NSMCE1

gene
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Also known as NSE1

Summary

NSMCE1 (NSE1 component of SMC5/6 complex, HGNC:29897) is a protein-coding gene on chromosome 16p12.1, encoding Non-structural maintenance of chromosomes element 1 homolog (Q8WV22). RING-type zinc finger-containing E3 ubiquitin ligase that assembles with melanoma antigen protein (MAGE) to catalyze the direct transfer of ubiquitin from E2 ubiquitin-conjugating enzyme to a specific substrate. It is a selective cancer dependency (DepMap: 60.3% of cell lines).

Enables protein dimerization activity and ubiquitin protein ligase activity. Involved in DNA damage response. Located in nucleoplasm. Part of Smc5-Smc6 complex.

Source: NCBI Gene 197370 — RefSeq curated summary.

At a glance

  • GWAS associations: 11
  • Clinical variants (ClinVar): 44 total
  • Cancer dependency (DepMap): dependent in 60.3% of screened cell lines
  • MANE Select transcript: NM_145080

Identifiers

Gene identifiers

FieldValue
HGNC IDHGNC:29897
Approved symbolNSMCE1
NameNSE1 component of SMC5/6 complex
Location16p12.1
Locus typegene with protein product
StatusApproved
AliasesNSE1
Ensembl geneENSG00000169189
Ensembl biotypeprotein_coding
OMIM617263
Entrez197370

Gene structure

Transcript identifiers

Ensembl transcripts: 30 — 22 protein_coding, 3 retained_intron, 3 protein_coding_CDS_not_defined, 2 nonsense_mediated_decay

ENST00000361439, ENST00000561960, ENST00000562039, ENST00000563273, ENST00000563512, ENST00000563900, ENST00000564342, ENST00000565070, ENST00000565384, ENST00000565626, ENST00000566087, ENST00000567375, ENST00000567710, ENST00000569236, ENST00000869097, ENST00000869098, ENST00000869099, ENST00000869100, ENST00000869101, ENST00000869102, ENST00000869103, ENST00000869104, ENST00000869105, ENST00000933463, ENST00000933464, ENST00000933465, ENST00000933466, ENST00000961548, ENST00000961549, ENST00000961550

RefSeq mRNA: 1 — MANE Select: NM_145080 NM_145080

CCDS: CCDS10628

Canonical transcript exons

ENST00000361439 — 8 exons

ExonStartEnd
ENSE000025997132722499427225236
ENSE000026149802726870627268772
ENSE000035102372723517827235299
ENSE000035165532722572627225846
ENSE000035776042723300127233147
ENSE000035938192722672027226836
ENSE000036016872725743527257581
ENSE000036615472723418827234265

Expression profiles

Bgee: expression breadth ubiquitous, 254 present calls, max score 96.75.

FANTOM5 (CAGE): breadth ubiquitous, TPM avg 38.5073 / max 509.6753, expressed in 1820 samples.

FANTOM5 promoters (3 alternative TSS)

Promoter IDTPM avgSamples expressed
15683438.08791820
1568240.346395
1568250.073131

Top tissues by expression

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

TissueAnatomy IDExpression scoreQuality
right testisUBERON:000453496.75gold quality
left testisUBERON:000453396.74gold quality
kidney epitheliumUBERON:000481996.46gold quality
ganglionic eminenceUBERON:000402396.41gold quality
right adrenal glandUBERON:000123396.37gold quality
right adrenal gland cortexUBERON:003582796.33gold quality
right coronary arteryUBERON:000162596.27gold quality
mucosa of transverse colonUBERON:000499196.13gold quality
lower esophagus muscularis layerUBERON:003583396.13gold quality
lower esophagusUBERON:001347396.11gold quality
left adrenal glandUBERON:000123496.05gold quality
left adrenal gland cortexUBERON:003582596.04gold quality
esophagogastric junction muscularis propriaUBERON:003584196.03gold quality
testisUBERON:000047395.88gold quality
spermCL:000001995.79gold quality
adrenal cortexUBERON:000123595.74gold quality
C1 segment of cervical spinal cordUBERON:000646995.68gold quality
popliteal arteryUBERON:000225095.57gold quality
tibial arteryUBERON:000761095.56gold quality
left coronary arteryUBERON:000162695.54gold quality
coronary arteryUBERON:000162195.52gold quality
islet of LangerhansUBERON:000000695.40gold quality
ventricular zoneUBERON:000305395.37gold quality
aortaUBERON:000094795.22gold quality
smooth muscle tissueUBERON:000113595.21gold quality
adrenal glandUBERON:000236995.21gold quality
mucosa of stomachUBERON:000119995.17gold quality
upper arm skinUBERON:000426395.08gold quality
prostate glandUBERON:000236795.06gold quality
spinal cordUBERON:000224095.02gold quality

