11-77332855-T-C

Variant names:

• chr11-77332855-T-C
• NM_002576.5:c.1426A>G

Variant summary

Our verdict is Likely pathogenic. The variant received 6 ACMG points: 6P and 0B. PM2 PM5 PP2 PP5

The NM_002576.5(PAK1):​c.1426A>G​(p.Ile476Val) variant causes a missense change involving the alteration of a conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. Variant has been reported in ClinVar as Likely pathogenic (no stars). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. I476T) has been classified as Likely pathogenic.

• Frequency: Genomes: not found (cov: 29)
• Consequence: PAK1 NM_002576.5 missense
• Clinical Significance: Likely pathogenic no assertion criteria provided P:1
• Conservation: PhyloP100: 7.64
• Publications: 0 publications found

Genes affected

PAK1 (HGNC:8590): (p21 (RAC1) activated kinase 1) This gene encodes a family member of serine/threonine p21-activating kinases, known as PAK proteins. These proteins are critical effectors that link RhoGTPases to cytoskeleton reorganization and nuclear signaling, and they serve as targets for the small GTP binding proteins Cdc42 and Rac. This specific family member regulates cell motility and morphology. Mutations in this gene have been associated with macrocephaly, seizures, and speech delay. Overexpression of this gene is also reported in many cancer types, and particularly in breast cancer. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Aug 2020]

PAK1 Gene-Disease associations (from GenCC):

• intellectual developmental disorder with macrocephaly, seizures, and speech delay

  Inheritance: AD Classification: STRONG, MODERATE Submitted by: Labcorp Genetics (formerly Invitae), Ambry Genetics, G2P

ACMG classification

Our verdict: Likely_pathogenic. The variant received 6 ACMG points.

• PM2: Very rare variant in population databases, with high coverage
• PM5: Other missense variant is known to change same aminoacid residue: Variant chr11-77332854-A-G is described in ClinVar as Pathogenic/Likely_pathogenic. ClinVar VariationId is 807646.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
• PP2: Missense variant in the PAK1 gene, where missense mutations are typically associated with disease (based on misZ statistic). The gene has 21 curated pathogenic missense variants (we use a threshold of 10). The gene has 3 curated benign missense variants. Gene score misZ: 4.0036 (above the threshold of 3.09). Trascript score misZ: 3.8133 (above the threshold of 3.09). GenCC associations: The gene is linked to intellectual developmental disorder with macrocephaly, seizures, and speech delay.
• PP5: Variant 11-77332855-T-C is Pathogenic according to our data. Variant chr11-77332855-T-C is described in ClinVar as Likely_pathogenic. ClinVar VariationId is 2506574.Status of the report is no_assertion_criteria_provided, 0 stars.

Variant Effect in Transcripts

ACMG analysis was done for transcript: NM_002576.5. You can select a different transcript below to see updated ACMG assignments.

RefSeq Transcripts

Sel.	Gene	Transcript	Tags	HGVSc	HGVSp	Effect	Exon Rank	Protein	UniProt
	PAK1	NM_002576.5	MANE Select	c.1426A>G	p.Ile476Val	missense	Exon 14 of 15	NP_002567.3
	PAK1	NM_001128620.2		c.1426A>G	p.Ile476Val	missense	Exon 14 of 16	NP_001122092.1	Q13153-2
	PAK1	NM_001376268.1		c.1426A>G	p.Ile476Val	missense	Exon 14 of 16	NP_001363197.1	Q13153-2

Ensembl Transcripts

Sel.	Gene	Transcript	Tags	HGVSc	HGVSp	Effect	Exon Rank	Protein	UniProt
	PAK1	ENST00000356341.8	TSL:1 MANE Select	c.1426A>G	p.Ile476Val	missense	Exon 14 of 15	ENSP00000348696.4	Q13153-1
	PAK1	ENST00000278568.8	TSL:2	c.1426A>G	p.Ile476Val	missense	Exon 14 of 16	ENSP00000278568.4	Q13153-2
	PAK1	ENST00000873292.1		c.1426A>G	p.Ile476Val	missense	Exon 14 of 15	ENSP00000543351.1

Frequencies

GnomAD3 genomes Cov.: 29

GnomAD4 exome Cov.: 30

GnomAD4 genome Cov.: 29

ClinVar

ClinVar submissions

Significance: Likely pathogenic

Revision: no assertion criteria provided

Pathogenic	VUS	Benign	Condition
1	-	-	Intellectual developmental disorder with macrocephaly, seizures, and speech delay (1)

Computational scores

Source: dbNSFP v4.9

Name	Calibrated prediction	Score	Prediction
AlphaMissense	Pathogenic	0.98
BayesDel_addAF	Uncertain	0.026	T
BayesDel_noAF	Benign	-0.20
CADD	Uncertain	25
DANN	Uncertain	1.0
DEOGEN2	Benign	0.14	T
Eigen	Uncertain	0.51
Eigen_PC	Uncertain	0.61
FATHMM_MKL	Pathogenic	0.98	D
LIST_S2	Uncertain	0.93	D
M_CAP	Benign	0.017	T
MetaRNN	Uncertain	0.72	D
MetaSVM	Benign	-1.1	T
MutationAssessor	Benign	0.83	L
PhyloP100		7.6
PrimateAI	Pathogenic	0.83	D
PROVEAN	Benign	-0.92	N
REVEL	Uncertain	0.33
Sift	Uncertain	0.014	D
Sift4G	Uncertain	0.019	D
Polyphen		0.33	B
Vest4		0.77
MutPred		0.78		Gain of methylation at R471 (P = 0.2086)
MVP		0.62
MPC		1.8
ClinPred		0.78	D
GERP RS		5.9
Varity_R		0.47
gMVP		0.58
Mutation Taster		=36/64	disease causing

Splicing

Name	Calibrated prediction	Score	Prediction
SpliceAI score (max)		0.0		Details are displayed if max score is > 0.2

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

Other links and lift over

hg19: chr11-77043900;