ABCD1

Chr X

ATP binding cassette subfamily D member 1

Also known as: ABC42, ALD, ALDP, AMN

The protein encoded by this gene is a member of the superfamily of ATP-binding cassette (ABC) transporters. ABC proteins transport various molecules across extra- and intra-cellular membranes. ABC genes are divided into seven distinct subfamilies (ABC1, MDR/TAP, MRP, ALD, OABP, GCN20, White). This protein is a member of the ALD subfamily, which is involved in peroxisomal import of fatty acids and/or fatty acyl-CoAs in the organelle. All known peroxisomal ABC transporters are half transporters which require a partner half transporter molecule to form a functional homodimeric or heterodimeric transporter. This peroxisomal membrane protein is likely involved in the peroxisomal transport or catabolism of very long chain fatty acids. Defects in this gene have been identified as the underlying cause of adrenoleukodystrophy, an X-chromosome recessively inherited demyelinating disorder of the nervous system. [provided by RefSeq, Jul 2008]

GeneReviewsResearchGenerating clinical summary…

Primary Disease Associations & Inheritance

UniProtAdrenoleukodystrophy

Clinical highlights

Gene-disease validity (ClinGen)
adrenoleukodystrophy · XLDefinitivesufficient evidence for diagnostic panels
Interpreting a novel variant
Loss of function is the curated mechanism (Gene2Phenotype) and the gene is intolerant of it in the population — truncating, frameshift and canonical splice variants carry more prior weight here than missense.Curated gene-level mechanism — a prior for triage, not a per-variant call.
7
Active trials
94
Pubs (1 yr)
P/LP submissions
P/LP missense
0.15
LOEUF· LoF intol.
LOF
Mechanism· G2P
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GeneReview available — ABCD1
Authoritative clinical overview · Recommended first read
Open GeneReview ↗
Some data sources returned errors (1)

omim: Error: OMIM fetch failed: 429

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

LoF intolerant — likely haploinsufficient
LoF Constraint?
0.15LOEUF
pLI 0.999
Z-score 4.13
OE 0.00 (0.000.15)
Highly constrained

Among the most LoF-intolerant genes (~top 3%)

Missense Constraint?
1.87Z-score
OE missense 0.72 (0.650.80)
250 obs / 347.9 exp
Tolerant

Mild missense constraint

Observed / Expected Ratios?
LoF OE?0.00 (0.000.15)
00.351.4
Missense OE?0.72 (0.650.80)
00.61.4
Synonymous OE?0.96
01.21.6
LoF obs/exp: 0 / 19.9Missense obs/exp: 250 / 347.9Syn Z: 0.44

ClinVar Variant Classifications

0 submitted variants in ClinVar

Protein Context — Lollipop Plot

ABCD1 · protein map & ClinVar variants

Showing all ClinVar variants across the protein. Search a specific variant to highlight its position.

VCEP specificationsPeroxisomal DisordersReleased
Panel ↗

Clinical Trials

Active and recruiting trials from ClinicalTrials.gov

X-linked Adrenoleukodystrophy

Quality of Life in Women With X-linked Adrenoleukodystrophy

RECRUITING
NCT04675749Leipzig University Medical CenterStarted 2019-12-01
Adrenomyeloneuropathy Without Cerebral Involvement

Epidural Spinal Cord Stimulation for Lower-limb Impairment in Adrenomyeloneuropathy

RECRUITING
NCT06796920Phase NAThird Military Medical UniversityStarted 2025-02-10
Spinal cord stimulation
AdrenoleukodystrophyAdrenomyeloneuropathyMetachromatic Leukodystrophy

Modeling Macrophages Activation Pattern in X-linked Adrenoleukodystrophy, Metachromatic Leukodystrophy and Adult Onset Leukoencephalopathy With Axonal Spheroids and Pigmented Glia

RECRUITING
NCT04925349Assistance Publique - Hôpitaux de ParisStarted 2021-08-30
Blood sample collection
X-linked Adrenoleukodystrophy

IT and IV Lentiviral Gene Therapy for X-ALD

NOT YET RECRUITING
NCT03727555Phase NAShenzhen Geno-Immune Medical InstituteStarted 2027-06-01
Intrathecal and intravenous LV gene therapy
Immune SystemStressChronic Stress

Impact of Peanut Consumption on Stress, Immune Function, Inflammation, and Cardiovascular Health in High-Stress Individuals

NOT YET RECRUITING
NCT07735221Phase NAUSDA, Western Human Nutrition Research CenterStarted 2026-09
Peanuts, roasted, salted with skinsIsocaloric food
LeukodystrophyWhite Matter DiseaseLeukoencephalopathies

The Myelin Disorders Biorepository Project

RECRUITING
NCT03047369Children's Hospital of PhiladelphiaStarted 2016-12-08
X-linked Adrenoleukodystrophy

Registry of X-linked Adrenoleukodystrophy

RECRUITING
NCT05939232Beijing Tiantan HospitalStarted 2023-07-20