10-99727157-G-C

Variant summary

Our verdict is Pathogenic. Variant got 11 ACMG points: 11P and 0B. PM2PP3PP5_Very_Strong

The NM_078470.6(COX15):​c.396-3C>G variant causes a splice region, splice polypyrimidine tract, intron change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.00018 in 1,613,982 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. 3/3 splice prediction tools predicting alterations to normal splicing. Variant has been reported in ClinVar as Likely pathogenic (★★).

Frequency

Genomes: 𝑓 0.00011 ( 0 hom., cov: 32)
Exomes 𝑓: 0.00019 ( 0 hom. )

Consequence

COX15
NM_078470.6 splice_region, splice_polypyrimidine_tract, intron

Scores

2
Splicing: ADA: 0.9997
2

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:4U:1

Conservation

PhyloP100: 1.75
Variant links:
Genes affected
COX15 (HGNC:2263): (cytochrome c oxidase assembly homolog COX15) Cytochrome c oxidase (COX), the terminal component of the mitochondrial respiratory chain, catalyzes the electron transfer from reduced cytochrome c to oxygen. This component is a heteromeric complex consisting of 3 catalytic subunits encoded by mitochondrial genes and multiple structural subunits encoded by nuclear genes. The mitochondrially-encoded subunits function in electron transfer, and the nuclear-encoded subunits may function in the regulation and assembly of the complex. This nuclear gene encodes a protein which is not a structural subunit, but may be essential for the biogenesis of COX formation and may function in the hydroxylation of heme O, according to the yeast mutant studies. This protein is predicted to contain 5 transmembrane domains localized in the mitochondrial inner membrane. Alternative splicing of this gene generates two transcript variants diverging in the 3' region. [provided by RefSeq, Jul 2008]
CUTC (HGNC:24271): (cutC copper transporter) Members of the CUT family of copper transporters are associated with copper homeostasis and are involved in the uptake, storage, delivery, and efflux of copper (Gupta et al., 1995 [PubMed 7635807]; Li et al., 2005 [PubMed 16182249]).[supplied by OMIM, Mar 2008]

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ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 11 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
PP3
Splicing scoreres supports a deletorius effect: Scorers claiming Pathogenic: dbscSNV1_ADA, dbscSNV1_RF, max_spliceai. No scorers claiming Uncertain. No scorers claiming Benign.
PP5
Variant 10-99727157-G-C is Pathogenic according to our data. Variant chr10-99727157-G-C is described in ClinVar as [Likely_pathogenic]. Clinvar id is 280009.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE UniProt
COX15NM_078470.6 linkuse as main transcriptc.396-3C>G splice_region_variant, splice_polypyrimidine_tract_variant, intron_variant ENST00000016171.6

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Appris UniProt
COX15ENST00000016171.6 linkuse as main transcriptc.396-3C>G splice_region_variant, splice_polypyrimidine_tract_variant, intron_variant 1 NM_078470.6 P1Q7KZN9-1
COX15ENST00000370483.9 linkuse as main transcriptc.396-3C>G splice_region_variant, splice_polypyrimidine_tract_variant, intron_variant 1 Q7KZN9-2
CUTCENST00000493385.5 linkuse as main transcriptn.309+4047G>C intron_variant, non_coding_transcript_variant 3

Frequencies

GnomAD3 genomes
AF:
0.000118
AC:
18
AN:
152144
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.0000655
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.000250
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000756
AC:
19
AN:
251368
Hom.:
0
AF XY:
0.0000810
AC XY:
11
AN XY:
135880
show subpopulations
Gnomad AFR exome
AF:
0.0000615
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.000150
Gnomad OTH exome
AF:
0.000163
GnomAD4 exome
AF:
0.000187
AC:
274
AN:
1461720
Hom.:
0
Cov.:
34
AF XY:
0.000161
AC XY:
117
AN XY:
727180
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.0000447
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.00
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.000227
Gnomad4 OTH exome
AF:
0.000331
GnomAD4 genome
AF:
0.000112
AC:
17
AN:
152262
Hom.:
0
Cov.:
32
AF XY:
0.0000806
AC XY:
6
AN XY:
74436
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.000250
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.000246
Hom.:
0
Bravo
AF:
0.0000945
Asia WGS
AF:
0.000289
AC:
1
AN:
3478
EpiCase
AF:
0.000382
EpiControl
AF:
0.000237

