COMT

Chr 22

catechol-O-methyltransferase

Also known as: HEL-S-98n

Catechol-O-methyltransferase catalyzes the O-methylation and inactivation of catecholamine neurotransmitters including dopamine, epinephrine, and norepinephrine, representing a major degradative pathway for these transmitters. This gene is highly tolerant to loss-of-function variants and is primarily associated with variation in catechol-O-methyltransferase activity rather than Mendelian disease. The enzyme also metabolizes catechol-based medications used to treat hypertension, asthma, and Parkinson disease.

GeneReviewsOMIMResearchSummary from RefSeq, OMIM, UniProt
GOFmechanismLOEUF 1.701 OMIM phenotype
Clinical SummaryCOMT
Population Constraint (gnomAD)
Low constraint (pLI 0.00) — loss-of-function variants are relatively tolerated in the population.
📋
ClinVar Variants
61 unique Pathogenic / Likely Pathogenic· 15 VUS of 81 total submissions
💊
Clinical Trials
12 active or recruiting trials — potential therapeutic options may be available
📖
GeneReview available — COMT
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
1.70LOEUF
pLI 0.000
Z-score -0.04
OE 1.02 (0.611.70)
Tolerant

Highly tolerant — LoF variants common in population

Missense Constraint
0.43Z-score
OE missense 0.91 (0.801.04)
157 obs / 172.9 exp
Tolerant

Mild missense constraint

Observed / Expected Ratios
LoF OE1.02 (0.611.70)
00.351.4
Missense OE0.91 (0.801.04)
00.61.4
Synonymous OE0.94
01.21.6
LoF obs/exp: 9 / 8.9Missense obs/exp: 157 / 172.9Syn Z: 0.45
DN
0.6163th %ile
GOF
0.6443th %ile
LOF
0.2969th %ile

The highest-scoring mechanism for this gene is gain-of-function.

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

81 submitted variants in ClinVar

Classification Summary

Pathogenic59
Likely Pathogenic2
VUS15
Likely Benign4
Benign1
59
Pathogenic
2
Likely Pathogenic
15
VUS
4
Likely Benign
1
Benign

Curated Variants Distribution

Classified variants from ClinVar · 5 ACMG categories

ClassificationLoFMissense + InframeNon-codingSynonymousTotal
Pathogenic
0
0
59
0
59
Likely Pathogenic
0
0
2
0
2
VUS
1
6
8
0
15
Likely Benign
0
0
2
2
4
Benign
0
0
1
0
1
Total1672281

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

View in ClinVar →

Protein Context — Lollipop Plot

COMT · 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

Sleep ApneaSleep-Disordered Breathing

The Meaning of Dopaminergic Pathway in Sleep Breathing Disorders.

ENROLLING BY INVITATION
NCT05890911Wroclaw Medical UniversityStarted 2023-06-01
PolysomnographyBlood dopamine level measurementGenetical test
Opioid Use DisorderPregnancy Related

Predicting and Preventing Adverse Maternal and Child Outcomes of Opioid Use Disorder in Pregnancy

RECRUITING
NCT05942313Ilana HullStarted 2023-08-28
Buprenorphine/ Methadone exposure
Parkinson DiseaseImpulse Control Disorder

Efficacy of a Prediction Model-based Algorithm to PREVENT Drug-induced Impulse Control Disorders in Parkinson's Disease

NOT YET RECRUITING
NCT07505394Phase NAAssistance Publique - Hôpitaux de ParisStarted 2026-06-01
Algorithm-guided groupStandard of Care (SoC) group
Healthy

Effect of Sleep Extension in Prevention to Sleep Deprivation

RECRUITING
NCT06928168Phase NACentre Hospitalier Universitaire de Saint EtienneStarted 2025-06-12
Total sleep deprivationpartial sleep deprivationReproductibility
Fibromyalgia (FM)tDCSDuloxetine

Home-based Transcranial Direct Current Stimulation (tDCS) Compared to Duloxetine: Non-inferiority Clinical Trial (FIBROSTIM)

RECRUITING
NCT07203339Phase NAHospital de Clinicas de Porto AlegreStarted 2025-09-30
Transcranial direct current stimulation (tDCS) plus placebo.Duloxetine (60 mg) once dailyHome-based transcranial direct current stimulation
PPAPSpine Fusion

Personalized Perioperative Analgesia Platform (PPAP) for Pediatric Spine Fusion Surgery (sIRB)

RECRUITING
NCT05367609Phase NASenthil SadhasivamStarted 2022-09-20
Preoperative Genotyping
CannabisTHC

Modulation of THC Effects by CBD: a Dose-ranging Study

RECRUITING
NCT06099379Phase PHASE1, PHASE2Centre hospitalier de l'Université de Montréal (CHUM)Started 2024-06-27
∆9-tetrahydrocannabinol
Patients With Schizophrenia

PhaRmacOgenetics and Therapeutic Drug Monitoring In SchizophrEnia

NOT YET RECRUITING
NCT05839613Phase NAAssistance Publique Hopitaux De MarseilleStarted 2023-05
Therapeutic Drug Monitoring (TDM) and Pharmacogenetics (PG)
Stage I Breast Cancer AJCC v7Stage IA Breast Cancer AJCC v7Stage IB Breast Cancer AJCC v7

Electroacupuncture Therapy in Reducing Chronic Pain in Patients After Breast Cancer Treatment

ACTIVE NOT RECRUITING
NCT02754752Phase PHASE2M.D. Anderson Cancer CenterStarted 2016-09-13
Electroacupuncture TherapyElectroacupuncture TherapyLaboratory Biomarker Analysis
Breast CancerChronic PainAcute Pain

Evaluation And Risk Assessment For Persistent Postsurgical Pain After Breast Surgery

ACTIVE NOT RECRUITING
NCT03408717KK Women's and Children's HospitalStarted 2018-01-03
QuestionnairesMechanical Temporal Summation assessmentPain threshold assessment
Vasovagal Syncope

Study of Atomoxetine in the Prevention of Vasovagal Syncope

RECRUITING
NCT05159687Phase PHASE3University of CalgaryStarted 2022-06-01
Atomoxetine HydrochloridePlacebo
Hyperhomocysteinemia

Evaluation of a Genetically Determined Personalized Approach in Prescribing Biologically Active Substances in Patients With Elevated Blood Homocysteine Levels.

RECRUITING
NCT06264570Phase NAS.LAB (SOLOWAYS)Started 2023-10-23
B-TMG supplementationB-SAM supplementationB-TMG placebo
Clinical Literature
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Key Publications
Landmark & review papers · by relevance
PubMed
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