Single-cell (SCXA)

Detected in 4 experiment(s), a significant marker in 3.

ExperimentMarker?Max mean expression
E-HCAD-4yes65.75
E-MTAB-8410yes9.95
E-MTAB-7606no553.61
E-ANND-3no0.00

Regulation

Is transcription factor: no

Upstream regulators (CollecTRI, top): NR1I2

miRNA regulators (miRDB)

6 targeting NSMCE1, top 30 by miRDB confidence (max_score; target_count = how many genes the miRNA targets in total — lower means more specific):

miRNAMax scoreAvg scoremiRNA target_count
HSA-MIR-6875-3P99.8270.262983
HSA-MIR-6840-3P98.6865.951923
HSA-MIR-299-5P98.5671.141140
HSA-MIR-208A-3P95.8766.51397
HSA-MIR-208B-3P95.8766.56396
HSA-MIR-433-5P94.6764.8299

Functional genomics

DepMap (CRISPR cell-line fitness): dependent in 60.3% of screened cell lines.

Literature-anchored findings (GeneRIF, showing 3)

  • Nse1 RING-like motif is a protein-protein interaction domain required for Smc5-Smc6 holocomplex integrity and recruitment to, or retention at, DNA lesions (PMID:18667531)
  • Molecular Insights into the Architecture of the Human SMC5/6 Complex. (PMID:32389690)
  • Crucial role of the NSE1 RING domain in Smc5/6 stability and FANCM-independent fork progression. (PMID:38847937)

Cross-species orthologs

5 orthologs

OrganismSymbolGene ID
danio_rerionsmce1ENSDARG00000098780
mus_musculusNsmce1ENSMUSG00000030750
rattus_norvegicusNsmce1ENSRNOG00000015218
drosophila_melanogasterNse1FBGN0031848
caenorhabditis_elegansnse-1WBGENE00020843

Protein

Protein identifiers

Non-structural maintenance of chromosomes element 1 homologQ8WV22 (reviewed: Q8WV22)

All UniProt accessions (7): Q8WV22, H3BN81, H3BR31, H3BR73, H3BSL0, H3BV05, I3L1I3

UniProt curated annotations — full annotation on UniProt →

Function. RING-type zinc finger-containing E3 ubiquitin ligase that assembles with melanoma antigen protein (MAGE) to catalyze the direct transfer of ubiquitin from E2 ubiquitin-conjugating enzyme to a specific substrate. Within MAGE-RING ubiquitin ligase complex, MAGE stimulates and specifies ubiquitin ligase activity likely through recruitment and/or stabilization of the E2 ubiquitin-conjugating enzyme at the E3:substrate complex. Involved in maintenance of genome integrity, DNA damage response and DNA repair. NSMCE3/MAGEG1 and NSMCE1 ubiquitin ligase are components of SMC5-SMC6 complex and may positively regulate homologous recombination-mediated DNA repair. MAGEF1-NSMCE1 ubiquitin ligase promotes proteasomal degradation of MMS19, a key component of the cytosolic iron-sulfur protein assembly (CIA) machinery. Down-regulation of MMS19 impairs the activity of several DNA repair and metabolism enzymes such as ERCC2/XPD, FANCJ, RTEL1 and POLD1 that require iron-sulfur clusters as cofactors.

Subunit / interactions. Component of the SMC5-SMC6 complex which consists at least of SMC5, SMC6, NSMCE2, NSMCE1, NSMCE4A or EID3 and NSMCE3. NSMCE1, NSMCE4A or EID3 and NSMCE3 probably form a subcomplex that bridges the head domains of the SMC5-SMC6 heterodimer. Interacts with NSMCE3. Interacts with MAGEF1.

