18-23586283-T-C

Variant names:

• chr18-23586283-T-C
• rs1057519229
• NM_000271.5:c.57+4A>G

Variant summary

Our verdict is Uncertain significance. The variant received 2 ACMG points: 3P and 1B. PM2 PP5 BP4

The NM_000271.5(NPC1):​c.57+4A>G variant causes a splice region, intron change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000029 in 1,380,178 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 predict no significant impact on normal splicing. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).

• Frequency:
  • Genomes: not found (cov: 33)
  • Exomes 𝑓: 0.0000029 (0 hom.)
• Consequence: NPC1 NM_000271.5 splice_region, intron
• Scores: Splicing: ADA: 0.9847
• Clinical Significance: Conflicting classifications of pathogenicity criteria provided, conflicting classifications P:1 U:2
• Conservation: PhyloP100: 1.10
• Publications: 2 publications found

Genes affected

NPC1 (HGNC:7897): (NPC intracellular cholesterol transporter 1) This gene encodes a large protein that resides in the limiting membrane of endosomes and lysosomes and mediates intracellular cholesterol trafficking via binding of cholesterol to its N-terminal domain. It is predicted to have a cytoplasmic C-terminus, 13 transmembrane domains, and 3 large loops in the lumen of the endosome - the last loop being at the N-terminus. This protein transports low-density lipoproteins to late endosomal/lysosomal compartments where they are hydrolized and released as free cholesterol. Defects in this gene cause Niemann-Pick type C disease, a rare autosomal recessive neurodegenerative disorder characterized by over accumulation of cholesterol and glycosphingolipids in late endosomal/lysosomal compartments.[provided by RefSeq, Aug 2009]

NPC1 Gene-Disease associations (from GenCC):

• Niemann-Pick disease, type C1

  Inheritance: AR Classification: DEFINITIVE, STRONG Submitted by: ClinGen, Laboratory for Molecular Medicine, Labcorp Genetics (formerly Invitae), G2P, Genomics England PanelApp, Myriad Women’s Health
• Niemann-Pick disease type C, adult neurologic onset

  Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
• Niemann-Pick disease type C, juvenile neurologic onset

  Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
• Niemann-Pick disease type C, late infantile neurologic onset

  Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
• Niemann-Pick disease type C, severe early infantile neurologic onset

  Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
• Niemann-Pick disease type C, severe perinatal form

  Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet

ACMG classification

Our verdict: Uncertain_significance. The variant received 2 ACMG points.

• PM2: Very rare variant in population databases, with high coverage
• PP5: Variant 18-23586283-T-C is Pathogenic according to our data. Variant chr18-23586283-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 374748. Variant chr18-23586283-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 374748. Variant chr18-23586283-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 374748. Variant chr18-23586283-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 374748. Variant chr18-23586283-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 374748. Variant chr18-23586283-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 374748. Variant chr18-23586283-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 374748. Variant chr18-23586283-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 374748. Variant chr18-23586283-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 374748. Variant chr18-23586283-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 374748. Variant chr18-23586283-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 374748. Variant chr18-23586283-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 374748. Variant chr18-23586283-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 374748. Variant chr18-23586283-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 374748. Variant chr18-23586283-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 374748. Variant chr18-23586283-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 374748.
• BP4: Computational evidence support a benign effect (BayesDel_noAF=-0.26). . Strength limited to SUPPORTING due to the PP5.

Transcripts

RefSeq

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	MANE	Protein	UniProt
NPC1	NM_000271.5	c.57+4A>G		splice_region_variant, intron_variant	Intron 1 of 24	ENST00000269228.10	NP_000262.2

Ensembl

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	TSL	MANE	Protein	Appris	UniProt
NPC1	ENST00000269228.10	c.57+4A>G		splice_region_variant, intron_variant	Intron 1 of 24	1	NM_000271.5	ENSP00000269228.4
NPC1	ENST00000540608.5	n.201+4A>G		splice_region_variant, intron_variant	Intron 1 of 15	2

Frequencies

GnomAD3 genomes Cov.: 33

GnomAD4 exome AF: 0.00000290 AC: 4 AN: 1380178 Hom.: 0 Cov.: 31 AF XY: 0.00000147 AC XY: 1 AN XY: 680948

African (AFR) AF: 0.00 AC: 0 AN: 31350

American (AMR) AF: 0.00 AC: 0 AN: 35580

Ashkenazi Jewish (ASJ) AF: 0.00 AC: 0 AN: 25094

East Asian (EAS) AF: 0.00 AC: 0 AN: 35644

South Asian (SAS) AF: 0.00 AC: 0 AN: 79000

European-Finnish (FIN) AF: 0.00 AC: 0 AN: 34364

Middle Eastern (MID) AF: 0.00 AC: 0 AN: 4076

European-Non Finnish (NFE) AF: 0.00000371 AC: 4 AN: 1077498

Other (OTH) AF: 0.00 AC: 0 AN: 57572

GnomAD4 genome Cov.: 33

ClinVar

Significance: Conflicting classifications of pathogenicity

Submissions summary: Pathogenic:1 Uncertain:2

Revision: criteria provided, conflicting classifications

Submissions by phenotype

Niemann-Pick disease, type C1 Pathogenic:1 Uncertain:1

Dec 21, 2017

Counsyl

Significance: Uncertain significance

Review Status: no assertion criteria provided

Collection Method: clinical testing

This submission and the accompanying classification are no longer maintained by the submitter. For more information on current observations and classification, please contact variantquestions@myriad.com. -

May 28, 2019

Mendelics

Significance: Likely pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

- -

not provided Uncertain:1

Jul 01, 2016

CeGaT Center for Human Genetics Tuebingen

Significance: Uncertain significance

Review Status: criteria provided, single submitter

Collection Method: clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name	Calibrated prediction	Score	Prediction
BayesDel_noAF	Benign	-0.26
CADD	Benign	22
DANN	Benign	0.88
PhyloP100		1.1
PromoterAI		-0.41	Neutral
Mutation Taster		=27/73	disease causing (ClinVar)

Splicing

Name	Calibrated prediction	Score	Prediction
dbscSNV1_ADA	Pathogenic	0.98
dbscSNV1_RF	Benign	0.68
SpliceAI score (max)		0.11		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

dbSNP: rs1057519229; hg19: chr18-21166247;