15-45376612-T-C

Variant summary

Our verdict is Likely benign. Variant got -5 ACMG points: 0P and 5B. BS1BP4

This summary comes from the ClinGen Evidence Repository: The NM_001482.3:c.277A>G variant in GATM is a missense variant that is predicted to cause the substitution of an isoleucine by a valine at amino acid position 93 (p.Ile93Val). The highest population minor allele frequency in gnomAD v2.1.1 is 0.00012 (2/16256 alleles) in the African population, which is higher than the ClinGen CCDS VCEP’s threshold for BS1 (>0.0001), and therefore meets this criterion (BS1). The computational predictor REVEL gives a score of 0.143 which is below the threshold of 0.15, evidence that does not predict a damaging effect on AGAT function (BP4). Expression of the variant in HeLa cells resulted in 18% of wild type AGAT activity, over than the cutoff for PS3_Supporting (<15%) and less than the cutoff for BS3_Supporting (≥30%), such that no experimental evidence codes are met. There is a ClinVar entry for this variant (Variation ID: 205610). In summary, this variant meets the criteria to be classified as likely benign for AGAT deficiency based on the ACMG/AMP criteria applied, as specified by the ClinGen Cerebral Creatine Deficiency Syndromes Variant Curation Expert Panel (Specifications Version 1.1.0): BS1, BP4.(Classification approved by the ClinGen Cerebral Creatine Deficiency Syndromes Variant Curation Expert Panel on October 8th, 2024). LINK:https://erepo.genome.network/evrepo/ui/classification/CA314862/MONDO:0012996/025

Frequency

Genomes: 𝑓 0.000053 ( 0 hom., cov: 32)
Exomes 𝑓: 0.000025 ( 0 hom. )

Consequence

GATM
NM_001482.3 missense

Scores

19

Clinical Significance

Likely benign reviewed by expert panel U:1B:3O:1

Conservation

PhyloP100: 2.54
Variant links:
Genes affected
GATM (HGNC:4175): (glycine amidinotransferase) This gene encodes a mitochondrial enzyme that belongs to the amidinotransferase family. This enzyme is involved in creatine biosynthesis, whereby it catalyzes the transfer of a guanido group from L-arginine to glycine, resulting in guanidinoacetic acid, the immediate precursor of creatine. Mutations in this gene cause arginine:glycine amidinotransferase deficiency, an inborn error of creatine synthesis characterized by cognitive disability, language impairment, and behavioral disorders. [provided by RefSeq, Jul 2008]

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ACMG classification

Classification made for transcript

Verdict is Likely_benign. Variant got -5 ACMG points.

BP4
For more information check the summary or visit ClinGen Evidence Repository.
BS1
For more information check the summary or visit ClinGen Evidence Repository.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
GATMNM_001482.3 linkuse as main transcriptc.277A>G p.Ile93Val missense_variant 2/9 ENST00000396659.8 NP_001473.1 P50440-1A0A140VK19

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
GATMENST00000396659.8 linkuse as main transcriptc.277A>G p.Ile93Val missense_variant 2/91 NM_001482.3 ENSP00000379895.3 P50440-1

Frequencies

GnomAD3 genomes
AF:
0.0000526
AC:
8
AN:
152176
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.000169
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
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:
0.0000147
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000159
AC:
4
AN:
251488
Hom.:
0
AF XY:
0.0000147
AC XY:
2
AN XY:
135922
show subpopulations
Gnomad AFR exome
AF:
0.000123
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:
0.0000176
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000246
AC:
36
AN:
1461436
Hom.:
0
Cov.:
32
AF XY:
0.0000289
AC XY:
21
AN XY:
727080
show subpopulations
Gnomad4 AFR exome
AF:
0.0000597
Gnomad4 AMR exome
AF:
0.00
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:
0.0000306
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
AF:
0.0000526
AC:
8
AN:
152176
Hom.:
0
Cov.:
32
AF XY:
0.0000538
AC XY:
4
AN XY:
74332
show subpopulations
Gnomad4 AFR
AF:
0.000169
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:
0.0000147
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.0000965
Hom.:
0
Bravo
AF:
0.0000453
TwinsUK
AF:
0.000270
AC:
1
ALSPAC
AF:
0.00
AC:
0
ESP6500AA
AF:
0.00
AC:
0
ESP6500EA
AF:
0.000116
AC:
1
ExAC
AF:
0.0000330
AC:
4

