18-36142309-A-G

Variant names:

Variant summary

Our verdict is Pathogenic. The variant received 14 ACMG points: 14P and 0B. PM2PP3_StrongPP5_Very_Strong

The NM_018255.4(ELP2):c.617A>G(p.His206Arg) variant causes a missense change. The variant allele was found at a frequency of 0.00000248 in 1,613,910 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

Genomes: 𝑓 0.0000066 ( 0 hom., cov: 32)

Exomes 𝑓: 0.0000021 ( 0 hom. )

Consequence

ELP2
NM_018255.4 missense

Scores

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:4O:1

Conservation

PhyloP100: 5.42

Publications

4 publications found

Variant links:

Genes affected

ELP2 (HGNC:18248): (elongator acetyltransferase complex subunit 2) The protein encoded by this gene is a core subunit of the elongator complex, a histone acetyltransferase complex that associates with RNA polymerase II. In addition to histone acetylation, the encoded protein effects transcriptional elongation and may help remodel chromatin. [provided by RefSeq, May 2016]

ELP2 Gene-Disease associations (from GenCC):

intellectual disability, autosomal recessive 58
Inheritance: AR Classification: STRONG, MODERATE, LIMITED Submitted by: Ambry Genetics, G2P, Labcorp Genetics (formerly Invitae)

ELP2 links:

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Pathogenic. The variant received 14 ACMG points.

PM2

Very rare variant in population databases, with high coverage;

PP3

MetaRNN computational evidence supports a deleterious effect, 0.981

PP5

Variant 18-36142309-A-G is Pathogenic according to our data. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-36142309-A-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 225008.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Transcripts

RefSeq

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	MANE	Protein	UniProt
ELP2	NM_018255.4 link	c.617A>G	p.His206Arg	missense_variant	Exon 7 of 22	ENST00000358232.11	NP_060725.1

Ensembl

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	TSL	MANE	Protein	Appris	UniProt
ELP2	ENST00000358232.11 link	c.617A>G	p.His206Arg	missense_variant	Exon 7 of 22	1	NM_018255.4	ENSP00000350967.6		Q6IA86-1

Frequencies

GnomAD3 genomes

AF:

0.00000657

AC:

AN:

152206

Hom.:

Cov.:

show subpopulations

Gnomad AFR

AF:

0.00

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

GnomAD2 exomes

AF:

0.00000398

AC:

AN:

251380

AF XY:

0.00000736

show subpopulations

Gnomad AFR exome

AF:

0.00

Gnomad AMR exome

AF:

0.00

Gnomad ASJ exome

AF:

0.00

Gnomad EAS exome

AF:

0.00

Gnomad FIN exome

AF:

0.00

Gnomad NFE exome

AF:

0.00000880

Gnomad OTH exome

AF:

0.00

GnomAD4 exome

AF:

0.00000205

AC:

AN:

1461704

Hom.:

Cov.:

AF XY:

0.00000138

AC XY:

AN XY:

727158

show subpopulations

African (AFR)

AF:

0.00

AC:

AN:

33470

American (AMR)

AF:

0.00

AC:

AN:

44722

Ashkenazi Jewish (ASJ)

AF:

0.00

AC:

AN:

26128

East Asian (EAS)

AF:

0.00

AC:

AN:

39648

South Asian (SAS)

AF:

0.00

AC:

AN:

86256

European-Finnish (FIN)

AF:

0.00

AC:

AN:

53408

Middle Eastern (MID)

AF:

0.00

AC:

AN:

5766

European-Non Finnish (NFE)

AF:

0.00000270

AC:

AN:

1111920

Other (OTH)

AF:

0.00

AC:

AN:

60386

Allele Balance Distribution

Red line indicates average allele balance

Average allele balance: 0.425

Heterozygous variant carriers

0.00

0.20

0.40

0.60

0.80

0.95

Allele balance

Age Distribution

Exome Het

Variant carriers

<30

30-35

35-40

40-45

45-50

50-55

55-60

60-65

65-70

70-75

75-80

>80

Age

GnomAD4 genome

AF:

0.00000657

AC:

AN:

152206

Hom.:

Cov.:

AF XY:

0.0000134

AC XY:

AN XY:

74356

show subpopulations

African (AFR)

AF:

0.00

AC:

AN:

41452

American (AMR)

AF:

0.00

AC:

AN:

15282

Ashkenazi Jewish (ASJ)

AF:

0.00

AC:

AN:

3470

East Asian (EAS)

AF:

0.00

AC:

AN:

5188

South Asian (SAS)

AF:

0.00

AC:

AN:

4828

European-Finnish (FIN)

AF:

0.00

AC:

AN:

10628

Middle Eastern (MID)

AF:

0.00

AC:

AN:

316

European-Non Finnish (NFE)

AF:

0.0000147

AC:

AN:

68036

Other (OTH)

AF:

0.00

AC:

AN:

2094

Allele Balance Distribution

Red line indicates average allele balance

Average allele balance: 0.525

Heterozygous variant carriers

0.00

0.20

0.40

0.60

0.80

0.95

Allele balance

Alfa

AF:

0.00

Hom.:

Bravo

AF:

0.00000378

ExAC

AF:

