SMN1

Chr 5

survival of motor neuron 1, telomeric

Also known as: BCD541, GEMIN1, SMA, SMA1, SMA2, SMA3, SMA4, SMA@

This gene is part of a 500 kb inverted duplication on chromosome 5q13. This duplicated region contains at least four genes and repetitive elements which make it prone to rearrangements and deletions. The repetitiveness and complexity of the sequence have also caused difficulty in determining the organization of this genomic region. The telomeric and centromeric copies of this gene are nearly identical and encode the same protein. However, mutations in this gene, the telomeric copy, are associated with spinal muscular atrophy; mutations in the centromeric copy do not lead to disease. The centromeric copy may be a modifier of disease caused by mutation in the telomeric copy. The critical sequence difference between the two genes is a single nucleotide in exon 7, which is thought to be an exon splice enhancer. Note that the nine exons of both the telomeric and centromeric copies are designated historically as exon 1, 2a, 2b, and 3-8. It is thought that gene conversion events may involve the two genes, leading to varying copy numbers of each gene. The protein encoded by this gene localizes to both the cytoplasm and the nucleus. Within the nucleus, the protein localizes to subnuclear bodies called gems which are found near coiled bodies containing high concentrations of small ribonucleoproteins (snRNPs). This protein forms heteromeric complexes with proteins such as SIP1 and GEMIN4, and also interacts with several proteins known to be involved in the biogenesis of snRNPs, such as hnRNP U protein and the small nucleolar RNA binding protein. Multiple transcript variants encoding distinct isoforms have been described. [provided by RefSeq, Jul 2014]

Primary Disease Associations & Inheritance

UniProtSpinal muscular atrophy 1
UniProtSpinal muscular atrophy 2
UniProtSpinal muscular atrophy 3
UniProtSpinal muscular atrophy 4
246
ClinVar variants
101
Pathogenic / LP
0.02
pLI score
12
Active trials
Clinical SummarySMN1
Population Constraint (gnomAD)
Low constraint (pLI 0.02) — loss-of-function variants are relatively tolerated in the population.
📋
ClinVar Variants
101 Pathogenic / Likely Pathogenic· 59 VUS of 246 total submissions
💊
Clinical Trials
12 active or recruiting trials — potential therapeutic options may be available
Some data sources returned errors (1)

omim: Error: OMIM fetch failed: 429

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Tolerant — LoF & missense variants common in population
LoF Constraint?LOEUF (Loss-of-function Observed/Expected Upper bound Fraction) is the upper bound of the 90% CI for LoF OE — the preferred gnomAD v4 metric. Lower = more intolerant to LoF. LOEUF < 0.35 = highly constrained.
1.93LOEUF
pLI 0.016
Z-score -0.63
OE 1.61 (0.481.93)
Tolerant

Highly tolerant — LoF variants common in population

Missense Constraint?Missense Z-score: standard deviations fewer missense variants observed vs. expected. Z > 3.09 (p < 0.001) = gene does not tolerate missense variation. OE missense < 0.6 is also considered constrained.
0.06Z-score
OE missense 0.94 (0.531.68)
7 obs / 7.4 exp
Tolerant

Mild missense constraint

Observed / Expected Ratios?Shaded band = 90% confidence interval. Vertical tick = point estimate. Grey threshold line = gnomAD constraint cutoff for that variant class.
LoF OE?Ratio of observed to expected LoF variants. Upper CI bound (LOEUF) ≤ 0.35 = strong LoF constraint signal.1.61 (0.481.93)
00.351.4
Missense OE?Ratio of observed to expected missense variants. OE ≤ 0.6 = fewer missense variants than expected by chance.0.94 (0.531.68)
00.61.4
Synonymous OE?Control metric — synonymous variants are largely neutral and expected near OE = 1.0. Significant deviation may indicate annotation issues.1.72
01.21.6
LoF obs/exp: 2 / 1.2Missense obs/exp: 7 / 7.4Syn Z: -0.86

ClinVar Variant Classifications

246 submitted variants in ClinVar

Classification Summary

Pathogenic66
Likely Pathogenic35
VUS59
Likely Benign18
Benign57
Conflicting9
66
Pathogenic
35
Likely Pathogenic
59
VUS
18
Likely Benign
57
Benign
9
Conflicting

Curated Variants Distribution

Classified variants from ClinVar · 5 ACMG categories

ClassificationLoFMissense + InframeNon-codingSynonymousTotal
Pathogenic
19
12
35
0
66
Likely Pathogenic
12
14
9
0
35
VUS
4
25
26
4
59
Likely Benign
0
0
15
3
18
Benign
0
0
56
1
57
Conflicting
9
Total35511418244

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

View in ClinVar →

Protein Context — Lollipop Plot

SMN1 · protein map & ClinVar variants

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

OMIM — Genotype-Phenotype

No OMIM entries found.

