT04697186PHASE4COMPLETEDHelicobacter Pylori Eradication With Berberine Plus Amoxicillin Triple Therapy Versus Bismuth-containing Quadruple Therapy
NCT05029453PHASE4UNKNOWNApatinib Combined With Chemotherapy Versus Chemotherapy in Second-line Gastric Cancer Receiving Prior Anti-PD-1 Therapy
NCT05183126PHASE4RECRUITINGPharmacokinetic Study of Skeletal Muscle Area-based Paclitaxel Infusion in Patients With Cancer
NCT05354856PHASE4TERMINATEDThe Effect of Chemoradiotherapy on Gastric Perfusion in Patients With Gastric Cancer.
NCT05410535PHASE4COMPLETEDTo Evaluate Efficacy of Ursodeoxycholic Acid (UDCA) for the Prevention of Gallstone Formation After Gasterectomy
NCT05498766PHASE4NOT_YET_RECRUITINGEffect and Safety of Huaier Granule Versus SOX Regimen in Gastric Cancer Patients
NCT05518929PHASE4COMPLETEDHypoxia During Gastroenterological Endoscope Procedures Sedated With Ciprofol In Overweight Or Obesity Patients