CMT-SEPTIN9

SEPTIN9 | 2020

What Is CMT-SEPT9?

CMT-SEPT9 is a type of CMT caused by autosomal dominant mutations in the SEPT9 gene. This gene provides instructions for making septin-9, a protein that contributes to the structural organization and division of peripheral nerve cells. Mutations in the SEPT9 gene disrupt this function, leading to impaired nerve signal transmission.

CMT-SEPT9 is autosomal dominant, meaning that just one of the gene’s two copies needs a mutation to cause this subtype.

Clinical Features

The age of symptom onset in CMT-SEPT9 is variable, ranging from childhood to adulthood. Symptoms typically begin in the lower extremities and progress over time to involve the upper limbs. Nerve conduction studies usually show slowed conduction velocities, consistent with a demyelinating form of CMT.

CMT-SEPT9 symptoms may include:

  • Weakness in the feet and lower legs
  • Muscle atrophy
  • Foot drop
  • Reduced or absent reflexes
  • Reduced sensation
  • A steppage-style walking pattern
  • Foot deformities, including high arches, and hammertoes (clawed toes)
  • Progressive involvement of the hands and forearms
  • Difficulty with fine motor skills and manual dexterity
  • Additional symptoms not listed here

Disease Course

CMT-SEPT9 shows wide variability in severity and progression. Some individuals are mildly affected, while others develop a more severe disease. Disease progression is generally slow, and life expectancy is not reduced.

Clinical Basics

Subtype
CMT-SEPTIN9

Classification
Unclassified Subtypes

Neuropathy Type
Demyelinating

Inheritance Pattern
autosomal dominant

Genetic Context

HGNC-Approved Gene Symbol
SEPTIN9

Gene Full Name
septin 9

Chromosome
17q25.3

Zygosity of Responsible Variant
Heterozygous

Variant Mechanism

Toxic Gain of Function (GoF)

Details

Mechanistic basis:
Dosage

Confidence:
Medium

Prediction:
CMT-SEPTIN9 is predicted in the literature to act through gene dosage: intragenic duplications within SEPTIN9 raise the amount of a normal-sequence septin rather than removing a working copy, so the pathogenic quantity is an excess and supplementation is not predicted to help. Clustered N-terminal missense alleles are also reported and would work differently, by disrupting assembly of the hetero-oligomeric septin filament, and that unresolved split between two allele classes sets confidence at medium.

Rationale:
An extra normal-sequence copy cannot cause disease through insufficiency, which is the argument that separates the duplication alleles from haploinsufficiency and places them with excess septin. The N-terminal missense cluster points elsewhere, toward interference within the filament, and the two allele classes have not been reconciled.

ClinVar Pathogenic Variants

View SEPTIN9 ClinVar Variants

SEPTIN9 OMIM Entry

SEPTIN9 OMIM

More Info

CMT-SEPTIN9 Research Opportunity

CMT Natural History Study

Original Discovery Publication

Publication Title

Identification of a Rare SEPT9 Variant in a Family with Autosomal Dominant Charcot-Marie-Tooth Disease

Authors

Grosse, G. M., Bauer, C., Kopp, B., Schrader, C., & Osmanovic, A.

Publication Date
March 2, 2020

Updated: July 18, 2026 | By: K. Raymond

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