DMD

Chr XXLRX-linked

dystrophin

Also known as: BMD, CMD3B, DXS142, DXS164, DXS206, DXS230, DXS239, DXS268

This gene spans a genomic range of greater than 2 Mb and encodes a large protein containing an N-terminal actin-binding domain and multiple spectrin repeats. The encoded protein forms a component of the dystrophin-glycoprotein complex (DGC), which bridges the inner cytoskeleton and the extracellular matrix. Deletions, duplications, and point mutations at this gene locus may cause Duchenne muscular dystrophy (DMD), Becker muscular dystrophy (BMD), or cardiomyopathy. Alternative promoter usage and alternative splicing result in numerous distinct transcript variants and protein isoforms for this gene. [provided by RefSeq, Dec 2016]

OMIMResearchGenerating clinical summary…

Primary Disease Associations & Inheritance

Duchenne muscular dystrophyMIM #310200
XLR
Becker muscular dystrophyMIM #300376
XLR
Cardiomyopathy, dilated, 3BMIM #302045
X-linked
Duchenne muscular dystrophyMIM #310200
XLR

Clinical highlights

Gene-disease validity (ClinGen)
progressive muscular dystrophy · XLDefinitivesufficient evidence for diagnostic panels
Interpreting a novel variant
Loss of function is the established mechanism and the gene is intolerant of it in the population — truncating, frameshift and canonical splice variants carry more prior weight here than missense.Curated gene-level mechanism — a prior for triage, not a per-variant call.
12
Active trials
1373
Pubs (1 yr)
P/LP submissions
P/LP missense
0.15
LOEUF· LoF intol.
LOF
Mechanism· annotated
  • delandistrogene moxeparvovec (Elevidys)
    AAV gene therapyApproved · FDA 2023

    One-time delivery of a micro-dystrophin transgene.

    Delivery: One-time IV infusionEligibility: Per-label age/ambulatory criteria; excludes certain exon 8/9 deletions

    Not reading-frame-dependent (see the exon-del/dup card)

  • exon-skipping ASOs (eteplirsen·51, casimersen·45, golodirsen/viltolarsen·53)
    ASOApproved · FDA 2016-2021

    Skip a targeted exon to restore the reading frame.

    Delivery: Weekly IVEligibility: Only deletions amenable to the specific exon skip

    Mutation-specific — the reading-frame card flags skip-amenability

Therapeutic landscape as of 2026-07. Educational only. Investigational ≠ available; not medical advice or eligibility. Approved entries are precise; investigational program names/phases are conservative and move fast. Curated from FDA/EMA approvals and the clinical-trial literature; verify against current labeling + ClinicalTrials.gov.

ClinicalTrials.gov

DMD deletion / duplication — reading frame & therapy

Enter a multi-exon del/dup in any form (exon shorthand, HGVS c., or genomic). Predicts Becker vs Duchenne by the reading-frame rule and flags exon-skip therapy amenability.

Out-of-frameDuchenne-typeDeletion of exons 45–50 · 871 coding ntMajor distal hotspot (exons 45–55)
HGVS (c.): NM_004006.3:c.(6439-?)_(7309+?)delGenomic: chrX:g.31,819,975–31,968,514 (GRCh38)Exons: 45, 46, 47, 48, 49, 50Resolved from: exon notation

Deletion of exons 45–50 removes 871 coding nt (frame shifted by 1), so exon 44 now meets exon 51 and downstream sequence is OUT OF FRAME — the reading-frame rule predicts loss of dystrophin (Duchenne-type).

Exon 39 · phases 0→0 · 138 nt39Exon 40 · phases 0→0 · 153 nt40Exon 41 · phases 0→0 · 183 nt41Exon 42 · phases 0→0 · 195 nt42Exon 43 · phases 0→2 · 173 nt43Exon 44 · phases 2→0 · 148 nt44Exon 45 · phases 0→2 · 176 nt · deleted45Exon 46 · phases 2→0 · 148 nt · deleted46Exon 47 · phases 0→0 · 150 nt · deleted47Exon 48 · phases 0→0 · 186 nt · deleted48Exon 49 · phases 0→0 · 102 nt · deleted49Exon 50 · phases 0→1 · 109 nt · deleted50Exon 51 · phases 1→0 · 233 nt · skipping restores frame51skipExon 52 · phases 0→1 · 118 nt52Exon 53 · phases 1→0 · 212 nt53Exon 54 · phases 0→2 · 155 nt54Exon 55 · phases 2→0 · 190 nt55Exon 56 · phases 0→2 · 173 nt56
Edges clash — OUT OF FRAME · exon 44 (ends phase 0) meets exon 51 (starts phase 1) → Duchenne-type (dystrophin lost)
kept exon deleted skip restores frameedge shape = intron phase (0 (codon boundary), 1, 2)

Exon-skip therapy — amenable

  • Skipping exon 51 restores frame → eteplirsen (Exondys 51)
Classification framingPVS1 appliesExpected: Pathogenic / Likely pathogenic

Out-of-frame deletion → predicted loss of function. DMD loss of function is an established Duchenne mechanism, so PVS1 applies (frame-disrupting multi-exon deletion of a gene where LOF is the mechanism).