Subcellular location. Nucleus. Chromosome. Telomere.

Post-translational modifications. Ubiquitinated.

Similarity. Belongs to the NSE1 family.

RefSeq proteins (1): NP_659547* (*=MANE)

Domains & families (InterPro)

IDNameType
IPR001841Znf_RINGDomain
IPR002219PKC_DAG/PEDomain
IPR011513Nse1Family
IPR013083Znf_RING/FYVE/PHDHomologous_superfamily
IPR014857Nse1_RING_C4HC3-typeDomain
IPR036388WH-like_DNA-bd_sfHomologous_superfamily

Pfam: PF07574, PF08746

UniProt features (34 total): helix 11, strand 10, turn 5, region of interest 2, sequence variant 2, chain 1, zinc finger region 1, compositionally biased region 1, modified residue 1

Structure

Experimental structures (PDB)

6 structures.

PDBMethodResolution (Å)
5WY5X-RAY DIFFRACTION2.92
5HVQX-RAY DIFFRACTION2.92
9LWIELECTRON MICROSCOPY3.12
9LWJELECTRON MICROSCOPY7.19
9LWLELECTRON MICROSCOPY7.25
2CT0SOLUTION NMR

Predicted structure (AlphaFold)

ModelpLDDTFraction very-high
AF-Q8WV22-F189.410.80

Functional residue map

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

Post-translational modifications (1): 251

Function

Pathways and Gene Ontology

Reactome pathways

1 pathways

IDPathway
R-HSA-3108214SUMOylation of DNA damage response and repair proteins

MSigDB gene sets: 186 (showing top): GSE45365_NK_CELL_VS_CD11B_DC_DN, GOBP_CHROMOSOME_ORGANIZATION, GRAESSMANN_APOPTOSIS_BY_DOXORUBICIN_DN, GRAESSMANN_RESPONSE_TO_MC_AND_DOXORUBICIN_DN, GOBP_TELOMERE_ORGANIZATION, GOBP_REGULATION_OF_TELOMERE_MAINTENANCE, GOBP_PEPTIDYL_LYSINE_MODIFICATION, GOBP_PROTEIN_SUMOYLATION, GOBP_DNA_DAMAGE_RESPONSE, GOBP_POST_TRANSLATIONAL_PROTEIN_MODIFICATION, GOBP_REGULATION_OF_CHROMOSOME_ORGANIZATION, GOBP_RECOMBINATIONAL_REPAIR, GRYDER_PAX3FOXO1_ENHANCERS_IN_TADS, MARTORIATI_MDM4_TARGETS_FETAL_LIVER_UP, GOCC_SPINDLE

GO Biological Process (7): double-strand break repair via homologous recombination (GO:0000724), DNA damage response (GO:0006974), protein sumoylation (GO:0016925), regulation of telomere maintenance (GO:0032204), chromatin looping (GO:0140588), DNA repair (GO:0006281), DNA recombination (GO:0006310)

GO Molecular Function (7): ubiquitin-protein transferase activity (GO:0004842), zinc ion binding (GO:0008270), protein dimerization activity (GO:0046983), ubiquitin protein ligase activity (GO:0061630), protein binding (GO:0005515), transferase activity (GO:0016740), metal ion binding (GO:0046872)

GO Cellular Component (7): chromosome, centromeric region (GO:0000775), chromosome, telomeric region (GO:0000781), nucleus (GO:0005634), nucleoplasm (GO:0005654), Smc5-Smc6 complex (GO:0030915), mitotic spindle pole (GO:0097431), chromosome (GO:0005694)

Reactome top-level categories

Rollup of top-1 pathways:

CategoryPathways
SUMO E3 ligases SUMOylate target proteins1

GO top-level categories

Rollup of top GO terms by namespace:

