COL2A1

Chr 12AD

collagen type II alpha 1 chain

Also known as: ACG2, ANFH, ANFH1, AOM, COL11A3, EDMMD, LCPD, OSCDP

This gene encodes the alpha-1 chain of type II collagen, which is essential for cartilage development and the ability to resist compressive forces. Mutations cause a spectrum of skeletal dysplasias including achondrogenesis, Kniest dysplasia, spondyloepiphyseal dysplasia congenita, and Stickler syndrome type I, with phenotypes ranging from perinatal lethal to milder forms with joint problems and sensory impairments. The gene follows autosomal dominant inheritance and is highly constrained against loss-of-function variants.

OMIMResearchSummary from RefSeq, OMIM, UniProt
MultiplemechanismADLOEUF 0.1316 OMIM phenotypes
Clinical SummaryCOL2A1
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Gene-Disease Validity (ClinGen)
spondyloepiphyseal dysplasia, Stanescu type · ADModerate

Moderate evidence — consider for supplementary testing

8 total gene-disease associations curated

Population Constraint (gnomAD)
Highly constrained gene — heterozygous loss-of-function variants are very rare in the population (pLI 1.00). One damaged copy is likely sufficient to cause disease.
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ClinVar Variants
157 unique Pathogenic / Likely Pathogenic· 117 VUS of 500 total submissions
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Clinical Trials
1 active or recruiting trial — potential therapeutic options may be available

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Dual constrained — LoF & missense intolerant
LoF Constraint
0.13LOEUF
pLI 1.000
Z-score 8.12
OE 0.07 (0.040.13)
Highly constrained

Among the most LoF-intolerant genes (~top 3%)

Missense Constraint
3.29Z-score
OE missense 0.69 (0.640.73)
604 obs / 878.6 exp
Constrained

Highly missense-constrained (top ~0.1%)

Observed / Expected Ratios
LoF OE0.07 (0.040.13)
00.351.4
Missense OE0.69 (0.640.73)
00.61.4
Synonymous OE1.12
01.21.6
LoF obs/exp: 6 / 88.4Missense obs/exp: 604 / 878.6Syn Z: -1.67
Curated Mechanism (G2P)Gene2Phenotype (DDG2P) ↗
definitiveCOL2A1-related spondyloepiphyseal dysplasia congenitaOTHERAD
definitiveCOL2A1-related spondyloepimetaphyseal dysplasia, Strudwick typeDNAD
definitiveCOL2A1-related achondrogenesisDNAD
definitiveCOL2A1-related Kniest dysplasiaDNAD
definitiveCOL2A1-related spondyloepiphyseal dysplasia congenitaOTHERAR
definitiveCOL2A1-related Stickler syndrome, non-syndromic ocularLOFAD
DN
0.5279th %ile
GOF
0.3788th %ile
LOF
0.69top 10%

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

LOFprediction above median · 1 literature citation · 52% of P/LP variants are LoF · LOEUF 0.13
DN1 literature citation

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.

Literature Evidence

DNDominant negative mutations in the C-propeptide of COL2A1 cause platyspondylic lethal skeletal dysplasia, torrance type, and define a novel subfamily within the type 2 collagenopathiesPMID:15643621
LOFPremature termination codons in COL2A1 that result in haploinsufficiency of type II collagen are a common finding.PMID:11007540

Predictions from Badonyi M, Marsh JA. PLoS ONE. 2024;19(8):e0307312. Mechanism ranking also informed by gnomAD constraint, ClinVar, and ClinGen data.

ClinVar Variant Classifications

500 submitted variants in ClinVar

Classification Summary

Pathogenic85
Likely Pathogenic72
VUS117
Likely Benign133
Benign12
Conflicting80
85
Pathogenic
72
Likely Pathogenic
117
VUS
133
Likely Benign
12
Benign
80
Conflicting

Curated Variants Distribution

Classified variants from ClinVar · 5 ACMG categories

ClassificationLoFMissense + InframeNon-codingSynonymousTotal
Pathogenic
64
16
5
0
85
Likely Pathogenic
18
50
2
2
72
VUS
4
90
20
3
117
Likely Benign
0
29
59
45
133
Benign
0
9
3
0
12
Conflicting
80
Total861948950499

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

View in ClinVar →

Protein Context — Lollipop Plot

COL2A1 · protein map & ClinVar variants

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

3D Protein StructureAlphaFold
Clinical Literature
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