19-13455138-T-C

Variant names:

• chr19-13455138-T-C
• NM_001127222.2:c.368A>G

Variant summary

Our verdict is Uncertain significance. Variant got 3 ACMG points: 5P and 2B. PM1 PM2 PP2 BP4_Moderate

The NM_001127222.2(CACNA1A):​c.368A>G​(p.Asp123Gly) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. In-silico tool predicts a benign outcome for this variant. 12/21 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Uncertain significance (★).

• Frequency: Genomes: not found (cov: 31)
• Consequence: CACNA1A NM_001127222.2 missense
• Clinical Significance: Uncertain significance criteria provided, single submitter U:1
• Conservation: PhyloP100: 3.17

Genes affected

CACNA1A (HGNC:1388): (calcium voltage-gated channel subunit alpha1 A) Voltage-dependent calcium channels mediate the entry of calcium ions into excitable cells, and are also involved in a variety of calcium-dependent processes, including muscle contraction, hormone or neurotransmitter release, and gene expression. Calcium channels are multisubunit complexes composed of alpha-1, beta, alpha-2/delta, and gamma subunits. The channel activity is directed by the pore-forming alpha-1 subunit, whereas, the others act as auxiliary subunits regulating this activity. The distinctive properties of the calcium channel types are related primarily to the expression of a variety of alpha-1 isoforms, alpha-1A, B, C, D, E, and S. This gene encodes the alpha-1A subunit, which is predominantly expressed in neuronal tissue. Mutations in this gene are associated with 2 neurologic disorders, familial hemiplegic migraine and episodic ataxia 2. This gene also exhibits polymorphic variation due to (CAG)n-repeats. Multiple transcript variants encoding different isoforms have been found for this gene. In one set of transcript variants, the (CAG)n-repeats occur in the 3' UTR, and are not associated with any disease. But in another set of variants, an insertion extends the coding region to include the (CAG)n-repeats which encode a polyglutamine tract. Expansion of the (CAG)n-repeats from the normal 4-18 to 21-33 in the coding region is associated with spinocerebellar ataxia 6. [provided by RefSeq, Jul 2016]

ACMG classification

Verdict is Uncertain_significance. Variant got 3 ACMG points.

• PM1: In a repeat I (size 278) in uniprot entity CAC1A_HUMAN there are 11 pathogenic changes around while only 1 benign (92%) in NM_001127222.2
• PM2: Very rare variant in population databases, with high coverage
• PP2: Missense variant in the CACNA1A gene, where missense mutations are typically associated with disease (based on misZ statistic). The gene has 137 curated pathogenic missense variants (we use a threshold of 10). The gene has 132 curated benign missense variants. Gene score misZ: 5.7845 (above the threshold of 3.09). Trascript score misZ: 3.9354 (above the threshold of 3.09). GenCC associations: The gene is linked to benign paroxysmal torticollis of infancy, developmental and epileptic encephalopathy, 42, undetermined early-onset epileptic encephalopathy, episodic ataxia type 2, familial or sporadic hemiplegic migraine, spinocerebellar ataxia type 6, Lennox-Gastaut syndrome, migraine, familial hemiplegic, 1.
• BP4: Computational evidence support a benign effect (MetaRNN=0.19481167).

Transcripts

RefSeq

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	MANE	Protein	UniProt
CACNA1A	NM_001127222.2	c.368A>G	p.Asp123Gly	missense_variant	Exon 2 of 47	ENST00000360228.11	NP_001120694.1

