15-48446701-C-T
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Variant summary
Our verdict is Pathogenic. Variant got 10 ACMG points: 10P and 0B. PM2PP5_Very_Strong
The NM_000138.5(FBN1):c.5788+5G>A variant causes a splice region, intron change. The variant allele was found at a frequency of 0.00000253 in 1,578,482 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. 2/3 splice prediction tools predicting alterations to normal splicing. Variant has been reported in ClinVar as Likely pathogenic (★★).
Frequency
Genomes: 𝑓 0.0000066 ( 0 hom., cov: 32)
Exomes 𝑓: 0.0000021 ( 0 hom. )
Consequence
FBN1
NM_000138.5 splice_region, intron
NM_000138.5 splice_region, intron
Scores
2
Splicing: ADA: 1.000
2
Clinical Significance
Conservation
PhyloP100: 6.90
Genes affected
FBN1 (HGNC:3603): (fibrillin 1) This gene encodes a member of the fibrillin family of proteins. The encoded preproprotein is proteolytically processed to generate two proteins including the extracellular matrix component fibrillin-1 and the protein hormone asprosin. Fibrillin-1 is an extracellular matrix glycoprotein that serves as a structural component of calcium-binding microfibrils. These microfibrils provide force-bearing structural support in elastic and nonelastic connective tissue throughout the body. Asprosin, secreted by white adipose tissue, has been shown to regulate glucose homeostasis. Mutations in this gene are associated with Marfan syndrome and the related MASS phenotype, as well as ectopia lentis syndrome, Weill-Marchesani syndrome, Shprintzen-Goldberg syndrome and neonatal progeroid syndrome. [provided by RefSeq, Apr 2016]
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ACMG classification
Classification made for transcript
Verdict is Pathogenic. Variant got 10 ACMG points.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 15-48446701-C-T is Pathogenic according to our data. Variant chr15-48446701-C-T is described in ClinVar as [Likely_pathogenic]. Clinvar id is 42394.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
Transcripts
RefSeq
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | MANE | Protein | UniProt |
---|---|---|---|---|---|---|---|---|
FBN1 | NM_000138.5 | c.5788+5G>A | splice_region_variant, intron_variant | ENST00000316623.10 | NP_000129.3 | |||
FBN1 | NM_001406716.1 | c.5788+5G>A | splice_region_variant, intron_variant | NP_001393645.1 |
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | TSL | MANE | Protein | Appris | UniProt |
---|---|---|---|---|---|---|---|---|---|---|
FBN1 | ENST00000316623.10 | c.5788+5G>A | splice_region_variant, intron_variant | 1 | NM_000138.5 | ENSP00000325527.5 |
Frequencies
GnomAD3 genomes AF: 0.00000657 AC: 1AN: 152136Hom.: 0 Cov.: 32
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GnomAD4 exome AF: 0.00000210 AC: 3AN: 1426346Hom.: 0 Cov.: 26 AF XY: 0.00000140 AC XY: 1AN XY: 711940
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GnomAD4 genome AF: 0.00000657 AC: 1AN: 152136Hom.: 0 Cov.: 32 AF XY: 0.0000135 AC XY: 1AN XY: 74308
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ClinVar
Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:19
Revision: criteria provided, multiple submitters, no conflicts
LINK: link
Submissions by phenotype
Marfan syndrome Pathogenic:10
Likely pathogenic, no assertion criteria provided | clinical testing | Center for Medical Genetics Ghent, University of Ghent | Nov 07, 2017 | - - |
Pathogenic, no assertion criteria provided | literature only | OMIM | Sep 01, 2003 | - - |
Pathogenic, no assertion criteria provided | case-control | deCODE genetics, Amgen | Apr 10, 2023 | The c.5788+5G>A variant occurred de novo in two siblings (shared de novo) with Marfan syndrome, maternity and paternity confirmed, parental mosaicism assumed. Applied ACMG criteria: PS2, PM2, PP2, PP4, PP5_strong - |
Pathogenic, criteria provided, single submitter | clinical testing | Center for Human Genetics, Inc, Center for Human Genetics, Inc | Nov 01, 2016 | - - |