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:4Uncertain:1
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Pathogenic:2Uncertain:1
Uncertain significance, flagged submissionclinical testingEurofins Ntd Llc (ga)Jan 05, 2017- -
Likely pathogenic, criteria provided, single submitterclinical testingInvitaeJan 13, 2024This sequence change falls in intron 3 of the COX15 gene. It does not directly change the encoded amino acid sequence of the COX15 protein. It affects a nucleotide within the consensus splice site. This variant is present in population databases (rs200910834, gnomAD 0.01%). This variant has been observed in individual(s) with mitochondrial complex IV deficiency (PMID: 12474143). In at least one individual the data is consistent with being in trans (on the opposite chromosome) from a pathogenic variant. This variant is also known as C447-3G. ClinVar contains an entry for this variant (Variation ID: 280009). Studies have shown that this variant alters COX15 gene expression (PMID: 12474143). Variants that disrupt the consensus splice site are a relatively common cause of aberrant splicing (PMID: 17576681, 9536098). Algorithms developed to predict the effect of sequence changes on RNA splicing suggest that this variant may disrupt the consensus splice site. In summary, the currently available evidence indicates that the variant is pathogenic, but additional data are needed to prove that conclusively. Therefore, this variant has been classified as Likely Pathogenic. -
Pathogenic, criteria provided, single submitterclinical testingGeneDxMar 25, 2023Canonical splice site variant predicted to result in a null allele in a gene for which loss of function is a known mechanism of disease; Not observed at significant frequency in large population cohorts (gnomAD); This variant is associated with the following publications: (PMID: 34426522, 32232962, 29431110, 12474143) -
Leigh syndrome Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingWomen's Health and Genetics/Laboratory Corporation of America, LabCorpNov 23, 2022Variant summary: COX15 c.396-3C>G alters a non-conserved nucleotide located close to a canonical splice site and therefore could affect mRNA splicing, leading to a significantly altered protein sequence. Several computational tools predict a significant impact on normal splicing: Three predict the variant abolishes a canonical 3' acceptor site and one predicts the variant weakens the canonical 3' acceptor site. One publication reports experimental evidence that this variant indeed affects mRNA splicing, causing a frameshift and premature truncation as a result of the skipping of exon 4 (Antonicka_2003). The variant allele was found at a frequency of 7.6e-05 in 251368 control chromosomes, predominantly at a frequency of 0.00015 within the Non-Finnish European subpopulation in the gnomAD database. This frequency is not significantly higher than expected for a pathogenic variant in COX15 causing Leigh Syndrome (7.6e-05 vs 0.0013), allowing no conclusion about variant significance. c.396-3C>G has been reported in the literature in the compound heterozygous state together with a pathogenic variant in an individual with isolated cytochrome c oxidase (COX) deficiency and early onset, fatal hypertrophic cardiomyopathy (Antonicka_2003). This individual had reduced COX activity, particularly in heart tissue, and overexpression of COX15 in cultured fibroblasts restored activity to approximately 60% of normal (Antonicka_2003). Altogether these data suggest the variant is likely associated with disease. Three submitters have provided clinical-significance assessments for this variant to ClinVar after 2014 with conflicting assessments. Two laboratories classified the variant as either pathogenic (n=1) or likely pathogenic (n=1) and one classified it as VUS (n=1). Based on the evidence outlined above, the variant was classified as pathogenic. -
Cardioencephalomyopathy, fatal infantile, due to cytochrome c oxidase deficiency 2 Pathogenic:1
Pathogenic, no assertion criteria providedliterature onlyOMIMJan 01, 2003- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
BayesDel_noAF
Benign
-0.34
CADD
Benign
17
DANN
Benign
0.87

Splicing

Name
Calibrated prediction
Score
Prediction
dbscSNV1_ADA
Pathogenic
1.0
dbscSNV1_RF
Pathogenic
0.86
SpliceAI score (max)
0.57
Details are displayed if max score is > 0.2
DS_AL_spliceai
0.57
Position offset: -3

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Publications

LitVar

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs200910834; hg19: chr10-101486914; API