SMN2

Chr 5AR

survival of motor neuron 2, centromeric

Also known as: BCD541, C-BCD541, GEMIN1, SMNC, TDRD16B

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. While mutations in the telomeric copy are associated with spinal muscular atrophy, mutations in this gene, the centromeric copy, do not lead to disease. This gene 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 full length 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. Four transcript variants encoding distinct isoforms have been described. [provided by RefSeq, Sep 2008]

Primary Disease Associations & Inheritance

{Spinal muscular atrophy, type III, modifier of}MIM #253400
AR
12
Active trials
8
Pathogenic / LP
58
ClinVar variants
119
Pubs (1 yr)
0.4
Missense Z
1.87
LOEUF
Clinical SummarySMN2
Population Constraint (gnomAD)
Low constraint (pLI 0.10) — loss-of-function variants are relatively tolerated in the population.
📋
ClinVar Variants
8 Pathogenic / Likely Pathogenic· 7 VUS of 58 total submissions
💊
Clinical Trials
12 active or recruiting trials — potential therapeutic options may be available
📖
GeneReview available — SMN2
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
1.87LOEUF
pLI 0.103
Z-score 0.20
OE 0.80 (0.231.87)
Tolerant

Highly tolerant — LoF variants common in population

Missense Constraint
0.44Z-score
OE missense 0.54 (0.271.24)
4 obs / 7.4 exp
Tolerant

Mild missense constraint

Observed / Expected Ratios
LoF OE0.80 (0.231.87)
00.351.4
Missense OE0.54 (0.271.24)
00.61.4
Synonymous OE1.83
01.21.6
LoF obs/exp: 1 / 1.2Missense obs/exp: 4 / 7.4Syn Z: -0.96
DN
DN
0.6649th %ile
GOF
0.3491th %ile
LOF
0.53top 25%

The highest-scoring mechanism for this gene is dominant-negative.

DNprediction 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

58 submitted variants in ClinVar

Classification Summary

Pathogenic6
Likely Pathogenic2
VUS7
Likely Benign7
Benign35
Conflicting1
6
Pathogenic
2
Likely Pathogenic
7
VUS
7
Likely Benign
35
Benign
1
Conflicting

Curated Variants Distribution

Classified variants from ClinVar · 5 ACMG categories

ClassificationLoFMissense + InframeNon-codingSynonymousTotal
Pathogenic
0
0
6
0
6
Likely Pathogenic
0
0
2
0
2
VUS
0
1
6
0
7
Likely Benign
0
0
6
1
7
Benign
0
0
34
1
35
Conflicting
1
Total0154258

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

View in ClinVar →

SMN2 · 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

Muscular Atrophy, Spinal

A Study Evaluating the Effectiveness and Safety of Risdiplam Administered as an Early Intervention in Pediatric Participants With Spinal Muscular Atrophy After Gene Therapy

RECRUITING
NCT05861986Phase PHASE4Hoffmann-La RocheStarted 2024-05-30
Risdiplam
Muscular Atrophy, Spinal

A Study Evaluating the Effectiveness and Safety of Risdiplam Administered in Pediatric Patients With Spinal Muscular Atrophy Who Experienced a Plateau or Decline in Function After Gene Therapy

RECRUITING
NCT05861999Phase PHASE4Hoffmann-La RocheStarted 2024-08-14
Risdiplam
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
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
Muscular Atrophy, Spinal

A Study to Learn About Salanersen's (BIIB115) Effects on Movement and Its Safety When Given Before Symptoms Appear in Babies With Genetically Diagnosed Spinal Muscular Atrophy (SMA)

RECRUITING
NCT07221669Phase PHASE3BiogenStarted 2026-01-30
Salanersen
Spinal Muscular Atrophy (SMA)

Long Read Analysis in Spinal Muscular Atrophy - LOREASI

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

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
Muscular Atrophy, Spinal

A Study of Risdiplam in Infants With Genetically Diagnosed and Presymptomatic Spinal Muscular Atrophy

ACTIVE NOT RECRUITING
NCT03779334Phase PHASE2Hoffmann-La RocheStarted 2019-08-07
Risdiplam
Spinal Muscular Atrophy

Spinal Muscular Atrophy Neonatal Screening Program

RECRUITING
NCT06310421IRCCS Burlo GarofoloStarted 2023-10-16
Screening SMA test
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
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
Clinical Literature
Landmark / reviewRecent case evidence
Key Publications
Landmark & review papers · by relevance
PubMed
Top 5 results · since 2015Search PubMed ↗