15-89319053-C-T
Variant summary
Our verdict is Pathogenic. Variant got 12 ACMG points: 12P and 0B. PP3_StrongPP5_Very_Strong
The NM_002693.3(POLG):c.3151G>A(p.Gly1051Arg) variant causes a missense change. The variant allele was found at a frequency of 0.000013 in 1,614,032 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Likely pathogenic (★★).
Frequency
Consequence
NM_002693.3 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Pathogenic. Variant got 12 ACMG points.
Transcripts
RefSeq
Ensembl
Frequencies
GnomAD3 genomes AF: 0.00000657 AC: 1AN: 152154Hom.: 0 Cov.: 32
GnomAD3 exomes AF: 0.00000398 AC: 1AN: 251328Hom.: 0 AF XY: 0.00 AC XY: 0AN XY: 135848
GnomAD4 exome AF: 0.0000137 AC: 20AN: 1461878Hom.: 0 Cov.: 32 AF XY: 0.0000124 AC XY: 9AN XY: 727240
GnomAD4 genome AF: 0.00000657 AC: 1AN: 152154Hom.: 0 Cov.: 32 AF XY: 0.00 AC XY: 0AN XY: 74322
ClinVar
Submissions by phenotype
Progressive sclerosing poliodystrophy Pathogenic:3
The NM_002693.2:c.3151G>A (NP_002684.1:p.Gly1051Arg) [GRCH38: NC_000015.10:g.89319053C>T] variant in POLG gene is interpretated to be a Likely Pathogenic based on ACMG guidelines (PMID: 25741868). This variant has been reported in PMID:14745080 . This variant meets the following evidence codes reported in the ACMG-guideline. PM2:This variant is absent in key population databases. PM3:Detected in trans with a pathogenic variant for Mitochondrial DNA depletion syndrome 4A (Alpers type) which is a recessive disorder. PP1:This variant is co-segregated with Mitochondrial DNA depletion syndrome 4A (Alpers type) in multiple affected family members. PP2:This is a missense variant in POLG with a low rate of benign and high rate of pathogenic missense variations. PP4:Patient's phenotype or family history is highly specific for POLG. Based on the evidence criteria codes applied, the variant is suggested to be Likely Pathogenic. -
This sequence change replaces glycine, which is neutral and non-polar, with arginine, which is basic and polar, at codon 1051 of the POLG protein (p.Gly1051Arg). This variant is present in population databases (rs121918049, gnomAD 0.0008%). This missense change has been observed in individual(s) with autosomal recessive POLG-related conditions (PMID: 14745080, 28130605, 30818899). In at least one individual the data is consistent with being in trans (on the opposite chromosome) from a pathogenic variant. It has also been observed to segregate with disease in related individuals. ClinVar contains an entry for this variant (Variation ID: 566044). 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 expected to disrupt POLG protein function with a positive predictive value of 95%. Experimental studies have shown that this missense change affects POLG function (PMID: 17980715, 20185557). For these reasons, this variant has been classified as Pathogenic. -
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Inborn genetic diseases Pathogenic:1
The c.3151G>A (p.G1051R) alteration is located in exon 20 (coding exon 19) of the POLG gene. This alteration results from a G to A substitution at nucleotide position 3151, causing the glycine (G) at amino acid position 1051 to be replaced by an arginine (R). Based on the available evidence, this variant is classified as likely pathogenic for autosomal recessive POLG-related mitochondrial disorders; however, the clinical significance for autosomal dominant POLG-related progressive external ophthalmoplegia is unclear. Based on data from gnomAD, the A allele has an overall frequency of 0.001% (2/282698) total alleles studied. This variant has been confirmed in trans with a second POLG variant in a patient with Alpers syndrome (Li, 2021). It has also been observed in the homozygous state in an individual from a large autism cohort; however, no details were provided regarding whether the patient had clinical symptoms of a POLG-related disorder (Doan, 2019). A different nucleotide substitution resulting in the same missense change, c.3151G>C (p.G1051R), has been previously reported in the compound heterozygous state with other POLG variants in multiple individuals with autosomal recessive POLG-related disorders (Mancuso, 2004; Formichi, 2016; Da Pozzo, 2017). This amino acid position is well conserved in available vertebrate species. Based on internal structural analysis, G1051R is highly destabilizing to the local structure (Ambry internal data). Functional studies using yeast models have shown that G1051R causes increased mtDNA instability and mutant frequency, indicative of defects in the mtDNA genome (Baruffini, 2007; Baruffini, 2010; Stumpf, 2010). This alteration is predicted to be deleterious by in silico analysis. Based on the available evidence, this alteration is classified as likely pathogenic. -
Progressive sclerosing poliodystrophy;C1834846:Progressive external ophthalmoplegia with mitochondrial DNA deletions, autosomal dominant 1;C1843851:Sensory ataxic neuropathy, dysarthria, and ophthalmoparesis;C3150914:Mitochondrial DNA depletion syndrome 4b;C4225153:Progressive external ophthalmoplegia with mitochondrial DNA deletions, autosomal recessive 1 Pathogenic:1
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Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at