TTN
Chr 2ADARtitin
Also known as: CMD1G, CMH9, CMPD4, CMYO5, CMYP5, EOMFC, HMERF, LGMD2J
This gene encodes a large abundant protein of striated muscle. The product of this gene is divided into two regions, a N-terminal I-band and a C-terminal A-band. The I-band, which is the elastic part of the molecule, contains two regions of tandem immunoglobulin domains on either side of a PEVK region that is rich in proline, glutamate, valine and lysine. The A-band, which is thought to act as a protein-ruler, contains a mixture of immunoglobulin and fibronectin repeats, and possesses kinase activity. An N-terminal Z-disc region and a C-terminal M-line region bind to the Z-line and M-line of the sarcomere, respectively, so that a single titin molecule spans half the length of a sarcomere. Titin also contains binding sites for muscle associated proteins so it serves as an adhesion template for the assembly of contractile machinery in muscle cells. It has also been identified as a structural protein for chromosomes. Alternative splicing of this gene results in multiple transcript variants. Considerable variability exists in the I-band, the M-line and the Z-disc regions of titin. Variability in the I-band region contributes to the differences in elasticity of different titin isoforms and, therefore, to the differences in elasticity of different muscle types. Mutations in this gene are associated with familial hypertrophic cardiomyopathy 9, and autoantibodies to titin are produced in patients with the autoimmune disease scleroderma. [provided by RefSeq, Feb 2012]
Primary Disease Associations & Inheritance
Definitive — sufficient evidence for diagnostic panels
6 total gene-disease associations curated
Population Genetics & Constraint
gnomAD v4 — loss-of-function & missense intolerance
More LoF-intolerant than ~75% of genes
Tolerant to missense variation
ClinVar Variant Classifications
391 submitted variants in ClinVar
Classification Summary
Curated Variants Distribution
Classified variants from ClinVar · 5 ACMG categories
| Classification | LoF | Missense + Inframe | Non-coding | Synonymous | Total |
|---|---|---|---|---|---|
Pathogenic | 6 | 0 | 5 | 0 | 11 |
Likely Pathogenic | 42 | 1 | 21 | 0 | 64 |
VUS | 4 | 45 | 4 | 2 | 55 |
Likely Benign | 0 | 0 | 90 | 170 | 260 |
Benign | 0 | 0 | 1 | 0 | 1 |
| Total | 52 | 46 | 121 | 172 | 391 |
LoF = frameshift, stop gained/lost, canonical splice · Counts from ClinVar esearch · Updated hourly
View in ClinVar →Protein Context — Lollipop Plot
TTN · protein map & ClinVar variants
Showing all ClinVar variants across the protein. Search a specific variant to highlight its position.
Gene2Phenotype Curations
TTN-related hypertrophic cardiomyopathy
limitedTTN-related arrhythmogenic right ventricular cardiomyopathy
limitedTTN-related dilated cardiomyopathy
definitiveTTN-related titinopathy with arthrogryposis and/or myopathy
definitiveGene2Phenotype curations · DECIPHER consortium patient cohort (public variants) · deciphergenomics.org
OMIM — Genotype-Phenotype Relationships
1 OMIM entry
Myopathy myofibrillar, 9, with early respiratory failure
MIM #603689Molecular basis of disorder known
External Resources
Links to major genomics databases and tools
Variant Interpretation
Population Databases
Gene Resources
Expert Curation
Clinical Trials
Active and recruiting trials from ClinicalTrials.gov
Defining the Risk of Ventricular Tachycardia in Genetic Forms of Early-onset Atrial Fibrillation
RECRUITINGSpastic Myopathy in Adults With Cerebral Palsy
RECRUITINGUrinary Titin Biomarker in DMD
RECRUITINGClinical and Functional Assessment of Patients With Inherited Non-Duchenne Myopathies in Sohag University Hospital
RECRUITINGBiomarkers in SCOTland CardiomyopatHy Registry (Bio-SCOTCH)
RECRUITINGOxaliplatin, Leucovorin, and Fluorouracil With or Without Bevacizumab in Treating Patients Who Have Undergone Surgery for Stage II Colon Cancer
ACTIVE NOT RECRUITINGAnticoagulation in ICH Survivors for Stroke Prevention and Recovery
RECRUITINGDefining the Risk of Ventricular Tachycardia in Genetic Cardiomyopathies
RECRUITINGExternal Resources
Links to major genomics databases and tools