ATP2A2

protein-coding

ATPase sarcoplasmic/endoplasmic reticulum Ca2+ transporting 2, the group of ATPases Ca2+ transporting

Gene summary

This gene encodes one of the SERCA Ca(2+)-ATPases, which are intracellular pumps located in the sarcoplasmic or endoplasmic reticula of the skeletal muscle. This enzyme catalyzes the hydrolysis of ATP coupled with the translocation of calcium from the cytosol into the sarcoplasmic reticulum lumen, and is involved in regulation of the contraction/relaxation cycle. Mutations in this gene cause Darier-White disease, also known as keratosis follicularis, an autosomal dominant skin disorder characterized by loss of adhesion between epidermal cells and abnormal keratinization. Other types of mutations in this gene have been associated with various forms of muscular dystrophies. Alternative splicing results in multiple transcript variants encoding different isoforms. [provided by RefSeq, Dec 2019]

Previous symbols:
  • ATP2B
  • DAR

MANE transcript

NM_170665.4

Inheritance

AD

ClinVar variants

P:100U:157B:73

Top phenotype

Darier-White disease; Acrokeratosis verruciformis (Hopf disease)

gnomAD constraint

pLI —, LoF o/e 0.12

Max pathogenic AF

—

Genomic locus

chr12:110,280,756-110,351,093

External References & Databases

Transcript & Mutation Effects

hg38 • Region Span ~70.3 kb
Loading mutation effect viewer...

GenCC Phenotypes & Disease Associations

Curated gene-disease validity assertions and inheritance patterns

epilepsyNO_KNOWN

Inheritance Pattern: AD

Disease ID:MONDO:0005027

Submitter: ClinGen

*ATP2A2* was evaluated by the ClinGen Epilepsy GCEP in June 2026 due to its presence on at least 8 multi-gene testing panels for epilepsy per data from the Genetic Testing Registry at the time of review. Disease assertions available for this gene were reviewed in accordance with the ClinGen Lumping and Splitting Criteria. Variants in *ATP2A2* have primarily been reported in individuals in the literature with autosomal dominant Darier disease, a primarily dermatological condition. Additionally, variants in *ATP2A2* have been reported in individuals with autosomal dominant acrokeratosis verruciformis (AKV), autosomal dominant susceptibility to rhabdomyolysis, and in one family with autosomal recessive progressive proximal myopathy. As discussed below, while some individuals with variants in this gene and these other clinical presentations have also been reported to have epilepsy (PMIDs: 10441325, 11168576, 30345710, and 28498512), *ATP2A2* does not appear to be a primary cause of epilepsy; therefore, the Epilepsy GCEP is splitting this disease assertion from the others to refute. The other diseases are not being evaluated as part of this curation. *ATP2A2* was first reported in three individuals with epilepsy and Darier disease in 1999 (PMID: 10441325). At least six individuals with variants in *ATP2A2* (four missense, a frameshift, and a canonical splice) amongst over 200 other individuals with molecularly confirmed Darier disease have been reported to have epilepsy (PMIDs: 10441325, 11168576, 30345710). One individual with AKV and a recurrent missense variant has been reported to have short recurrent seizures not related to fevers (PMID: 28498512). Due to clinical suspicion of Darier disease, genetic testing for the seven probands described with seizures was limited to sequencing of only the *ATP2A2* gene; other potential genetic etiologies for their epilepsy were not ruled out. The frequency of epilepsy amongst individuals with *ATP2A2*-related Darier disease is similar to that of the general population frequency of epilepsy. Epidemiologic studies of individuals with clinically diagnosed Darier Disease show a slightly elevated risk for epilepsy; however, this risk is still relatively low, indicating that *ATP2A2* is not a primary epilepsy gene (PMID: 38820685, 38531956, 20456342). In summary, the evidence supporting the relationship between *ATP2A2* and autosomal dominant epilepsy has been refuted, and no valid evidence remains to support the claim. This classification was approved by the ClinGen Epilepsy GCEP on June 16, 2026 (SOP version 12).