Dystrophin domains affected

  • Central rod domain (24 spectrin repeats + 4 hinges) (exons 861) — Flexible spacer; in-frame deletions confined to the rod most often give milder Becker.

Micro-dystrophin gene therapy (delandistrogene moxeparvovec, Elevidys) is not reading-frame-dependent; eligibility is set by age/ambulatory criteria and excludes certain exon 8/9 deletions — confirm against current labeling. · Reference NM_004006.3 / LRG_199t1 (Dp427m). The reading-frame rule is ~90% concordant — a prediction, not a diagnosis; confirm phenotype clinically. Exon coordinates: DMD LRG_199 exon table.

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

LoF intolerant — likely haploinsufficient
LoF Constraint?
0.15LOEUF
pLI 1.000
Z-score 10.69
OE 0.10 (0.070.15)
Highly constrained

Highly LoF-intolerant (top ~10% of genes)

Missense Constraint?
-2.43Z-score
OE missense 1.19 (1.141.24)
1568 obs / 1319.4 exp
Tolerant

Tolerant to missense variation

Observed / Expected Ratios?
LoF OE?0.10 (0.070.15)
00.351.4
Missense OE?1.19 (1.141.24)
00.61.4
Synonymous OE?1.20
01.21.6
LoF obs/exp: 17 / 165.4Missense obs/exp: 1568 / 1319.4Syn Z: -3.44

ClinVar Variant Classifications

0 submitted variants in ClinVar

Protein Context — Lollipop Plot

DMD · protein map & ClinVar variants

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

Clinical Trials

Active and recruiting trials from ClinicalTrials.gov

Oral LeukoplakiaOral Leukoplakia of TongueOral Leukoplakia of Gingiva

Prediction of Malignant Transformation of Oral Leukoplakia Using a MAGE-A-based Immunoscore

RECRUITING
NCT03975322University of Erlangen-Nürnberg Medical SchoolStarted 2019-12-01
Duchenne Muscular Dystrophy

A Study to Evaluate the Tolerability, Safety and Efficacy of GNR-097 Gene Therapy in Pediatric Patients With Duchenne Muscular Dystrophy

RECRUITING
NCT07673809Phase PHASE1, PHASE2AO GENERIUMStarted 2025-09-30
GNR-097Placebo followed by GNR-097
Duchenne Muscular Dystrophy

A Study of SGT-003 Gene Therapy in Duchenne Muscular Dystrophy (INSPIRE DUCHENNE)

RECRUITING
NCT06138639Phase PHASE1, PHASE2Solid Biosciences Inc.Started 2024-05-06
SGT-003
Smoking, CigaretteAlveolar Bone GraftingWound Healing

Wound Healing Following Extraction and Ridge Preservation in Smokers and Non-smokers

NOT YET RECRUITING
NCT07372183Marquette UniversityStarted 2026-01-25
observational study
Duchenne Muscular Dystrophy

A Study of SGT-003 Gene Therapy in Ambulant Males With Duchenne Muscular Dystrophy (IMPACT DUCHENNE)

RECRUITING
NCT07160634Phase PHASE3Solid Biosciences Inc.Started 2025-10-22
SGT-003Placebo
Duchenne Muscular Dystrophy (DMD)Becker Muscular DystrophyDystrophinopathy

Duchenne Electronic Health Record Study

RECRUITING
NCT07609394The Duchenne RegistryStarted 2022-12-01
Observational study with patients who may be treated with various disease-modifying therapies
Duchenne Muscular DystrophyBecker Muscular Dystrophy

Characterization of Clinical Skeletal and Cardiac Impairment in Carriers of DMD and BMD

ACTIVE NOT RECRUITING
NCT02972580Nationwide Children's HospitalStarted 2016-06
Genetic characterization
Duchenne Muscular Dystrophy (DMD)

A Study to Evaluate the Safety and Tolerability of GEN6050X in Duchenne Muscular Dystrophy.

ACTIVE NOT RECRUITING
NCT06392724Phase EARLY_PHASE1Peking Union Medical College HospitalStarted 2024-07-05
GEN6050X intravenous injection
Gaucher Disease, Type 1Healthy

Prodromal Parkinsonian Features in GBA1 Mutation Carriers

RECRUITING
NCT05253560Shaare Zedek Medical CenterStarted 2017-05-16
The investigators aim to identify prodromal PD in a cohort of carriers of Gaucher disease.
OsteoporosisSarcopeniaObesity

Skeletal Maturation and Endocrine Health in Young Adults

ENROLLING BY INVITATION
NCT06509776Holbaek SygehusStarted 2024-11-11
DMD

A Clinical Study to Evaluate the Safety, Tolerability, and Efficacy of BBM-D101 in the Treatment of Duchenne Muscular Dystrophy.

RECRUITING
NCT07058662Phase PHASE1, PHASE2Belief BioMed (Beijing) Co., LtdStarted 2025-07-31
Single dose intravenous of BBM-D101
Duchenne Muscular Dystrophy

Open-label Study of WVE-N531 in Patients With Duchenne Muscular Dystrophy (FORWARD-53)

RECRUITING
NCT04906460Phase PHASE1, PHASE2Wave Life Sciences USA, Inc.Started 2021-09-28
WVE-N531