Pathogenic, criteria provided, single submitter | clinical testing | Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine | Feb 17, 2014 | The 5788+5G>A variant has been previously reported in >15 individuals with a cli nical diagnosis or features of Marfan syndrome, and was reported to have occurre d de novo in >10 of these individuals (Nijbroek 1995, Yuan 1999, Loeys 2001, Com eglio 2007, Rommel 2002, Biggin 2004, Arbustini 2005, Sakai 2006, Rand-Hendrikse n 2007, Stheneur 2009, Soylen 2009, Baetens 2011, Aalberts 2014, LMM unpublished data). This variant was absent from large population studies. This variant occu rs in the highly conserved 5' splicing consensus sequence. Nijbroek et al. (1995 ) observed skipping of exon 46 in fibroblasts from an affected individual with t his variant, which is predicted to result in an abnormal protein product. In sum mary, this variant meets our criteria to be classified as pathogenic (http://pcp gm.partners.org/LMM). - |
Likely pathogenic, criteria provided, single submitter | research | Centre of Medical Genetics, University of Antwerp | Mar 01, 2021 | PM2, PS1, PP1, PP4 and PM2, PS1, PP4 - |
Pathogenic, criteria provided, single submitter | clinical testing | Victorian Clinical Genetics Services, Murdoch Childrens Research Institute | Feb 02, 2022 | Based on the classification scheme VCGS_Germline_v1.3.4, this variant is classified as Pathogenic. Following criteria are met: 0103 - Dominant negative and loss of function are known mechanisms of disease in this gene and are associated with FBN1-related disease. Variants predicted to result in nonsense mediated decay cause loss of function effects and are more commonly associated with severe Marfan syndrome (MIM#154700). Missense variants with both dominant negative and loss of function effects on protein function, are also associated with causing Marfan syndrome and ectopia lentis (MIM#129600) (OMIM, PMID: 29357934). (I) 0107 - This gene is predominantly associated with autosomal dominant disease; however some individuals have been reported with an autosomal recessive form of Marfan syndrome (OMIM). (I) 0115 - Variants in this gene are known to have variable expressivity. The genotype-phenotype correlations for this gene are unclear, with the same variant reported in patients with a range of phenotypes (OMIM). (I) 0210 - Splice site variant proven to affect splicing of the transcript with a known effect on protein sequence. RT-PCR analysis of cultured fibroblasts from an affected individual showed that the variant causes in-frame skipping of exon 47 and a small amount of abnormally spliced transcripts utilized a cryptic splice donor or a cryptic splice acceptor (PMID: 7611299). (SP) 0251 - This variant is heterozygous. (I) 0302 - Variant is present in gnomAD (v3) <0.001 for a dominant condition (1 heterozygote, 0 homozygotes). (SP) 0704 - Another splice variant comparable to the one identified in this case has limited previous evidence for pathogenicity. The c.5788+5G>T variant has been observed in an individual with Marfan syndrome and classified as likely pathogenic (VCGS laboratory). This variant has also been reported twice as a VUS in ClinVar. (SP) 0801 - This variant has strong previous evidence of pathogenicity in unrelated individuals. This variant has been reported in multiple individuals with Marfan syndrome (ClinVar, PMID: 7611299, PMID: 24161884). (SP) 1208 - Inheritance information for this variant is not currently available in this individual. (I) Legend: (SP) - Supporting pathogenic, (I) - Information, (SB) - Supporting benign - |
Pathogenic, criteria provided, single submitter | clinical testing | Suma Genomics | - | - - |
Pathogenic, criteria provided, single submitter | clinical testing | Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center | Apr 04, 2024 | - - |