CategoryTerms
DNA metabolic process2
chromosomal region2
recombinational repair1
double-strand break repair1
cellular response to stress1
peptidyl-lysine modification1
protein modification by small protein conjugation1
telomere maintenance1
regulation of chromosome organization1
regulation of DNA metabolic process1
chromatin organization1
DNA damage response1
ubiquitin-like protein transferase activity1
transition metal ion binding1
protein binding1
ubiquitin-protein transferase activity1
ubiquitin-like protein ligase activity1
binding1
catalytic activity1
cation binding1
intracellular membrane-bounded organelle1
nuclear lumen1
cellular anatomical structure1
condensed chromosome1
SUMO ligase complex1
spindle pole1
mitotic spindle1
intracellular membraneless organelle1

Protein interactions and networks

STRING

1068 interactions, top by confidence (×1000):

Protein AProtein BPartner UniProtScore
NSMCE1NSMCE4AQ9NXX6803
NSMCE1NSMCE2Q96MF7795
NSMCE1SMC6Q96SB8788
NSMCE1NSMCE3Q96MG7673
NSMCE1SMC5Q8IY18667
NSMCE1SLF1Q9BQI6593
NSMCE1MAGEB18Q96M61435
NSMCE1DCAF1Q9Y4B6433
NSMCE1STYK1Q6J9G0431
NSMCE1SLF2Q8IX21428
NSMCE1RNF151Q2KHN1396
NSMCE1HLTFQ14527391
NSMCE1STPG4Q8N801391
NSMCE1MAIP1Q8WWC4389
NSMCE1RNF168Q8IYW5379

IntAct

59 interactions, top by confidence:

ABTypeScore
NSMCE3NSMCE1psi-mi:“MI:0915”(physical association)0.970
NSMCE3NSMCE1psi-mi:“MI:0407”(direct interaction)0.970
NSMCE1NSMCE3psi-mi:“MI:0407”(direct interaction)0.970
NSMCE3NSMCE1psi-mi:“MI:0914”(association)0.970
NSMCE1NSMCE3psi-mi:“MI:0915”(physical association)0.970
NSMCE1NSMCE3psi-mi:“MI:0403”(colocalization)0.970
SMC6SMC5psi-mi:“MI:0914”(association)0.860
EID3NSMCE1psi-mi:“MI:0915”(physical association)0.830
EID3NSMCE1psi-mi:“MI:0914”(association)0.830
NSMCE3EID3psi-mi:“MI:0914”(association)0.820
SMC6NSMCE1psi-mi:“MI:0915”(physical association)0.810
NSMCE1SMC6psi-mi:“MI:0915”(physical association)0.810
NSMCE1SMC5psi-mi:“MI:0914”(association)0.760
NSMCE1SMC5psi-mi:“MI:0915”(physical association)0.760
EID3SMC5psi-mi:“MI:0915”(physical association)0.740
NSMCE4ANSMCE1psi-mi:“MI:0914”(association)0.740
NSMCE1NSMCE2psi-mi:“MI:0914”(association)0.710
NSMCE3PJA1psi-mi:“MI:0914”(association)0.710
ZNF597TASOR2psi-mi:“MI:0914”(association)0.640

BioGRID (125): SMC6 (Affinity Capture-MS), NSMCE2 (Affinity Capture-MS), NDNL2 (Affinity Capture-MS), SMC5 (Affinity Capture-MS), PMF1 (Affinity Capture-MS), SIMC1 (Affinity Capture-MS), FAM178A (Affinity Capture-MS), NSMCE4A (Affinity Capture-MS), NSMCE1 (Affinity Capture-MS), NSMCE1 (Affinity Capture-MS), NSMCE1 (Affinity Capture-MS), NDNL2 (Co-fractionation), NSMCE1 (Co-fractionation), SMC5 (Co-fractionation), SMC6 (Co-fractionation)

ESM2 similar proteins: O01757, O13873, O42857, O60072, O74462, O74967, O94553, O94663, P32910, P36617, P40555, P41810, P53914, P87157, P87303, P91529, Q02939, Q09760, Q10410, Q12483, Q19555, Q2TBL4, Q3T0X7, Q499U6, Q54NQ0, Q54S43, Q5RAZ5, Q6BGW8, Q6BZX4, Q6CLR2, Q6FM46, Q6FP41, Q6FWT4, Q75B51, Q84K16, Q86JM3, Q8WV22, Q9BUI4, Q9C106, Q9D483

Diamond homologs: Q3T0X7, Q499U6, Q53EK2, Q5RAZ5, Q6DGT7, Q6P881, Q6PAF4, Q8WV22, Q9D720, Q9VMA0

SIGNOR signaling

3 interactions.

