ALPL

Chr 1

alkaline phosphatase, biomineralization associated

Also known as: AP-TNAP, APTNAP, HOPS, HPPA, HPPC, HPPI, HPPO, TNALP

This gene encodes a member of the alkaline phosphatase family of proteins. There are at least four distinct but related alkaline phosphatases: intestinal, placental, placental-like, and liver/bone/kidney (tissue non-specific). The first three are located together on chromosome 2, while the tissue non-specific form is located on chromosome 1. The product of this gene is a membrane bound glycosylated enzyme that is not expressed in any particular tissue and is, therefore, referred to as the tissue-nonspecific form of the enzyme. Alternative splicing results in multiple transcript variants, at least one of which encodes a preproprotein that is proteolytically processed to generate the mature enzyme. This enzyme may play a role in bone mineralization. Mutations in this gene have been linked to hypophosphatasia, a disorder that is characterized by hypercalcemia and skeletal defects. [provided by RefSeq, Oct 2015]

GeneReviewsResearchGenerating clinical summary…
LOFmechanismLOEUF 0.69
Clinical SummaryALPL
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Gene-Disease Validity (ClinGen)
ALPL-related autosomal dominant hypophosphatasia · ADDefinitive

Definitive — sufficient evidence for diagnostic panels

2 total gene-disease associations curated

Population Constraint (gnomAD)
Low constraint (pLI 0.00) — loss-of-function variants are relatively tolerated in the population.
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ClinVar Variants
544 unique Pathogenic / Likely Pathogenic· 359 VUS of 1609 total submissions
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Clinical Trials
6 active or recruiting trials — potential therapeutic options may be available
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GeneReview available — ALPL
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

Tolerant — LoF & missense variants common in population
LoF Constraint?
0.69LOEUF
pLI 0.000
Z-score 2.71
OE 0.41 (0.250.69)
Tolerant

Typical tolerance to LoF variation

Missense Constraint?
1.27Z-score
OE missense 0.80 (0.730.89)
266 obs / 330.9 exp
Tolerant

Mild missense constraint

Observed / Expected Ratios?
LoF OE?0.41 (0.250.69)
00.351.4
Missense OE?0.80 (0.730.89)
00.61.4
Synonymous OE?1.07
01.21.6
LoF obs/exp: 10 / 24.5Missense obs/exp: 266 / 330.9Syn Z: -0.72
Curated Mechanism (G2P)Gene2Phenotype (DDG2P) ↗
definitiveALPL-related hypophosphatasiaLOFAR

This gene — mechanism propensity

Predictions shown for reference only — model trained on dominant genes, not applicable to AR conditions.

DN
0.74top 25%
GOF
0.6052th %ile
LOF
0.2387th %ile

The Badonyi & Marsh prediction model was trained exclusively on dominant disease genes. Predictions are not reliable for genes with autosomal recessive inheritance and are shown at reduced opacity for reference only.

Literature Evidence

DNNovel mutation in the ALPL gene with a dominant negative effect in a Japanese family.1

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

References

  1. 1.PMID 33821301

ClinVar Variant Classifications

1609 submitted variants in ClinVar

Classification Summary

Pathogenic154
Likely Pathogenic390
VUS359
Likely Benign475
Benign74
Conflicting150
154
Pathogenic
390
Likely Pathogenic
359
VUS
475
Likely Benign
74
Benign
150
Conflicting

Curated Variants Distribution

Classified variants from ClinVar · 5 ACMG categories

ClassificationLoFMissense + InframeNon-codingSynonymousTotal
Pathogenic
98
44
12
0
154
Likely Pathogenic
84
300
5
1
390
VUS
11
287
47
14
359
Likely Benign
2
8
203
262
475
Benign
0
2
70
2
74
Conflicting
150
Total1956413372791,602

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

View in ClinVar →

9 pathogenic / likely-pathogenic (of 21) ClinVar copy-number / structural variants overlap ALPL — these span large chromosomal regions, not the gene specifically, and are excluded from the counts above. Explore in CNV tools →

Protein Context — Lollipop Plot

ALPL · protein map & ClinVar variants

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

Clinical Trials

Active and recruiting trials from ClinicalTrials.gov

Gene Expression ProfilingOrthodentic Appliances

Genes Associated With Bone Metabolism in the Saliva During Orthodontic Treatment

ACTIVE NOT RECRUITING
NCT07303647Kurdistan Higher Council of Medical SpecialtiesStarted 2025-10-12
PCR
Hypophosphatasia

Characteristics of Hypophosphatasia in Adult Patients in Rheumatology and Their Value in Developing an Algorithm to HPP-diagnosis - the COHIR Multi-center Study

RECRUITING
NCT06574282University of BonnStarted 2024-08-25
Second alkaline phosphatase measurement
Hypophosphatasia

The Effect of Monoallelic Variants in the ALPL Gene on the Natural Course of Hypophosphatasia in Russia

RECRUITING
NCT07390240AstraZenecaStarted 2025-12-29
Gene ExpressionGene Expression ProfilingInfection

Host Response to Infection by Direct Analysis of Leukocyte Single Cell-type Gene Expression/transcript Abundance, Direct LS-TA

ACTIVE NOT RECRUITING
NCT06838780Chinese University of Hong KongStarted 2018-01-01
No intervention
Hypophosphatasia

Natural History Study of Patients With Hypophosphatasia (HPP)

RECRUITING
NCT02237625Duke UniversityStarted 2014-09
Single Cell Sequencing TechnologyGene Expression ProfilingGene Expression

Host Response to Infection by Direct Analysis of Leukocyte Single Cell-type Gene Expression/transcript Abundance, Direct LS-TA. a Prospective Study Will Evaluate the Performance of Direct LS-TA in Triage Febrile Patients Into Major Categories of Infections: Viral, Bacterial or Active Tuberculosis.

NOT YET RECRUITING
NCT06846645Chinese University of Hong KongStarted 2025-02
No intervention