Pathogenic, criteria provided, single submitter | clinical testing | All of Us Research Program, National Institutes of Health | Nov 07, 2023 | The c.5788+5G>A intronic variant in the FBN1 gene has been detected in heterozygous status including de novo occurrences in multiple unrelated individuals (>15) with classic Marfan syndrome features (PMID: 7611299, 11700157, 12402346, 8894692, 21542060, 16222657). Functional studies using RT-PCR performed on patient derived fibroblasts harboring this variant demonstrated in-frame skipping of the preceding exon 46 (117bp), resulting in aberrant protein product with deletion of 39 amino acids from the calcium-binding EGF-like domain of the fibrillin-1 protein (PMID: 7611299, 8894692). This variant is absent in the general population database gnomAD and is interpreted as pathogenic by several submitters in ClinVar database (ClinVar ID: 42394). Therefore, the c.5788+5G>A variant in FBN1 is classified as pathogenic. - |
Familial thoracic aortic aneurysm and aortic dissection Pathogenic:2
Pathogenic, criteria provided, single submitter | clinical testing | CHEO Genetics Diagnostic Laboratory, Children's Hospital of Eastern Ontario | Feb 03, 2018 | - - |
Pathogenic, criteria provided, single submitter | clinical testing | Ambry Genetics | Oct 07, 2024 | The c.5788+5G>A intronic pathogenic mutation results from a G to A substitution 5 nucleotides downstream of coding exon 46 in the FBN1 gene. This mutation (also referred to as IVS 46+5G>A) was first described in three unrelated patients (two of whom were reported as de novo) with classic Marfan syndrome (MFS), and was shown to cause exon 46 skipping by mRNA analysis using cultured skin fibroblasts from one patient (Nijbroek G et al, Am. J. Hum. Genet. 1995 Jul; 57(1):8-21). This mutation has also been described in multiple additional patients with MFS with additional reported de novo occurrences (Loeys B et al, Arch. Intern. Med. 2001 Nov; 161(20):2447-54; Rommel K et al, Hum. Mutat. 2002 Nov; 20(5):406-7; Arbustini E et al, Hum. Mutat. 2005 Nov; 26(5):494; Sakai H et al, Am. J. Med. Genet. A 2006 Aug; 140(16):1719-25; Rand-Hendriksen S et al, Am. J. Med. Genet. A 2007 Sep; 143A(17):1968-77; Söylen B et al, Clin. Genet. 2009 Mar; 75(3):265-70; Baetens M et al, Hum. Mutat. 2011 Sep; 32(9):1053-62; Li J et al. Sci China Life Sci. 2019;62(12):1630-1637). This nucleotide position is highly conserved in available vertebrate species. In silico splice site analysis predicts that this alteration may weaken the native splice donor site and may result in the creation or strengthening of a novel splice donor site. This variant is considered to be rare based on population cohorts in the Genome Aggregation Database (gnomAD). Based on the supporting evidence, this alteration is interpreted as a disease-causing mutation. - |
not provided Pathogenic:2
Pathogenic, criteria provided, single submitter | clinical testing | GeneDx | Apr 01, 2022 | Published functional studies showed RT-PCR performed on fibroblasts from individuals harboring this variant revealed c.5788+5 G>A leads to in-frame skipping of the preceding exon (Nijbroek et al., 1995; Lui et al., 1996; Wai et al., 2020).; Reported in ClinVar as pathogenic or likely pathogenic (ClinVar Variant ID# 42394; ClinVar); Intronic +5 splice site variant in a gene for which loss of function is a known mechanism of disease, and splice predictors support a deleterious effect; This variant is associated with the following publications: (PMID: 19293843, 11700157, 21542060, 14695540, 24161884, 8894692, 34818515, 34550612, 34498425, 7611299, 25525159, 17657824, 10533071, 12402346, 16835936, 17663468, 19159394, 33174221, 33083483, 31098894, 31730815, 16220557, 32123317, 16222657, 26582918) - |
Pathogenic, criteria provided, single submitter | clinical testing | Institute of Medical Genetics and Applied Genomics, University Hospital Tübingen | Oct 23, 2020 | - - |
Arachnodactyly;C0012736:Dissecting aortic dilatation;C0013581:Ectopia lentis;C0025202:Melanoma;C0271183:High myopia;C0948008:Ischemic stroke;C1298820:Aortic root aneurysm Pathogenic:1
Pathogenic, no assertion criteria provided | clinical testing | Centre for Mendelian Genomics, University Medical Centre Ljubljana | May 25, 2016 | - - |
See cases Pathogenic:1
