CMT1J

ITPR3 | 2020

What Is CMT1J?

CMT1J is a type of CMT caused by mutations in the ITPR3 gene. This gene encodes inositol 1,4,5-trisphosphate receptor type 3, a protein involved in intracellular calcium signaling that plays an important role in neuronal function. Mutations in the ITPR3 gene disrupt normal signaling pathways in peripheral nerves, leading to impaired myelin function and slowed nerve signal transmission.

CMT1J 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 CMT1J is variable, ranging from childhood to middle adulthood. Symptoms often begin in the lower extremities and progress gradually over time. Nerve conduction studies typically show demyelinating or intermediate-range conduction velocities, reflecting involvement of peripheral nerve myelin.

CMT1J symptoms may include:

  • Symptoms may begin in childhood or adulthood
  • First symptoms typically appear in the lower extremities
  • Weakness in the feet and lower legs
  • Muscle atrophy
  • Foot drop
  • Gait abnormalities
  • Reduced sensation
  • Reduced or absent reflexes
  • Foot deformities, including high arches and hammertoes (clawed toes)
  • Progressive involvement of the hands and forearms
  • Additional symptoms not listed here

Disease Course

CMT1J shows variability in severity and progression. Some individuals experience a relatively mild course, while others develop a more severe presentation. Progression is generally slow, and life expectancy is not reduced.

Clinical Basics

Subtype
CMT1J

Classification
CMT1

Neuropathy Type
Demyelinating

Inheritance Pattern
autosomal dominant

Genetic Context

HGNC-Approved Gene Symbol
ITPR3

Gene Full Name
inositol 1,4,5-trisphosphate receptor type 3

HGNC Gene Alias(es)
IP3R3

Chromosome
6p21.31

Zygosity of Responsible Variant
Heterozygous

Mitochondrial Involvement
No

Variant Mechanism

Unknown

Details

Mechanistic basis:
Unresolved

Confidence:
Low

Prediction:
The reported evidence on CMT1J does not settle a mechanism: recurrent heterozygous ITPR3 missense variants affect a subunit of the homotetrameric IP3 receptor, so one mutant subunit is present in most assembled channels and can pull function well below half. That architecture accommodates suppressed calcium release and a leaky, overactive channel equally well, and no electrophysiology or calcium imaging on the patient alleles has been published.

Rationale:
Tetramer assembly is what makes this ambiguous: subunit-level interference and constitutive channel opening are both dominant at the same genotype, yet they move cytosolic calcium in opposite directions. Measuring IP3-evoked release from the mutant alone and alongside wild-type would separate them, and that experiment is missing.

ClinVar Pathogenic Variants

View CMT1J ClinVar Variants

CMT1J OMIM Entry

CMT1J OMIM

ITPR3 OMIM Entry

ITPR3 OMIM

More Info

CMT1J Research Opportunity

CMT Natural History Study

Original Discovery Publication

Publication Title

Dominant Mutations in ITPR3 Cause Charcot-Marie-Tooth Disease

Authors

Rönkkö, J., Molchanova, S., Revah-Politi, A., Pereira, E. M., Auranen, M., Toppila, J., Kvist, J., Ludwig, A., Neumann, J., Bultynck, G., Humblet-Baron, S., Liston, A., Paetau, A., Rivera, C., Harms, M. B., Tyynismaa, H., & Ylikallio, E

Publication Date
September 19, 2020

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

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