Darier diseaseDEFINITIVE

Inheritance Pattern: AD

Disease ID:MONDO:0007417

Submitter: Illumina

Darier diseaseSTRONG

Inheritance Pattern: AD

Disease ID:MONDO:0007417

Submitter: Labcorp Genetics (formerly Invitae)

acrokeratosis verruciformisSUPPORTIVE

Inheritance Pattern: AD

Disease ID:MONDO:0007048

Submitter: Orphanet

Darier diseaseSUPPORTIVE

Inheritance Pattern: AD

Disease ID:MONDO:0007417

Submitter: Orphanet

acrokeratosis verruciformisDEFINITIVE

Inheritance Pattern: AD

Disease ID:MONDO:0007048

Submitter: G2P

acrokeratosis verruciformisSTRONG

Inheritance Pattern: AD

Disease ID:MONDO:0007048

Submitter: PanelApp Australia

acrokeratosis verruciformisSTRONG

Inheritance Pattern: AD

Disease ID:MONDO:0007048

Submitter: Labcorp Genetics (formerly Invitae)

Clinical Genomic Database (CGD)

Darier-White disease; Acrokeratosis verruciformis (Hopf disease)AD

Manifestation: Dermatologic

Intervention: General

Rationale: Genetic knowledge may be beneficial related to issues such as selection of optimal supportive care, informed medical decision-making, prognostic considerations, and avoidance of unnecessary testing

Comments: In Darier-White disease, oral retinoids may be beneficial

Refs: 921905; 1619075; 10441324; 10080178; 10441323; 11121153; 12542527; 12925205; 14675181; 22004489; 22035154; 22329366; 22814319; 22909361Source: CGD (NHGRI)

ClinVar Associated Diseases & Phenotypes

Reported disease conditions connected to ATP2A2 variants in ClinVar

9 Conditions Cataloged
not providedTotal: 223
Keratosis follicularisTotal: 88
Inborn genetic diseasesTotal: 66
not specifiedTotal: 35
ATP2A2-related disorderTotal: 33
Acrokeratosis verruciformis of HopfTotal: 26
Rhabdomyolysis, susceptibility to, 2Total: 3
Darier disease, acral hemorrhagic typeTotal: 2

ClinVar Variants & Pathogenicity by Type

Statistics based on transcript NM_170665.4. Only rare variants are included.

We include only reliable ClinVar variants with their consequences to MANE Select, MANE Plus Clinical transcripts, or transcripts with TSL equal to 1. Click a count to filter the variants table below.

Slight differences between displayed counts and ClinVar may occur due to a different transcript/consequence chosen by our variant effect predictor, or because we classify Benign/Likely benign as Likely benign and Pathogenic/Likely pathogenic as Likely pathogenic.

EffectPLPVUSLBBSum
synonymous
8
clinvar
46
clinvar
13
clinvar
67
missense
12
clinvar
33
clinvar
139
clinvar
12
clinvar
2
clinvar
198
nonsense
10
clinvar
3
clinvar
1
clinvar
14
start loss
2
clinvar
2
frameshift
13
clinvar
16
clinvar
1
clinvar
30
splice donor/acceptor (+/-2bp)
4
clinvar
7
clinvar
8
clinvar
19
Total41591575815330

Highest pathogenic variant AF is 0.000006571857

Loading ClinVar variants...

Transcript Catalog

Annotated transcript isoforms across RefSeq and Ensembl databases

Showing 4 of 21 transcripts
Transcript IDSourceProtein IDCoding ExonsMANE Status
NM_170665.4RefSeqNP_733765.120MANE Select
ENST00000539276.7EnsemblENSP00000440045.220MANE Select
NM_001413013.1RefSeqNP_001399942.119Standard
NM_001413014.1RefSeqNP_001399943.121Standard

Model Organisms & Knockout Phenotypes

Observed phenotypic effects in mouse and zebrafish models

Gene / ModelOrganismObserved Phenotype
atp2a2aDanio rerio

Structure: atrium

Quality: decreased contractility

abnormal

Gene Ontology (GO) Annotations & Pathways

Biological processes, molecular functions, cellular components and pathways

Pathways ConsensusPathDB

  • Cardiac muscle contraction - Homo sapiens (human)
  • Dilated cardiomyopathy (DCM) - Homo sapiens (human)
  • Arrhythmogenic right ventricular cardiomyopathy (ARVC) - Homo sapiens (human)
  • Alzheimer,s disease - Homo sapiens (human)
  • Hypertrophic cardiomyopathy (HCM) - Homo sapiens (human)

Biological Process

  • regulation of the force of heart contraction
  • skeletal muscle contraction
  • cellular calcium ion homeostasis
  • ER-nucleus signaling pathway
  • organelle organization

Molecular Function

  • calcium-transporting ATPase activity
  • calcium ion binding
  • protein binding
  • ATP binding
  • proton-exporting ATPase activity, phosphorylative mechanism

