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POMT1 gene
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Gene

POMT1 gene

The POMT1 gene provides instructions for creating a critical enzyme complex involved in the glycosylation of alpha-dystroglycan, a protein essential for muscle stability and brain development.

Normal Function

The POMT1 gene provides instructions for making one piece of the protein O-mannosyltransferase (POMT) enzyme complex. The other piece is produced from the POMT2 gene. This enzyme complex is present in many different tissues in the body but is particularly abundant in the muscles used for movement (skeletal muscles), fetal brain, and testes.

The POMT complex helps modify a protein called alpha (α)-dystroglycan. Specifically, this complex adds a sugar molecule called mannose to α-dystroglycan through a process called glycosylation. Glycosylation is critical for the normal function of α-dystroglycan.

The α-dystroglycan protein helps anchor the structural framework inside each cell (cytoskeleton) to the lattice of proteins and other molecules outside the cell (extracellular matrix). In skeletal muscles, glycosylated α-dystroglycan helps stabilize and protect muscle fibers. In the brain, it helps direct the movement (migration) of nerve cells (neurons) during early development.

Health Conditions Related to Genetic Changes

Walker-Warburg syndrome

At least 24 mutations in the POMT1 gene have been found to cause Walker-Warburg syndrome, the most severe form of a group of disorders known as congenital muscular dystrophies. Individuals with Walker-Warburg syndrome have skeletal muscle weakness and abnormalities of the brain and eyes. Because of the severity of the problems caused by this condition, affected individuals usually do not survive past early childhood.

POMT1 gene mutations that cause Walker-Warburg syndrome lead to the formation of nonfunctional POMT enzyme complexes that cannot transfer mannose to α-dystroglycan, preventing its normal glycosylation. As a result, α-dystroglycan can no longer effectively anchor cells to the proteins and other molecules that surround them. Without functional α-dystroglycan to stabilize the muscle fibers, they become damaged as they repeatedly contract and relax with use. The damaged fibers weaken and die over time, which affects the development, structure, and function of skeletal muscles in people with Walker-Warburg syndrome.

Defective α-dystroglycan also affects the migration of neurons during the early development of the brain. Instead of stopping when they reach their intended destinations, some neurons migrate past the surface of the brain into the fluid-filled space that surrounds it. Researchers believe that this problem with neuronal migration causes a brain abnormality called cobblestone lissencephaly, in which the surface of the brain lacks the normal folds and grooves and instead appears bumpy and irregular.

Limb-girdle muscular dystrophy

MedlinePlus Genetics provides information about Limb-girdle muscular dystrophy.

Other disorders

Mutations in the POMT1 gene are also involved in less severe forms of muscular dystrophy, including muscle-eye-brain disease and POMT1-related congenital muscular dystrophy (also known as MDDGB1). Muscle-eye-brain disease is similar to Walker-Warburg syndrome, although affected individuals usually survive into childhood or adolescence. POMT1-related congenital muscular dystrophy causes muscle weakness, brain abnormalities, and intellectual disability, but usually does not affect the eyes.

POMT1 gene mutations that cause these conditions result in POMT enzyme complexes with reduced function. As a result, glycosylation of α-dystroglycan is impaired. The severity of the resulting condition appears to be related to the level of α-dystroglycan glycosylation; the less glycosylation, the more severe the condition.

Other Names for This Gene

  • dolichyl-phosphate-mannose--protein mannosyltransferase 1
  • dolichyl-phosphate-mannose-protein mannosyltransferase
  • LGMD2K
  • MDDGA1
  • MDDGB1
  • MDDGC1
  • POMT1_HUMAN
  • protein O-mannosyl-transferase 1
  • protein-O-mannosyltransferase 1
  • RT

Frequently Asked Questions

Infants with POMT1 mutations often show profound hypotonia (low muscle tone), feeding difficulties, and delayed motor milestones. Neurologic signs such as seizures, abnormal brain imaging (e.g., lissencephaly or hydrocephalus), and eye abnormalities (e.g., retinal detachment or microphthalmia) can also appear within the first weeks of life. Early recognition of these features should prompt genetic evaluation.
Confirmation typically involves a combination of biochemical testing (e.g., reduced glycosylation of α‑dystroglycan in muscle biopsy) and molecular genetic testing. Whole‑exome sequencing or targeted POMT1 sequencing panels are used to identify pathogenic variants; segregation analysis can confirm inheritance patterns.
There is no cure, but supportive care is essential. Physical therapy, occupational therapy, and respiratory support can improve quality of life. Some clinical trials are exploring gene therapy or enzyme replacement strategies, but these remain experimental. Early multidisciplinary care is recommended to manage muscle weakness, feeding, and developmental delays.
POMT1 mutations are inherited in an autosomal recessive manner. If both parents carry a pathogenic variant, each pregnancy has a 25 % chance of being affected, a 50 % chance of being a carrier, and a 25 % chance of being unaffected. Prenatal testing (amniocentesis or chorionic villus sampling) or preimplantation genetic testing can identify affected embryos.===
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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