ATP7B

Chr 13AR

ATPase copper transporting beta

Also known as: PWD, WC1, WD, WND

The protein functions as a copper-transporting ATPase that exports copper out of cells, particularly ensuring efflux of copper from hepatocytes into bile to maintain copper homeostasis in the liver. Mutations cause Wilson disease, an autosomal recessive disorder characterized by pathological copper accumulation in tissues. The disease mechanism involves loss of normal copper export function leading to toxic copper buildup primarily in the liver and brain.

GeneReviewsOMIMResearchSummary from RefSeq, OMIM, UniProt, Mechanism
MultiplemechanismARLOEUF 1.191 OMIM phenotype
Clinical SummaryATP7B
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Gene-Disease Validity (ClinGen)
Wilson disease · ARDefinitive

Definitive — sufficient evidence for diagnostic panels

Population Constraint (gnomAD)
Low constraint (pLI 0.00) — loss-of-function variants are relatively tolerated in the population.
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ClinVar Variants
112 unique Pathogenic / Likely Pathogenic· 336 VUS of 600 total submissions
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Clinical Trials
10 active or recruiting trials — potential therapeutic options may be available
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GeneReview available — ATP7B
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
1.19LOEUF
pLI 0.000
Z-score 0.45
OE 0.93 (0.741.19)
Tolerant

Highly tolerant — LoF variants common in population

Missense Constraint
-0.88Z-score
OE missense 1.09 (1.031.15)
885 obs / 814.3 exp
Tolerant

Tolerant to missense variation

Observed / Expected Ratios
LoF OE0.93 (0.741.19)
00.351.4
Missense OE1.09 (1.031.15)
00.61.4
Synonymous OE1.07
01.21.6
LoF obs/exp: 47 / 50.4Missense obs/exp: 885 / 814.3Syn Z: -1.02
DN
0.6839th %ile
GOF
0.7029th %ile
LOF
0.3939th %ile

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

GOFprediction above median
DNprediction 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

600 submitted variants in ClinVar

Classification Summary

Pathogenic46
Likely Pathogenic66
VUS336
Likely Benign128
Benign2
Conflicting4
46
Pathogenic
66
Likely Pathogenic
336
VUS
128
Likely Benign
2
Benign
4
Conflicting

Curated Variants Distribution

Classified variants from ClinVar · 5 ACMG categories

ClassificationLoFMissense + InframeNon-codingSynonymousTotal
Pathogenic
42
2
2
0
46
Likely Pathogenic
44
22
0
0
66
VUS
6
280
35
15
336
Likely Benign
0
5
46
77
128
Benign
1
0
1
0
2
Conflicting
4
Total933098492582

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

View in ClinVar →

Protein Context — Lollipop Plot

ATP7B · 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

Wilson Disease

A Phase 1/2/3 Study of UX701 Gene Therapy in Adults With Wilson Disease

ACTIVE NOT RECRUITING
NCT04884815Phase PHASE1, PHASE2Ultragenyx Pharmaceutical IncStarted 2021-09-27
UX701Standard of Care (SOC)
Wilson Disease

Prescreening Study to Identify Potential Wilson Disease Participants for Gene-Editing Clinical Trial

ACTIVE NOT RECRUITING
NCT07226622Prime Medicine, Inc.Started 2025-12-29
Wilson's Disease

Description of the Copper Concentration in Breast Milk in Women Treated for Wilson's Disease

RECRUITING
NCT05183165Phase NAFondation Ophtalmologique Adolphe de RothschildStarted 2022-05-11
Patients with Wilson's disease declaring pregnancy,
Wilson Disease

Phase I/II Clinical Study to Evaluate the Safety, Tolerability, and Efficacy of GC310 Injection in Patients With Wilson's Disease (WD)

NOT YET RECRUITING
NCT07173933Phase PHASE1, PHASE2GeneCradle IncStarted 2025-10
GC310
Wilson's Disease

Multifaceted Assessment of Patients With Wilson's Disease in a Low-Resource Setting in Upper Egypt: Service Integration, Psychosocial Burden, Dietary Practices, and the Geo-Spatial Disease Map

NOT YET RECRUITING
NCT07241832Assiut UniversityStarted 2025-12-01
KAB-pB Scores
Wilson's Disease

A Phase I/II Study of VTX-801 in Adult Patients With Wilson's Disease

ACTIVE NOT RECRUITING
NCT04537377Phase PHASE1, PHASE2Vivet Therapeutics SASStarted 2021-09-03
VTX-801
Wilson Disease

Gene Therapy for Wilson Disease Evaluated by 64Cu PET/CT

ENROLLING BY INVITATION
NCT07159581Thomas Damgaard SandahlStarted 2025-07-08
Wilson DiseaseD-PenicillamineEffect of D-penicilline on Cutaneous Elastity of Wilson's Patient

Wilson's Disease Treated With D-Penicillamine: Characterization of Skin Damage Secondary to Treatment by Measuring Skin Elasticity

RECRUITING
NCT06945081Phase NACentre Hospitalier Universitaire de Saint EtienneStarted 2025-11-28
Preparation of forearm molds with SILFLO® silicone
Wilson Disease

A Clinical Study to Evaluate the Safety and Efficacy of LY-M003 Injection in Patients With Wilson Disease

RECRUITING
NCT06650319Phase EARLY_PHASE1Chaohui YuStarted 2024-09-24
LY-M003
Wilson Disease

An Exploratory Study to Evaluate the Tolerability and Safety of MWAV201 in Subjects With Wilson Disease

NOT YET RECRUITING
NCT06663878Phase NAXinhua Hospital, Shanghai Jiao Tong University School of MedicineStarted 2024-10
MWAV201
Clinical Literature
Open Research Assistant →
Key Publications
Landmark & review papers · by relevance
PubMed
Wilson disease.
Członkowska A et al.·Nat Rev Dis Primers
2018Review
Wilson's disease: overview.
Lucena-Valera A et al.·Med Clin (Barc)
2023Review
Copper metabolism in cell death and autophagy.
Xue Q et al.·Autophagy
2023Review
Wilson's disease and other neurological copper disorders.
Bandmann O et al.·Lancet Neurol
2015Review
Top 5 results · since 2015Search PubMed ↗