17-44261625-C-T

Variant summary

Our verdict is Benign. Variant got -13 ACMG points: 0P and 13B. BP4_StrongBP6BS1BS2

The NM_000342.4(SLC4A1):​c.118G>A​(p.Glu40Lys) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0145 in 1,614,150 control chromosomes in the GnomAD database, including 222 homozygotes. In-silico tool predicts a benign outcome for this variant. 13/20 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).

Frequency

Genomes: 𝑓 0.011 ( 13 hom., cov: 32)
Exomes 𝑓: 0.015 ( 209 hom. )

Consequence

SLC4A1
NM_000342.4 missense

Scores

2
16

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications P:2U:1B:12

Conservation

PhyloP100: 0.681
Variant links:
Genes affected
SLC4A1 (HGNC:11027): (solute carrier family 4 member 1 (Diego blood group)) The protein encoded by this gene is part of the anion exchanger (AE) family and is expressed in the erythrocyte plasma membrane, where it functions as a chloride/bicarbonate exchanger involved in carbon dioxide transport from tissues to lungs. The protein comprises two domains that are structurally and functionally distinct. The N-terminal 40kDa domain is located in the cytoplasm and acts as an attachment site for the red cell skeleton by binding ankyrin. The glycosylated C-terminal membrane-associated domain contains 12-14 membrane spanning segments and carries out the stilbene disulphonate-sensitive exchange transport of anions. The cytoplasmic tail at the extreme C-terminus of the membrane domain binds carbonic anhydrase II. The encoded protein associates with the red cell membrane protein glycophorin A and this association promotes the correct folding and translocation of the exchanger. This protein is predominantly dimeric but forms tetramers in the presence of ankyrin. Many mutations in this gene are known in man, and these mutations can lead to two types of disease: destabilization of red cell membrane leading to hereditary spherocytosis, and defective kidney acid secretion leading to distal renal tubular acidosis. Other mutations that do not give rise to disease result in novel blood group antigens, which form the Diego blood group system. Southeast Asian ovalocytosis (SAO, Melanesian ovalocytosis) results from the heterozygous presence of a deletion in the encoded protein and is common in areas where Plasmodium falciparum malaria is endemic. One null mutation in this gene is known, resulting in very severe anemia and nephrocalcinosis. [provided by RefSeq, Jul 2008]

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ACMG classification

Classification made for transcript

Verdict is Benign. Variant got -13 ACMG points.

BP4
Computational evidence support a benign effect (MetaRNN=0.044904858).
BP6
Variant 17-44261625-C-T is Benign according to our data. Variant chr17-44261625-C-T is described in ClinVar as [Conflicting_classifications_of_pathogenicity]. Clinvar id is 17756.We mark this variant Likely_benign, oryginal submissions are: {Likely_benign=2, Uncertain_significance=1, Pathogenic=1, Benign=8, Likely_pathogenic=1}. Variant chr17-44261625-C-T is described in Lovd as [Benign].
BS1
Variant frequency is greater than expected in population nfe. gnomad4 allele frequency = 0.0111 (1690/152288) while in subpopulation NFE AF= 0.018 (1224/68002). AF 95% confidence interval is 0.0172. There are 13 homozygotes in gnomad4. There are 744 alleles in male gnomad4 subpopulation. Median coverage is 32. This position pass quality control queck.
BS2
High Homozygotes in GnomAd4 at 13 AD,AR,BG gene

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
SLC4A1NM_000342.4 linkuse as main transcriptc.118G>A p.Glu40Lys missense_variant 4/20 ENST00000262418.12 NP_000333.1 P02730-1
SLC4A1XM_011525129.3 linkuse as main transcriptc.118G>A p.Glu40Lys missense_variant 4/19 XP_011523431.1
SLC4A1XM_011525130.2 linkuse as main transcriptc.118G>A p.Glu40Lys missense_variant 4/18 XP_011523432.1
SLC4A1XM_005257593.6 linkuse as main transcriptc.-78G>A 5_prime_UTR_variant 2/18 XP_005257650.1 P02730-2

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
SLC4A1ENST00000262418.12 linkuse as main transcriptc.118G>A p.Glu40Lys missense_variant 4/201 NM_000342.4 ENSP00000262418.6 P02730-1
SLC4A1ENST00000399246.3 linkuse as main transcriptc.118G>A p.Glu40Lys missense_variant 4/155 ENSP00000382190.3 A0A0A0MS98
SLC4A1ENST00000471005.5 linkuse as main transcriptn.52G>A non_coding_transcript_exon_variant 2/43
SLC4A1ENST00000498270.1 linkuse as main transcriptn.399G>A non_coding_transcript_exon_variant 3/45