AEffectBMechanism
Ub:E2“up-regulates activity”NSMCE1ubiquitination
NSMCE1“form complex”SMC5/6binding
NSMCE3“up-regulates activity”NSMCE1binding

Enriched among interaction partners

Reactome pathways and GO biological processes over-represented among this gene’s 34 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.

Reactome pathways:

PathwayPartnersFoldFDR
SUMOylation of DNA damage response and repair proteins850.9×3e-10

GO biological processes:

GO termPartnersFoldFDR
regulation of telomere maintenance6168.5×8e-11
protein sumoylation664.8×2e-08
double-strand break repair via homologous recombination841.6×9e-10
DNA damage response610.7×5e-04
DNA repair510.6×2e-03
protein ubiquitination56.9×8e-03

Disease & clinical

Clinical variants and AI predictions

ClinVar

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

ClassificationCount (floor)
Pathogenic0
Likely pathogenic0
Uncertain significance36
Likely benign3
Benign0

Top pathogenic / likely-pathogenic (0)

SpliceAI

1799 predictions. Top by Δscore:

VariantEffectΔscore
16:27225724:A:ACdonor_gain1.0000
16:27225725:C:CCdonor_gain1.0000
16:27226832:TCCTT:Tacceptor_gain1.0000
16:27226833:CCTTC:Cacceptor_gain1.0000
16:27226834:CTT:Cacceptor_gain1.0000
16:27226836:TCTGC:Tacceptor_loss1.0000
16:27226837:C:CCacceptor_gain1.0000
16:27226837:CTG:Cacceptor_loss1.0000
16:27232996:AGTAC:Adonor_loss1.0000
16:27232997:GTACC:Gdonor_loss1.0000
16:27232998:TA:Tdonor_loss1.0000
16:27232999:ACCTC:Adonor_loss1.0000
16:27233000:C:CGdonor_loss1.0000
16:27233050:T:TAdonor_gain1.0000
16:27233143:TCCAG:Tacceptor_gain1.0000
16:27233144:CCAG:Cacceptor_gain1.0000
16:27233144:CCAGC:Cacceptor_gain1.0000
16:27233145:CAG:Cacceptor_gain1.0000
16:27233145:CAGC:Cacceptor_gain1.0000
16:27233146:A:Tacceptor_gain1.0000
16:27233146:AG:Aacceptor_gain1.0000
16:27233147:GCTGG:Gacceptor_loss1.0000
16:27233148:C:CCacceptor_gain1.0000
16:27233148:C:Tacceptor_loss1.0000
16:27234186:A:ACdonor_gain1.0000
16:27234186:ACAG:Adonor_gain1.0000
16:27234186:ACAGC:Adonor_gain1.0000
16:27234187:C:CCdonor_gain1.0000
16:27234187:CAG:Cdonor_gain1.0000
16:27234187:CAGC:Cdonor_gain1.0000

AlphaMissense

1778 scored. Top likely-pathogenic:

VariantProtein changeam_pathogenicity
16:27233008:A:GL159P0.999
16:27225744:A:GW235R0.998
16:27225744:A:TW235R0.998
16:27225765:A:GC228R0.998
16:27225804:A:GC215R0.998
16:27226748:C:TC191Y0.998
16:27226749:A:GC191R0.998
16:27233012:A:GW158R0.998
16:27233012:A:TW158R0.998
16:27225837:A:GC204R0.997
16:27226747:G:CC191W0.997
16:27233098:A:TI129K0.997
16:27257524:C:GR16P0.997
16:27225742:C:AW235C0.996
16:27225742:C:GW235C0.996
16:27225764:C:GC228S0.996
16:27225765:A:TC228S0.996
16:27225802:G:CC215W0.996
16:27225803:C:GC215S0.996
16:27225804:A:TC215S0.996
16:27225836:C:TC204Y0.996
16:27233035:A:GL150P0.996
16:27257515:A:GL19P0.996
16:27225803:C:TC215Y0.995
16:27226738:A:CC194W0.995
16:27226748:C:AC191F0.995
16:27226748:C:GC191S0.995
16:27226749:A:TC191S0.995
16:27233095:A:GL130S0.995
16:27233098:A:CI129R0.995