Clinical Literature
Landmark / reviewRecent case evidence

Clinical Trials

Active and recruiting trials from ClinicalTrials.gov

Spinal Muscular Atrophy

Longitudinal Data Collection in Pediatric and Adult Patients With Spinal Muscular Atrophy in Latin America

ACTIVE NOT RECRUITING
NCT05475691Hospital Israelita Albert EinsteinStarted 2022-08-17
Spinal Muscular Atrophy (SMA)

Long-term Follow-up of Patients With Spinal Muscular Atrophy Treated With OAV101 in Clinical Trials

RECRUITING
NCT05335876Phase PHASE3Novartis PharmaceuticalsStarted 2022-12-19
onasemnogene abeparvovec
Spinal Muscular Atrophy

MAP THE SMA: a Machine-learning Based Algorithm to Predict THErapeutic Response in Spinal Muscular Atrophy

RECRUITING
NCT05769465Fondazione Policlinico Universitario Agostino Gemelli IRCCSStarted 2023-04-01
disease modifying treatments
Invasive PreNatal Diagnosis in a Context of Family History of Single-gene Disorders, IncludingSickle Cell DiseaseCystic Fibrosis

Development of Non-Invasive Prenatal Diagnosis for Single Gene Disorders

RECRUITING
NCT06147414Assistance Publique - Hôpitaux de ParisStarted 2024-10-23
Blood sample
Spinal Muscular Atrophy (SMA)

Study of the Safety and Efficacy of an Adeno-Associated Viral Vector Carrying the SMN Gene After a Single Intravenous Administration of Escalating Doses in Children With Spinal Muscular Atrophy (BLUEBELL)

RECRUITING
NCT05747261Phase PHASE1, PHASE2BiocadStarted 2023-02-02
ANB-004, dose 1ANB-004, dose 2ANB-004, dose 3
Spinal Muscular Atrophy

A Study to Learn About Salanersen's (BIIB115) Effects on Movement and Its Safety in Participants Aged 15 to 60 Years With Spinal Muscular Atrophy (SMA) Who Are Either New to SMA Treatment or Were Previously Treated With Risdiplam

NOT YET RECRUITING
NCT07444476Phase PHASE3BiogenStarted 2026-04-03
Salanersen
Spinal Muscular Atrophy (SMA)

Long Read Analysis in Spinal Muscular Atrophy - LOREASI

RECRUITING
NCT07332702Phase NAUniversity Hospital, RouenStarted 2025-05-15
blood sample
Muscular Atrophy, Spinal

A Study to Learn About the Safety and Effects of Salanersen (BIIB115) When Given to Babies With Spinal Muscular Atrophy (SMA) Who Were Previously Treated With Onasemnogene Abeparvovec

NOT YET RECRUITING
NCT07444450Phase PHASE3BiogenStarted 2026-09-04
SalanersenSham Procedure
Spinal AmyotrophyInfantile Spinal Muscular AtrophyJuvenile Spinal Muscular Atrophy

Evaluation of the Reproducibility of a Fatigability Test Fitted to Patients With Spinal Muscular Atrophy

RECRUITING
NCT06562283Phase NACentre Hospitalier Universitaire de Saint EtienneStarted 2024-12-06
Thumb testGrip testQuadriceps Intermittent Fatigue test (QIF test))
Spinal Muscular AtrophySMASpinal Muscular Atrophy Type 2

A Study to Evaluate How Apitegromab Works in Subjects Who Are Less Than 2 Years Old and Have Spinal Muscular Atrophy

RECRUITING
NCT07047144Phase PHASE2Scholar Rock, Inc.Started 2025-09-15
ApitegromabNusinersenRisdiplam
Spinal Muscular Atrophy Type I

Study of Safety, Tolerability and Efficacy of GB221 in Infants With Spinal Muscular Atrophy Type 1

RECRUITING
NCT07070999Phase PHASE1, PHASE2Gemma BiotherapeuticsStarted 2026-01-06
GB221
SMA - Spinal Muscular Atrophy

Safety and Efficacy Evaluation of GC101 Gene Therapy Via Intrathecal (IT) Injectionin the Treatment of Patients With Type 2 Spinal Muscular Atrophy (SMA) - Phase III

RECRUITING
NCT06971094Phase PHASE3GeneCradle IncStarted 2025-05-27
GC101 adeno-associated virus injection