Frequencies

GnomAD3 genomes
AF:
0.0111
AC:
1691
AN:
152170
Hom.:
13
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00314
Gnomad AMI
AF:
0.112
Gnomad AMR
AF:
0.00655
Gnomad ASJ
AF:
0.00173
Gnomad EAS
AF:
0.000193
Gnomad SAS
AF:
0.00228
Gnomad FIN
AF:
0.00904
Gnomad MID
AF:
0.00316
Gnomad NFE
AF:
0.0180
Gnomad OTH
AF:
0.00956
GnomAD3 exomes
AF:
0.0105
AC:
2638
AN:
251402
Hom.:
14
AF XY:
0.0105
AC XY:
1431
AN XY:
135876
show subpopulations
Gnomad AFR exome
AF:
0.00289
Gnomad AMR exome
AF:
0.00642
Gnomad ASJ exome
AF:
0.000893
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.00206
Gnomad FIN exome
AF:
0.00896
Gnomad NFE exome
AF:
0.0178
Gnomad OTH exome
AF:
0.0121
GnomAD4 exome
AF:
0.0149
AC:
21724
AN:
1461862
Hom.:
209
Cov.:
33
AF XY:
0.0145
AC XY:
10530
AN XY:
727234
show subpopulations
Gnomad4 AFR exome
AF:
0.00311
Gnomad4 AMR exome
AF:
0.00684
Gnomad4 ASJ exome
AF:
0.00115
Gnomad4 EAS exome
AF:
0.0000504
Gnomad4 SAS exome
AF:
0.00243
Gnomad4 FIN exome
AF:
0.0101
Gnomad4 NFE exome
AF:
0.0178
Gnomad4 OTH exome
AF:
0.0121
GnomAD4 genome
AF:
0.0111
AC:
1690
AN:
152288
Hom.:
13
Cov.:
32
AF XY:
0.00999
AC XY:
744
AN XY:
74466
show subpopulations
Gnomad4 AFR
AF:
0.00313
Gnomad4 AMR
AF:
0.00647
Gnomad4 ASJ
AF:
0.00173
Gnomad4 EAS
AF:
0.000193
Gnomad4 SAS
AF:
0.00228
Gnomad4 FIN
AF:
0.00904
Gnomad4 NFE
AF:
0.0180
Gnomad4 OTH
AF:
0.00946
Alfa
AF:
0.0160
Hom.:
37
Bravo
AF:
0.0111
TwinsUK
AF:
0.0173
AC:
64
ALSPAC
AF:
0.0140
AC:
54
ESP6500AA
AF:
0.00454
AC:
20
ESP6500EA
AF:
0.0159
AC:
137
ExAC
AF:
0.0108
AC:
1315
Asia WGS
AF:
0.00115
AC:
4
AN:
3478
EpiCase
AF:
0.0150
EpiControl
AF:
0.0162

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Pathogenic:2Uncertain:1Benign:12
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