Pathogenic, criteria provided, single submitter | clinical testing | Institute of Human Genetics, University Hospital Muenster | Dec 08, 2021 | ACMG categories: PS2,PM2,PP3,PP5 - |
Marfan Syndrome/Loeys-Dietz Syndrome/Familial Thoracic Aortic Aneurysms and Dissections Pathogenic:1
Pathogenic, criteria provided, single submitter | clinical testing | Women's Health and Genetics/Laboratory Corporation of America, LabCorp | Jan 16, 2023 | Variant summary: FBN1 c.5788+5G>A alters a 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: Four predict the variant abolishes the canonical 5' splicing donor site. One predicts the variant weakens the canonical 5' splicing donor site. Two publications report experimental evidence suggesting that this variant causes skipping of exon 46 (Liu_1996; Nijbroek_1995). The variant was absent in 251390 control chromosomes. c.5788+5G>A has been reported in the literature in multiple individuals affected with Marfan Syndrome (example, Baetens_2011, Liu_1996, Nijbroek_1995, Rand-Hendriksen_2007, Stheneur_2009). These data indicate that the variant is very likely to be associated with disease. Eleven clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 and all classified the variant as pathogenic/likely pathogenic. Based on the evidence outlined above, the variant was classified as pathogenic. - |
FBN1-related disorder Pathogenic:1
Pathogenic, no assertion criteria provided | clinical testing | PreventionGenetics, part of Exact Sciences | Jan 19, 2024 | The FBN1 c.5788+5G>A variant is predicted to interfere with splicing. This variant has been reported in many affected individuals in the FBN1 mutation database (http://www.umd.be/FBN1/) and is documented as pathogenic for Marfan syndrome (Liu et al. 1996. PubMed ID: 8894692; Nijbroek et al. 1995. PubMed ID: 7611299; Yuan et al. 1999. PubMed ID: 10533071; Table S1, Li et al. 2019. PubMed ID: 31098894; Mannucci et al. 2020. PubMed ID: 31730815). The c.5788+5G>A has been shown to result in exon skipping in patient-derived skin fibroblasts (Nijbroek et al. 1995. PubMed ID: 7611299; Liu et al. 1996. PubMed ID: 8894692). This variant has not been reported in a large population database, indicating this variant is rare. This variant is interpreted as pathogenic. - |
Marfan syndrome;C4707243:Familial thoracic aortic aneurysm and aortic dissection Pathogenic:1
Pathogenic, criteria provided, single submitter | clinical testing | Labcorp Genetics (formerly Invitae), Labcorp | Oct 25, 2023 | This sequence change falls in intron 47 of the FBN1 gene. It does not directly change the encoded amino acid sequence of the FBN1 protein. RNA analysis indicates that this variant induces altered splicing and likely results in a shortened protein product. This variant is not present in population databases (gnomAD no frequency). This variant has been observed in individual(s) with Marfan syndrome (PMID: 7611299, 11700157, 12402346, 14695540, 17657824, 17663468). In at least one individual the variant was observed to be de novo. This variant is also known as IVS46+5G>A. ClinVar contains an entry for this variant (Variation ID: 42394). Variants that disrupt the consensus splice site are a relatively common cause of aberrant splicing (PMID: 17576681, 9536098). Studies have shown that this variant results in skipping of exon 46, but is expected to preserve the integrity of the reading-frame (PMID: 7611299). For these reasons, this variant has been classified as Pathogenic. - |
Computational scores
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Name
Calibrated prediction
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BayesDel_noAF
Benign
CADD
Pathogenic
DANN
Benign
Splicing
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Calibrated prediction
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dbscSNV1_ADA
Pathogenic
dbscSNV1_RF
Pathogenic
SpliceAI score (max)
Details are displayed if max score is > 0.2
DS_DG_spliceai
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DS_DL_spliceai
Position offset: 5
Find out detailed SpliceAI scores and Pangolin per-transcript scores at