GJB2

Chr 13ADARDigenic dominant

gap junction protein beta 2

Also known as: BAPS, CX26, DFNA3, DFNA3A, DFNB1, DFNB1A, HID, KID

Connexin 26 forms gap junction channels that allow small molecules and ions to pass between adjacent cells. Mutations cause hearing loss ranging from isolated deafness (both autosomal recessive and dominant forms) to syndromic conditions involving skin abnormalities such as keratoderma and ichthyosis. This gene has very low constraint against loss-of-function variants and shows both autosomal recessive and dominant inheritance patterns depending on the specific variant.

OMIMResearchSummary from RefSeq, OMIM, UniProt
LOFmechanismAD/AR/Digenic dominantLOEUF 1.987 OMIM phenotypes
Clinical SummaryGJB2
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Gene-Disease Validity (ClinGen)
nonsyndromic genetic hearing loss · ARDefinitive

Definitive — sufficient evidence for diagnostic panels

2 total gene-disease associations curated

Population Constraint (gnomAD)
Low constraint (pLI 0.00) — loss-of-function variants are relatively tolerated in the population.
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ClinVar Variants
76 unique Pathogenic / Likely Pathogenic· 76 VUS of 200 total submissions
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Clinical Trials
3 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
1.98LOEUF
pLI 0.000
Z-score -3.82
OE 2.62 (1.391.98)
Tolerant

Highly tolerant — LoF variants common in population

Missense Constraint
-0.72Z-score
OE missense 1.17 (1.031.34)
161 obs / 137.2 exp
Tolerant

Tolerant to missense variation

Observed / Expected Ratios
LoF OE2.62 (1.391.98)
00.351.4
Missense OE1.17 (1.031.34)
00.61.4
Synonymous OE1.05
01.21.6
LoF obs/exp: 17 / 6.5Missense obs/exp: 161 / 137.2Syn Z: -0.29
Curated Mechanism (G2P)Gene2Phenotype (DDG2P) ↗
definitiveGJB2-related ichthyosis hystrix-like with deafness syndromeOTHERAD
definitiveGJB2-related deafnessLOFAR
definitiveGJB2-related keratoderma, palmoplantar, with deafnessOTHERAD
moderateGJB2-related keratitis-ichthyosis-deafness syndromeOTHERAD
definitiveGJB2-related knuckle pads, leuconychia and sensorineural deafnessOTHERAD
definitiveGJB2-related Vohwinkel syndromeOTHERAD
DN
0.7131th %ile
GOF
0.76top 25%
LOF
0.3261th %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 · 1 literature citation
DNprediction above median · 1 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

DNTransgenic expression of a dominant-negative connexin26 causes degeneration of the organ of Corti and non-syndromic deafnessPMID:12700168
GOFNumerous autosomal dominant mutations in the Cx26-encoding GJB2 gene lead to many skin disorders and sensorineural hearing loss.PMID:28428247

Predictions from Badonyi M, Marsh JA. PLoS ONE. 2024;19(8):e0307312.

ClinVar Variant Classifications

200 submitted variants in ClinVar

Classification Summary

Pathogenic28
Likely Pathogenic48
VUS76
Likely Benign44
Conflicting2
28
Pathogenic
48
Likely Pathogenic
76
VUS
44
Likely Benign
2
Conflicting

Curated Variants Distribution

Classified variants from ClinVar · 5 ACMG categories

ClassificationLoFMissense + InframeNon-codingSynonymousTotal
Pathogenic
17
5
6
0
28
Likely Pathogenic
9
39
0
0
48
VUS
2
62
11
1
76
Likely Benign
0
0
3
41
44
Benign
0
0
0
0
0
Conflicting
2
Total281062042198

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

View in ClinVar →

Protein Context — Lollipop Plot

GJB2 · 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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