ClinVar

Significance: Likely benign
Submissions summary: Uncertain:1Benign:3Other:1
Revision: reviewed by expert panel
LINK: link

Submissions by phenotype

Arginine:glycine amidinotransferase deficiency Uncertain:1Benign:1
Likely benign, reviewed by expert panelcurationClinGen Cerebral Creatine Deficiency Syndromes Variant Curation Expert Panel, ClinGenOct 08, 2024The NM_001482.3:c.277A>G variant in GATM is a missense variant that is predicted to cause the substitution of an isoleucine by a valine at amino acid position 93 (p.Ile93Val). The highest population minor allele frequency in gnomAD v2.1.1 is 0.00012 (2/16256 alleles) in the African population, which is higher than the ClinGen CCDS VCEP’s threshold for BS1 (>0.0001), and therefore meets this criterion (BS1). The computational predictor REVEL gives a score of 0.143 which is below the threshold of 0.15, evidence that does not predict a damaging effect on AGAT function (BP4). Expression of the variant in HeLa cells resulted in 18% of wild type AGAT activity, over than the cutoff for PS3_Supporting (<15%) and less than the cutoff for BS3_Supporting (≥30%), such that no experimental evidence codes are met. There is a ClinVar entry for this variant (Variation ID: 205610). In summary, this variant meets the criteria to be classified as likely benign for AGAT deficiency based on the ACMG/AMP criteria applied, as specified by the ClinGen Cerebral Creatine Deficiency Syndromes Variant Curation Expert Panel (Specifications Version 1.1.0): BS1, BP4. (Classification approved by the ClinGen Cerebral Creatine Deficiency Syndromes Variant Curation Expert Panel on October 8th, 2024). -
Uncertain significance, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpJan 24, 2024This sequence change replaces isoleucine, which is neutral and non-polar, with valine, which is neutral and non-polar, at codon 93 of the GATM protein (p.Ile93Val). This variant is present in population databases (rs34991226, gnomAD 0.007%). This variant has not been reported in the literature in individuals affected with GATM-related conditions. ClinVar contains an entry for this variant (Variation ID: 205610). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is not expected to disrupt GATM protein function with a negative predictive value of 80%. Experimental studies are conflicting or provide insufficient evidence to determine the effect of this variant on GATM function (PMID: 27233232). In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. -
not specified Benign:1
Likely benign, criteria provided, single submitterclinical testingGeneDxJun 10, 2013This variant is considered likely benign or benign based on one or more of the following criteria: it is a conservative change, it occurs at a poorly conserved position in the protein, it is predicted to be benign by multiple in silico algorithms, and/or has population frequency not consistent with disease. -
Inborn genetic diseases Benign:1
Likely benign, criteria provided, single submitterclinical testingAmbry GeneticsSep 22, 2018This alteration is classified as likely benign based on a combination of the following: seen in unaffected individuals, population frequency, intact protein function, lack of segregation with disease, co-occurrence, RNA analysis, in silico models, amino acid conservation, lack of disease association in case-control studies, and/or the mechanism of disease or impacted region is inconsistent with a known cause of pathogenicity. -
not provided Other:1
not provided, no classification providedin vitroHospital for Sick Children-- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.048
BayesDel_addAF
Benign
-0.48
T
BayesDel_noAF
Benign
-0.75
CADD
Benign
6.8
DANN
Benign
0.57
DEOGEN2
Benign
0.27
T;.
Eigen
Benign
-0.76
Eigen_PC
Benign
-0.51
FATHMM_MKL
Benign
0.25
N
LIST_S2
Benign
0.54
T;T
M_CAP
Benign
0.0062
T
MetaRNN
Benign
0.035
T;T
MetaSVM
Benign
-1.1
T
MutationAssessor
Benign
-1.6
N;N
PrimateAI
Benign
0.37
T
PROVEAN
Benign
0.52
N;N
REVEL
Benign
0.14
Sift
Benign
1.0
T;T
Sift4G
Benign
1.0
T;T
Polyphen
0.0
B;B
Vest4
0.13
MVP
0.082
MPC
0.57
ClinPred
0.0095
T
GERP RS
3.8
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.1
Varity_R
0.069
gMVP
0.41

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

Publications

LitVar

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

Other links and lift over

dbSNP: rs34991226; hg19: chr15-45668810; API