dbSNP variants (sampled 300 via entrez): RS1000007600 (16:27268950 C>T), RS1000103418 (16:27269234 C>G), RS1000142522 (16:27270291 C>A,G,T), RS1000157953 (16:27243843 G>A,C), RS1000169719 (16:27235790 G>A), RS1000235931 (16:27233128 G>A), RS1000236847 (16:27262968 G>C), RS1000351822 (16:27264529 T>C), RS1000413472 (16:27227161 G>A), RS1000455992 (16:27231453 A>G), RS1000573565 (16:27262973 A>T), RS1000804461 (16:27255989 T>C,G), RS1000807504 (16:27237743 T>A,C), RS1000842789 (16:27238224 C>T), RS1000926019 (16:27243069 G>A)

Disease associations

OMIM: gene MIM:617263 | disease phenotypes:

GenCC curated gene-disease

Mondo (0):

Orphanet (0):

HPO phenotypes

0 total (0 of 0 shown, HPO-id order):

GWAS associations

11 associations (top):

StudyTraitp-value
GCST003542_67Night sleep phenotypes4.000000e-06
GCST003875_18Gut microbiota (bacterial taxa)2.000000e-09
GCST004482_117Peripheral arterial disease (traffic-related air pollution interaction)4.000000e-08
GCST007732_9Allergic disease (asthma, hay fever or eczema)5.000000e-06
GCST007941_30Medication use (adrenergics, inhalants)3.000000e-08
GCST008916_121Asthma2.000000e-17
GCST008916_3Asthma1.000000e-12
GCST009798_29Asthma3.000000e-08
GCST009798_58Asthma3.000000e-09
GCST009798_64Asthma4.000000e-17
GCST009798_67Asthma5.000000e-11

EFO canonical traits (5, from GWAS)

EFO IDTrait name
EFO:0007827nighttime rest measurement
EFO:0007874gut microbiome measurement
EFO:0007883taxonomic microbiome measurement
EFO:0007908traffic air pollution measurement
EFO:0009941Inhalant adrenergic use measurement

Drugs & pharmacology

Drug and pharmacology data

Is drug target: no

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

CTD chemical–gene interactions

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

ChemicalActions (top 5)PubMed papers
sodium arseniteincreases abundance, increases expression, decreases expression, affects cotreatment2
(+)-JQ1 compounddecreases expression2
TAK-243increases sumoylation1
bufotalindecreases expression1
tris(2-butoxyethyl) phosphateaffects expression1
beta-lapachoneincreases expression1
arseniteaffects binding, increases reaction1
manganese chlorideaffects cotreatment, increases abundance, increases expression1
benzo(e)pyreneincreases methylation1
beta-methylcholineaffects expression1
di-n-butylphosphoric acidaffects expression1
perfluorooctane sulfonic acidincreases expression1
CGP 52608affects binding, increases reaction1
CPG-oligonucleotidedecreases expression1
ICG 001increases expression1
bisphenol Saffects cotreatment, increases expression1
jinfukangincreases expression1
4-(4-((5-(4,5-dimethyl-2-nitrophenyl)-2-furanyl)methylene)-4,5-dihydro-3-methyl-5-oxo-1H-pyrazol-1-yl)benzoic acidincreases expression1
Resveratrolaffects cotreatment, increases expression1
Arsenicaffects cotreatment, increases abundance, increases expression1
Benzo(a)pyreneaffects methylation1
Dexamethasoneincreases expression, affects cotreatment1
Dimethyl Sulfoxideincreases expression1
Indomethacinaffects cotreatment, increases expression1
Manganeseaffects cotreatment, increases abundance, increases expression1
Methapyrileneincreases methylation1
Plant Extractsaffects cotreatment, increases expression1
Thiramdecreases expression1
Tunicamycinincreases expression1
Urethanedecreases expression1

Clinical trials (associated diseases)

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

  • Disease cohort memberships (association, not causation — diseases whose associated-gene cohort lists this gene; a subset are also under Associated diseases): peripheral arterial disease