0.00000824

AC:

ClinVar

Significance: Pathogenic/Likely pathogenic

Submissions summary: Pathogenic:4Other:1

Revision: criteria provided, multiple submitters, no conflicts

LINK: link

Submissions by phenotype

Intellectual disability, autosomal recessive 58

Pathogenic:2

Feb 18, 2022

OMIM

Significance:Pathogenic

Review Status:no assertion criteria provided

Collection Method:literature only

- -

Mar 17, 2022

Women's Health and Genetics/Laboratory Corporation of America, LabCorp

Significance:Likely pathogenic

Review Status:criteria provided, single submitter

Collection Method:clinical testing

Variant summary: ELP2 c.617A>G (p.His206Arg) results in a non-conservative amino acid change in the encoded protein sequence. Five of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 4e-06 in 251380 control chromosomes (gnomAD). c.617A>G has been reported in the literature in compound heterozygous individuals affected with severe intellectual disability and neurodevelopmental delay (Cohen_2015, Kojic_2021) with strong co-segregation within a family where unaffected family members were either carriers for one ELP2 variant or non-carriers (Cohen_2015). These data indicate that the variant is likely to be associated with disease. One publication showed that the variant does not impact protein stability or Elongator protein complex formation, but significantly reduces tRNA induced acetyl COA hydroxylase activity (~60% activity, Kojic_2021). Mice homozygous for the same conserved amino acid residue have developmental delay and microcephaly, with reduction in cortical thickness, decrease in the number of interneurons, and significant changes in brain connectivity (Kojic_2021). Two ClinVar submitters have assessed the variant since 2014: one classified the variant as likely pathogenic and one as pathogenic. Based on the evidence outlined above, the variant was classified as likely pathogenic. -

Inborn genetic diseases

Pathogenic:1

Sep 10, 2013

Ambry Genetics

Significance:Pathogenic

Review Status:criteria provided, single submitter

Collection Method:clinical testing

- -

not provided

Pathogenic:1

Jun 07, 2017

GeneDx

Significance:Likely pathogenic

Review Status:criteria provided, single submitter

Collection Method:clinical testing

The H271R variant in the ELP2 gene has been reported previously in trans with another ELP2 variant in brothers with intellectual disability (Cohen et al., 2015). The H271R variant is not observed at a significant frequency in large population cohorts (Lek et al., 2016; 1000 Genomes Consortium et al., 2015; Exome Variant Server). The H271R variant is a conservative amino acid substitution, which is not likely to impact secondary protein structure as these residues share similar properties. However, this substitution occurs at a position that is conserved across species, and in silico analysis predicts this variant is probably damaging to the protein structure/function. The H271R variant is reported as pathogenic in ClinVar but additional evidence is not available (ClinVar SCV000262876.2; Landrum et al., 2016]. We interpret H271R as a likely pathogenic variant. -

ELP2-related disorder

Other:1

GenomeConnect, ClinGen

Significance:not provided

Review Status:no classification provided

Collection Method:phenotyping only

GenomeConnect assertions are reported exactly as they appear on the patient-provided report from the testing laboratory. GenomeConnect staff make no attempt to reinterpret the clinical significance of the variant. -

Computational scores

Source: dbNSFP v4.3

Name

Calibrated prediction

Score

Prediction

AlphaMissense

Pathogenic

0.95

BayesDel_addAF

Pathogenic

0.44

BayesDel_noAF

Pathogenic

0.40

CADD

Pathogenic

(source)

DANN

Uncertain

1.0

DEOGEN2

Uncertain

0.49

T;T;.;.;.;.

Eigen

Uncertain

0.63

Eigen_PC

Uncertain

0.65

FATHMM_MKL

Pathogenic

0.99

LIST_S2

Uncertain

0.90

D;D;D;D;D;D

M_CAP

Uncertain

0.27

MetaRNN

Pathogenic

0.98

D;D;D;D;D;D

MetaSVM

Uncertain

0.44

MutationAssessor

Pathogenic

3.9

.;H;.;.;.;.

PhyloP100

5.4

PrimateAI

Uncertain

0.61

PROVEAN

Pathogenic

-7.7

D;D;D;D;D;D

REVEL

Pathogenic

0.94

Sift

Pathogenic

0.0

D;D;D;D;D;D

Sift4G

Pathogenic

0.0

D;D;D;D;D;D

Polyphen

1.0

.;D;D;.;.;D

Vest4

0.93, 0.94, 0.91, 0.90, 0.94

MutPred

0.90

.;Gain of sheet (P = 0.0827);.;.;.;.;

MVP

0.90

MPC

0.50

ClinPred

1.0

GERP RS

5.7

Varity_R

0.82

gMVP

0.88

Mutation Taster

=1/99

disease causing (ClinVar)

(source)

Splicing

Name

Calibrated prediction

Score

Prediction

SpliceAI score (max)

0.060

Details are displayed if max score is > 0.2

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Publications

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Variant summary

Frequency

Consequence

Scores

Clinical Significance

Conservation

Publications

ACMG classification

Transcripts

RefSeq

Ensembl

Frequencies

Age Distribution

ClinVar

Submissions by phenotype

Computational scores

Splicing

Publications

Other links and lift over