not provided Uncertain:1Benign:5
Uncertain significance, criteria provided, single submitterclinical testingMayo Clinic Laboratories, Mayo ClinicJan 23, 2024This missense variant also known as Band 3 Montefiore occurs in an acidic region of the N-terminus that contains binding sites for aldolase, phosphofructokinase, glyceraldehyde-3-phosphate dehydrogenase, denatured hemoglobins, and protein 4.2 (PMID:11049968). Functional studies indicate the alteration results in impaired binding to protein 4.2. Introduction of a positive charge by the E40K mutants may serve to disrupt the acidic protein 4.2-binding surface on cdAE1 (PMID:21039340). In a single case report, this mutation was detected in the homozygous state in a patient reported to have moderate and episodic nonimmune hemolytic anemia coincident with pregnancy and splenomegaly, spherocytosis, and increased osmotic fragility with a 88% decrease in protein 4.2. None of the heterozygous relatives were symptomatic and had a normal RBC membrane protein 4.2 content (PMID:8471774). This alteration is common in Europeans (MAF 1.8%) but is found at low frequencies in almost all other populations in gnomAD. Due to insufficient data available to clearly classify this variant as pathogenic or benign, it is categorized as a variant of uncertain significance. -
Benign, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpJan 22, 2024- -
Likely benign, criteria provided, single submitterclinical testingARUP Laboratories, Molecular Genetics and Genomics, ARUP LaboratoriesOct 04, 2023- -
Benign, criteria provided, single submitterclinical testingGeneDxMar 19, 2020This variant is associated with the following publications: (PMID: 33226606, 31723846, 27535533, 27354418, 21039340, 16411779, 9207478, 8471774, 20981092) -
Likely benign, no assertion criteria providedclinical testingDepartment of Pathology and Laboratory Medicine, Sinai Health System-The SLC4A1 p.Glu40Lys variant was identified in the literature in a female with episodic hemolytic anemia that was homozygous for the p.E40K variant (Rybicki_1993_8471774). The variant was identified in dbSNP (ID: rs45562031), LOVD 3.0 and ClinVar (classified as likely benign by PreventionGenetics and Illumina, as likely pathogenic by Bioinformatics dept., Datar Cancer Genetics Limited, India and as uncertain signifiicance by ARUP Laboratories and CeGaT Praxis fuer Humangenetik Tuebingen). The variant was identified in control databases in 3038 of 282752 chromosomes (17 homozygous) at a frequency of 0.010744 increasing the likelihood this could be a low frequency benign variant (Genome Aggregation Database March 6, 2019, v2.1.1). The variant was observed in the following populations: European (non-Finnish) in 2337 of 129084 chromosomes (freq: 0.0181), Other in 90 of 7228 chromosomes (freq: 0.01245), European (Finnish) in 234 of 25114 chromosomes (freq: 0.009318), Latino in 231 of 35438 chromosomes (freq: 0.006518), African in 74 of 24954 chromosomes (freq: 0.002965), South Asian in 63 of 30616 chromosomes (freq: 0.002058) and Ashkenazi Jewish in 9 of 10368 chromosomes (freq: 0.000868), but was not observed in the East Asian population. The p.Glu40 residue is not conserved in mammals and four out of five computational analyses (PolyPhen-2, SIFT, AlignGVGD, BLOSUM, MutationTaster) do not suggest a high likelihood of impact to the protein; however, this information is not predictive enough to rule out pathogenicity. The variant occurs outside of the splicing consensus sequence and three of four in silico or computational prediction software programs (SpliceSiteFinder, MaxEntScan, NNSPLICE, GeneSplicer) do not predict a greater than 10% difference in splicing; this is not very predictive of pathogenicity. In summary, based on the above information the clinical significance of this variant cannot be determined with certainty at this time although we would lean towards a more benign role for this variant. This variant is classified as likely benign. -
Benign, criteria provided, single submitterclinical testingCeGaT Center for Human Genetics TuebingenMar 01, 2024SLC4A1: BP4, BS1, BS2 -
Hereditary spherocytosis type 4 Pathogenic:1Benign:3
Pathogenic, flagged submissionliterature onlyOMIMApr 15, 1993- -
Benign, criteria provided, single submitterclinical testingIllumina Laboratory Services, IlluminaMar 06, 2018This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as benign is not then subjected to further curation. The score for this variant resulted in a classification of benign for this disease. -
Likely benign, criteria provided, single submitterresearchBroad Center for Mendelian Genomics, Broad Institute of MIT and Harvard-The homozygous p.Glu40Lys variant in SLC4A1 has been identified in an individual with a previous splenectomy (PMID: 8471774), but has been identified in >1% of European (non-Finnish) chromosomes and 3 homozygotes by ExAC (http://gnomad.broadinstitute.org/). In summary, although additional studies are required to fully establish its clinical significance, this variant meets criteria to be classified as likely benign for autosomal recessive spherocytosis. -
Benign, criteria provided, single submitterclinical testingMendelicsAug 22, 2023- -
Cryohydrocytosis Pathogenic:1
Likely pathogenic, flagged submissionclinical testingBioinformatics dept., Datar Cancer Genetics Limited, IndiaJun 23, 2017- -
Autosomal dominant distal renal tubular acidosis Benign:1
Benign, criteria provided, single submitterclinical testingIllumina Laboratory Services, IlluminaMar 06, 2018This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as benign is not then subjected to further curation. The score for this variant resulted in a classification of benign for this disease. -
SLC4A1-related disorder Benign:1
Likely benign, no assertion criteria providedclinical testingPreventionGenetics, part of Exact SciencesMay 31, 2023This variant is classified as likely benign based on ACMG/AMP sequence variant interpretation guidelines (Richards et al. 2015 PMID: 25741868, with internal and published modifications). -
Distal renal tubular acidosis Benign:1
Benign, criteria provided, single submitterclinical testingMolecular Genetics, Royal Melbourne HospitalJun 06, 2023- -
Hemolytic anemia Benign:1
Benign, criteria provided, single submitterclinical testingIllumina Laboratory Services, IlluminaMar 06, 2018This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as benign is not then subjected to further curation. The score for this variant resulted in a classification of benign for this disease. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.076
BayesDel_addAF
Benign
-0.40
T
BayesDel_noAF
Benign
-0.33
CADD
Benign
16
DANN
Uncertain
0.98
DEOGEN2
Benign
0.28
T;T
Eigen
Benign
-0.95
Eigen_PC
Benign
-0.99
FATHMM_MKL
Benign
0.051
N
LIST_S2
Benign
0.85
D;D
MetaRNN
Benign
0.045
T;T
MetaSVM
Benign
-0.95
T
MutationAssessor
Uncertain
2.7
M;.
PrimateAI
Benign
0.31
T
PROVEAN
Benign
-1.0
N;.
REVEL
Benign
0.21
Sift
Benign
0.20
T;.
Sift4G
Benign
0.49
T;T
Polyphen
0.059
B;.
Vest4
0.30
MPC
0.50
ClinPred
0.017
T
GERP RS
1.1
Varity_R
0.12
gMVP
0.21

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: rs45562031; hg19: chr17-42338993; API