ACR

Chr 22AR

acrosin

Also known as: SPGF87

Acrosin is a serine protease that facilitates sperm penetration through the zona pellucida during fertilization by lysing the glycoprotein layers surrounding the ovum. Mutations cause spermatogenic failure with autosomal recessive inheritance. This gene is not highly constrained against loss-of-function variants, consistent with its specialized role in male fertility rather than essential developmental processes.

GeneReviewsOMIMResearchSummary from RefSeq, OMIM, UniProt
MultiplemechanismARLOEUF 0.881 OMIM phenotype
Clinical SummaryACR
Population Constraint (gnomAD)
Low constraint (pLI 0.01) — loss-of-function variants are relatively tolerated in the population.
📋
ClinVar Variants
167 unique Pathogenic / Likely Pathogenic· 78 VUS of 262 total submissions
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Clinical Trials
12 active or recruiting trials — potential therapeutic options may be available
📖
GeneReview available — ACR
Authoritative clinical overview · Recommended first read
Open GeneReview ↗

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Tolerant — LoF & missense variants common in population
LoF Constraint
0.88LOEUF
pLI 0.012
Z-score 1.86
OE 0.42 (0.220.88)
Tolerant

Typical tolerance to LoF variation

Missense Constraint
0.45Z-score
OE missense 0.92 (0.821.03)
215 obs / 234.3 exp
Tolerant

Mild missense constraint

Observed / Expected Ratios
LoF OE0.42 (0.220.88)
00.351.4
Missense OE0.92 (0.821.03)
00.61.4
Synonymous OE1.30
01.21.6
LoF obs/exp: 5 / 11.9Missense obs/exp: 215 / 234.3Syn Z: -2.34
DN
0.7036th %ile
GOF
0.6541th %ile
LOF
0.3162th %ile

This gene has evidence for multiple mechanisms of pathogenicity (dominant-negative and gain-of-function). Both the Badonyi & Marsh prediction and the broader genomic evidence point to dominant-negative as the predominant mechanism. Different variants in this gene may act through different mechanisms — interpret in context of the specific variant.

DNprediction above median
GOFprediction above median

Note: In-silico variant effect predictors (SIFT, PolyPhen, REVEL, CADD) may underestimate pathogenicity of missense variants in genes with GOF or DN mechanisms. Consider functional evidence and clinical context.

Predictions from Badonyi M, Marsh JA. PLoS ONE. 2024;19(8):e0307312.

ClinVar Variant Classifications

262 submitted variants in ClinVar

Classification Summary

Pathogenic166
Likely Pathogenic1
VUS78
Likely Benign6
Benign6
Conflicting1
166
Pathogenic
1
Likely Pathogenic
78
VUS
6
Likely Benign
6
Benign
1
Conflicting

Curated Variants Distribution

Classified variants from ClinVar · 5 ACMG categories

ClassificationLoFMissense + InframeNon-codingSynonymousTotal
Pathogenic
1
0
165
0
166
Likely Pathogenic
0
0
1
0
1
VUS
0
69
9
0
78
Likely Benign
0
5
0
1
6
Benign
0
3
3
0
6
Conflicting
1
Total1771781258

LoF = frameshift, stop gained/lost, canonical splice · Counts from ClinVar esearch · Updated hourly

View in ClinVar →

Protein Context — Lollipop Plot

ACR · protein map & ClinVar variants

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

3D Protein StructureAlphaFold

Clinical Trials

Active and recruiting trials from ClinicalTrials.gov

Systemic SclerosisScleroderma

Determine Effectiveness of Anifrolumab In SYstemic Sclerosis (DAISY)

ACTIVE NOT RECRUITING
NCT05925803Phase PHASE3AstraZenecaStarted 2023-11-08
Anifrolumab (blinded)Placebo (blinded)Anifrolumab (unblinded, open label)
ArthritisArthritis, Juvenile IdiopathicArthritis,Rheumatoid

Pain in Inflammatory Joint Diseases

RECRUITING
NCT06718569Diakonhjemmet HospitalStarted 2025-11-11
Biological or targeted synthetic DMARD
SLE (Systemic Lupus)Lupus Erythematosus, SystemicLupus Nephritis

A Safety and Efficacy Study Evaluating CTX112 in Adult Subjects With Refractory Autoimmune Disease

RECRUITING
NCT06925542Phase PHASE1CRISPR TherapeuticsStarted 2025-03-10
CTX112
Antibody-mediated RejectionLung Transplant Rejection

A Prospective Randomized Trial of ECP in Subclinical AMR

RECRUITING
NCT06112951Phase NAMedical University of ViennaStarted 2024-03-01
Extracorporeal Photopheresis
Chronic Kidney DiseasesMAFLD

Pathogenesis of Chronic Kidney Disease Associated With Metabolic Dysfunction- Associated Fatty Liver Disease (MAFLD) and Treatment Response of Oral Semaglutide.

NOT YET RECRUITING
NCT07391267Phase NAInstitute of Liver and Biliary Sciences, IndiaStarted 2026-02-01
Semaglutide Oral TabletPlaceboStandard medical treatment
Lung Transplant Rejection

Developing Hyperpolarized Gas MRI Signatures to Detect and Manage Acute Cellular Rejection

RECRUITING
NCT07046910Phase PHASE2University of VirginiaStarted 2019-04-01
Sub study (Active): Two Lung MRI study with two navigational BronchoscopyHyperpolarized Xenon129
FibromyalgiaDuloxetine

Duloxetine Metabolism and Fibromyalgia

RECRUITING
NCT06866444University of UtahStarted 2025-05-01
Observational
Diabetic Kidney Disease

Role of Finerenone in African American Veterans With Diabetic Kidney Disease

NOT YET RECRUITING
NCT07155694Phase PHASE4Washington D.C. Veterans Affairs Medical CenterStarted 2025-09
Finerenone 10 MGEmpagliflozin 10 MG
Systemic Lupus Erythematosus

" TREX1 Gene Mutations and Their Role in Systemic Lupus Erythematosus

RECRUITING
NCT07397728South Valley UniversityStarted 2025-06-10
TREX1 gene polymorphisms
Cardiac FailureGraft Rejection

OPtimal Adult Heart Transplant Immunosuppression With MicroRNA Levels

RECRUITING
NCT06939751Inova Health Care ServicesStarted 2025-10-28
Sickle Cell Disease (SCD)

Study of Two Doses of Crizanlizumab Versus Placebo in Adolescent and Adult Sickle Cell Disease Patients

ACTIVE NOT RECRUITING
NCT03814746Phase PHASE3Novartis PharmaceuticalsStarted 2019-07-26
Crizanlizumab (SEG101)Placebo
Diffuse Cutaneous Systemic Sclerosis

EncompaSSc: Evaluation of MTX-474 in Participants With Diffuse Cutaneous Systemic Sclerosis (dcSSc)

RECRUITING
NCT07287670Phase PHASE2Mediar TherapeuticsStarted 2026-05
MTX-474Placebo
Clinical Literature
Open Research Assistant →
Full-Text Mentions
NLP-detected gene mentions in article bodies · via PubTator3
PubTator3
Top 5 full-text resultsSearch PubTator3 ↗