ALPL

Chr 1

alkaline phosphatase, biomineralization associated

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

This gene encodes tissue-nonspecific alkaline phosphatase, a membrane-bound enzyme that hydrolyzes inorganic pyrophosphate and other phosphate compounds to promote bone and tooth mineralization, and also dephosphorylates pyridoxal 5'-phosphate for vitamin B6 metabolism in the brain. Mutations cause hypophosphatasia, which presents across a spectrum from severe infantile forms with life-threatening skeletal defects to milder childhood, adult, and dental-only variants. Inheritance can be either autosomal recessive (typically for severe early-onset forms) or autosomal dominant (often for milder presentations).

GeneReviewsResearchSummary from RefSeq, OMIM, UniProt
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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Clinical Trials
7 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 OE0.41 (0.250.69)
00.351.4
Missense OE0.80 (0.730.89)
00.61.4
Synonymous OE1.07
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

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.PMID:33821301

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

ClinVar Variant Classifications

0 submitted variants in ClinVar

Protein Context — Lollipop Plot

ALPL · 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

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
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

United States Hypophosphatasia Molecular Research Center

ACTIVE NOT RECRUITING
NCT05062629Children's Mercy Hospital Kansas CityStarted 2021-08-24
Whole Genome Sequencing
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
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
Clinical Literature
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