CMT2F

HSPB1 | 2004

What Is CMT2F?

CMT2F is a type of CMT caused by mutations in the HSPB1 gene. This gene provides instructions for producing heat shock protein beta-1, a molecular chaperone that helps protect cells from stress and supports normal protein folding. Mutations in the HSPB1 gene disrupt cellular stress responses in peripheral nerve cells, leading to axonal dysfunction and impaired nerve signal transmission.

CMT2F is autosomal dominant, meaning that just one of the gene’s two copies must have a CMT-causing mutation to cause this subtype.

Clinical Features

The age of symptom onset in CMT2F is variable, ranging from early childhood to the fifties. Symptoms typically begin in the lower extremities and progress over time to involve the upper limbs. An earlier onset isn’t necessarily associated with a more severe disease course. Nerve conduction studies usually show somewhat slowed conduction velocities and reduced amplitudes, consistent with an axonal form of CMT.

CMT2F symptoms may include:

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

Disease Course

CMT2F 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
CMT2F

Classification
CMT2

Neuropathy Type
Axonal

Inheritance Pattern
autosomal dominant

Genetic Context

HGNC-Approved Gene Symbol
HSPB1

Gene Full Name
heat shock protein family B (small) member 1

HGNC Gene Alias(es)
HSP27, HSP28, Hs.76067, HSP25

Chromosome
7q11.23

Zygosity of Responsible Variant
Heterozygous

Mitochondrial Involvement
No

Variant Mechanism

Toxic Gain of Function (GoF)

Details

Mechanistic basis:
Neomorphic

Confidence:
Medium

Prediction:
The literature predicts a neomorphic gain-of-function mechanism for CMT2F: dominant HSPB1 missense substitutions give HSP27 abnormally tight binding to tubulin, microtubules, and neurofilaments and a tendency to form insoluble species, so cargo transport along the long motor and sensory axons affected in CMT2F fails from a new activity rather than from lost chaperone capacity. Mice expressing mutant HSP27 reproduce the phenotype with reduced alpha-tubulin acetylation, while the Hspb1 null mouse is near normal, which places the defect in the mutant protein itself.

Rationale:
Hyperactive engagement of the cytoskeleton is the operative lesion, with mutant HSP27 clamping onto microtubules and neurofilaments and stalling the transport distal motor axons depend on, an activity the normal chaperone does not have. These same substitutions also reduce the chaperone capacity of the mixed oligomer, leaving a loss component that cannot be ruled out and holding the grade at medium.

ClinVar Pathogenic Variants

View HSPB1 ClinVar Variants

CMT2F OMIM Entry

CMT2F OMIM

HSPB1 OMIM Entry

HSPB1 OMIM

More Info

CMT2F Research Opportunity

CMT Natural History Study

Original Discovery Publication

Publication Title

Mutant Small Heat-Shock Protein 27 Causes Axonal Charcot-Marie-Tooth Disease and Distal Hereditary Motor Neuropathy

Authors

Evgrafov, O. V., Mersiyanova, I., Irobi, J., Van Den Bosch, L., Dierick, I., Leung, C. L., Schagina, O., Verpoorten, N., Van Impe, K., Fedotov, V., Dadali, E., Auer-Grumbach, M., Windpassinger, C., Wagner, K., Mitrovic, Z., Hilton-Jones, D., Talbot, K., Martin, J. J., Vasserman, N., Tverskaya, S., Polyakov, A., Liem, R.K.H., Gettemans, J., Robberecht, W., De Jonghe, P., & Timmerman, V.

Publication Date
May 2, 2004

Updated: May 9, 2026 | By: K. Raymond

The Dorsal Root

More From The Dorsal Root


A Name That Does Too Much Work

Jean-Martin Charcot's name appears throughout medicine, but nowhere does it create more confusion than in the foot. Learn why the CMT foot and Charcot neuroarthropathy, also known as Charcot foot, share a name yet differ in how they develop, appear, and are managed.


When Medicine Lost Its Compass

Evidence failed not because it was wrong, but because it was weaponized. I lived the downstream effects of that failure for more than a decade. This is what happens when medicine forgets that data always ends in a human being.


Error 404: Gene Not Found

CMT genetic testing often fails to identify the cause of the disease, even when comprehensive panels are used. Here, we discuss why this happens, what genetic tests can and cannot do, and why a negative result still matters.