Cellular Component

  • nucleoplasm
  • endoplasmic reticulum
  • endoplasmic reticulum membrane
  • integral component of plasma membrane
  • vesicle membrane

gnomAD Constraint

Source: gnomAD

Gene type
protein_coding
Transcript type
protein_coding
Transcript
ENST00000539276
Coding exons
20
Length
70338
Individuals with no LoFs
125741
Homozygous LoFs
0
Heterozygous LoFs
7
Defined
125748
p
0.0000278
Z-ScoreObservedExpectedObserved/ExpectedMutation RateTotal Possible
Missense4.882465750.4280.00003396824
Missense (PolyPhen)40228.790.174842656
Synonymous-0.1272262241.010.00001512094
Loss of Function5.62648.10.1250.00000274558

Population LoF Frequency

PopulationCAFp-valueStatus
African00.0absent
Latino/Admixed American0.0000290.000029rare
Ashkenazi Jewish00.0absent
East Asian00.0absent
Finnish0.0000460.000046rare
European (Non-Finnish)0.0000440.000044rare
South Asian00.0absent
Other00.0absent

dbNSFP Gene Annotations

Source: dbNSFP

Function
FUNCTION: This magnesium-dependent enzyme catalyzes the hydrolysis of ATP coupled with the translocation of calcium from the cytosol to the sarcoplasmic reticulum lumen. Isoform 2 is involved in the regulation of the contraction/relaxation cycle (PubMed:16402920). Acts as a regulator of TNFSF11-mediated Ca(2+) signaling pathways via its interaction with TMEM64 which is critical for the TNFSF11- induced CREB1 activation and mitochondrial ROS generation necessary for proper osteoclast generation. Association between TMEM64 and SERCA2 in the ER leads to cytosolic Ca (2+) spiking for activation of NFATC1 and production of mitochondrial ROS, thereby triggering Ca (2+) signaling cascades that promote osteoclast differentiation and activation (By similarity). {ECO:0000250|UniProtKB:O55143, ECO:0000269|PubMed:16402920}.;
Disease
DISEASE: Acrokeratosis verruciformis (AKV) [MIM:101900]: A localized disorder of keratinization, which is inherited as an autosomal dominant trait. Its onset is early in life with multiple flat-topped, flesh-colored papules on the hands and feet, punctate keratoses on the palms and soles, with varying degrees of nail involvement. The histopathology shows a distinctive pattern of epidermal features with hyperkeratosis, hypergranulosis and acanthosis together with papillomatosis. These changes are frequently associated with circumscribed elevations of the epidermis that are said to resemble church spires. There are no features of dyskeratosis or acantholysis, the typical findings in lesions of Darier disease. {ECO:0000269|PubMed:12542527}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Darier disease (DD) [MIM:124200]: A skin disorder characterized by warty papules and plaques in seborrheic areas (central trunk, flexures, scalp and forehead), palmoplantar pits and distinctive nail abnormalities. It is due to loss of adhesion between epidermal cells (acantholysis) and abnormal keratinization. Patients with mild disease may have no more than a few scattered keratotic papules or subtle nail changes, whereas those with severe disease are handicapped by widespread malodorous keratotic plaques. Some patients present with hemorrhage into acantholytic vesicles on the palms and dorsal aspects of the fingers which gives rise to black macules. In a few families affected by Darier disease, neuropsychiatric abnormalities such as mild mental retardation, schizophrenia, bipolar disorder and epilepsy have been reported. Stress, UV exposure, heat, sweat, friction and oral contraception exacerbate disease symptoms. Clinical variants of Darier disease include hypertrophic, vesicobullous, hypopigmented, cornifying, zosteriform or linear, acute and comedonal subtypes. Comedonal Darier disease is characterized by the coexistence of acne-like comedonal lesions with typical Darier hyperkeratotic papules on light-exposed areas. At histopathologic level, comedonal Darier disease differs from classic Darier disease in the prominent follicular involvement and the presence of greatly elongated dermal villi. {ECO:0000269|PubMed:10080178, ECO:0000269|PubMed:10441323, ECO:0000269|PubMed:10441324, ECO:0000269|PubMed:10441325, ECO:0000269|PubMed:19995371, ECO:0000269|PubMed:28035777}. Note=The disease is caused by mutations affecting the gene represented in this entry.;

Recessive Scores

pRec
0.461

Intolerance Scores

LoFtool
0.0220
RVIS EVS
-1.6
RVIS percentile EVS
3.04

Essentials

Essential (CRISPR)
E
Essential (CRISPR2)
E
Essential (gene trap)
E
Indispensability pred.
E
Indispensability score
0.989

Gene Damage Prediction

AllRecessiveDominant
MendelianMediumMediumMedium
Primary ImmunodeficiencyMediumMediumMedium
CancerMediumMediumMedium
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