ATP12A

Chr 13

ATPase H+/K+ transporting non-gastric alpha2 subunit

Also known as: ATP1AL1, H-K-ATPase, HK

ATP12A encodes the catalytic subunit of a H+/K+ ATPase pump that transports potassium ions in exchange for sodium and hydrogen ions across epithelial cell membranes, maintaining electrolyte homeostasis in kidney, colon, and airways. Mutations cause autosomal recessive neurogenic arthrogryposis multiplex congenita, a condition characterized by joint contractures and neurological abnormalities present from birth. This gene shows very low constraint against loss-of-function variants, consistent with recessive inheritance requiring biallelic mutations to cause disease.

OMIMResearchSummary from RefSeq, UniProt
MultiplemechanismLOEUF 0.81
Clinical SummaryATP12A
Population Constraint (gnomAD)
Low constraint (pLI 0.00) — loss-of-function variants are relatively tolerated in the population.
📋
ClinVar Variants
35 unique Pathogenic / Likely Pathogenic· 167 VUS of 218 total submissions
💊
Clinical Trials
6 active or recruiting trials — potential therapeutic options may be available

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Tolerant — LoF & missense variants common in population
LoF Constraint
0.81LOEUF
pLI 0.000
Z-score 2.60
OE 0.60 (0.440.81)
Tolerant

Typical tolerance to LoF variation

Missense Constraint
0.83Z-score
OE missense 0.90 (0.840.97)
547 obs / 604.7 exp
Tolerant

Mild missense constraint

Observed / Expected Ratios
LoF OE0.60 (0.440.81)
00.351.4
Missense OE0.90 (0.840.97)
00.61.4
Synonymous OE0.97
01.21.6
LoF obs/exp: 29 / 48.5Missense obs/exp: 547 / 604.7Syn Z: 0.35
DN
0.80top 10%
GOF
0.78top 25%
LOF
0.1993th %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

218 submitted variants in ClinVar

Classification Summary

Pathogenic33
Likely Pathogenic2
VUS167
Likely Benign8
Benign1
33
Pathogenic
2
Likely Pathogenic
167
VUS
8
Likely Benign
1
Benign

Curated Variants Distribution

Classified variants from ClinVar · 5 ACMG categories

ClassificationLoFMissense + InframeNon-codingSynonymousTotal
Pathogenic
0
0
33
0
33
Likely Pathogenic
0
0
2
0
2
VUS
1
153
13
0
167
Likely Benign
0
2
1
5
8
Benign
1
0
0
0
1
Total2155495211

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

View in ClinVar →

Protein Context — Lollipop Plot

ATP12A · 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

Healthy

A Study to Evaluate the Impact of Lactobacillus Rhamnosus GG on Proton Pump Inhibitor-Induced Gut Dysbiosis

RECRUITING
NCT05517928Phase NAMayo ClinicStarted 2023-03-03
OmeprazoleLactobacillus rhamnosus GGPlacebo
Non-erosive Reflux Disease (NERD)

Clinical Efficacy Evaluation of Chaizhi Hewei Decoction in the Treatment of Non-Erosive Reflux Disease With Liver-Stomach Disharmony Syndrome

NOT YET RECRUITING
NCT07518420Phase NAXiyuan Hospital of China Academy of Chinese Medical SciencesStarted 2026-05-15
Chaizhi Hewei DecoctionPlacebo
MASLD

Luminal Fructose Kinetics (MARTINI Study)

RECRUITING
NCT06539494Phase PHASE2Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)Started 2024-07-01
Omeprazole 40 MG
Proton Pump InhibitorsHuman Gastrointestinal TractGastroesophageal Reflux Disease

Intestinal Microbiota After PPI Treatment

NOT YET RECRUITING
NCT07036627University of BariStarted 2025-07-06
study of microbiota
Helicobacter Pylori Eradication Rate

Optimization of Keverprazan-amoxicillin Dual Therapy for Eradicating Helicobacter Pylori Infection

RECRUITING
NCT06734260Phase PHASE3Eighth Affiliated Hospital, Sun Yat-sen UniversityStarted 2024-09-10
Keverprazan Hydrochloride tablets + high dose amoxicillinKeverprazan Hydrochloride tablets + low dose amoxicillinKeverprazan Hydrochloride tablets + high dose amoxicillin(H-KA-10d)
Dysbiosis

Evidence Based Probiotic Therapy of Proton Pump Inhibitor Induced Dysbiosis

ACTIVE NOT RECRUITING
NCT05836155Phase NAMedical University of GrazStarted 2023-07-10
Intervention
Clinical Literature
Open Research Assistant →
Recent Gene-Specific Literature
Gene in title · MEDLINE · newest first
Europe PMC