Ensembl

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	TSL	MANE	Protein	Appris	UniProt
CACNA1A	ENST00000360228.11	c.368A>G	p.Asp123Gly	missense_variant	Exon 2 of 47	1	NM_001127222.2	ENSP00000353362.5
CACNA1A	ENST00000638029.1	c.368A>G	p.Asp123Gly	missense_variant	Exon 2 of 48	5		ENSP00000489829.1
CACNA1A	ENST00000573710.7	c.368A>G	p.Asp123Gly	missense_variant	Exon 2 of 47	5		ENSP00000460092.3
CACNA1A	ENST00000635727.1	c.368A>G	p.Asp123Gly	missense_variant	Exon 2 of 47	5		ENSP00000490001.1
CACNA1A	ENST00000637769.1	c.368A>G	p.Asp123Gly	missense_variant	Exon 2 of 47	1		ENSP00000489778.1
CACNA1A	ENST00000636012.1	c.368A>G	p.Asp123Gly	missense_variant	Exon 2 of 46	5		ENSP00000490223.1
CACNA1A	ENST00000636389.1	c.368A>G	p.Asp123Gly	missense_variant	Exon 2 of 47	5		ENSP00000489992.1
CACNA1A	ENST00000637432.1	c.368A>G	p.Asp123Gly	missense_variant	Exon 2 of 48	5		ENSP00000490617.1
CACNA1A	ENST00000636549.1	c.368A>G	p.Asp123Gly	missense_variant	Exon 2 of 48	5		ENSP00000490578.1
CACNA1A	ENST00000637927.1	c.368A>G	p.Asp123Gly	missense_variant	Exon 2 of 47	5		ENSP00000489715.1
CACNA1A	ENST00000635895.1	c.368A>G	p.Asp123Gly	missense_variant	Exon 2 of 47	5		ENSP00000490323.1
CACNA1A	ENST00000638009.2	c.368A>G	p.Asp123Gly	missense_variant	Exon 2 of 47	1		ENSP00000489913.1
CACNA1A	ENST00000637276.1	c.368A>G	p.Asp123Gly	missense_variant	Exon 2 of 46	5		ENSP00000489777.1
CACNA1A	ENST00000637736.1	c.259-2123A>G		intron_variant	Intron 1 of 45	5		ENSP00000489861.1

Frequencies

GnomAD3 genomes Cov.: 31

GnomAD4 exome Cov.: 28

GnomAD4 genome Cov.: 31

ClinVar

Significance: Uncertain significance

Submissions summary: Uncertain:1

Revision: criteria provided, single submitter

Submissions by phenotype

not provided Uncertain:1

Feb 06, 2024

GeneDx

Significance: Uncertain significance

Review Status: criteria provided, single submitter

Collection Method: clinical testing

Not observed at significant frequency in large population cohorts (gnomAD); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; Has not been previously published as pathogenic or benign to our knowledge -

Computational scores

Source: dbNSFP v4.3

Name	Calibrated prediction	Score	Prediction
AlphaMissense	Uncertain	0.34
BayesDel_addAF	Benign	-0.054	T
BayesDel_noAF	Benign	-0.32
CADD	Uncertain	24
DANN	Benign	0.97
DEOGEN2	Pathogenic	0.82	.;D;T;.;.;.;.;.;T;.;.;.;T;.;.
Eigen	Benign	-0.27
Eigen_PC	Benign	-0.17
FATHMM_MKL	Uncertain	0.89	D
LIST_S2	Uncertain	0.86	D;D;D;D;D;D;D;.;D;D;D;D;D;D;.
M_CAP	Benign	0.014	T
MetaRNN	Benign	0.19	T;T;T;T;T;T;T;T;T;T;T;T;T;T;T
MetaSVM	Benign	-0.95	T
MutationAssessor	Benign	1.5	.;L;.;.;L;.;L;.;.;.;.;L;.;.;.
PrimateAI	Uncertain	0.64	T
PROVEAN	Uncertain	-3.8	.;D;.;.;.;.;.;.;.;.;.;.;.;.;.
REVEL	Benign	0.14
Sift	Benign	0.39	.;T;.;.;.;.;.;.;.;.;.;.;.;.;.
Sift4G	Benign	0.60	T;T;.;.;.;.;.;.;.;.;T;.;.;.;T
Polyphen		0.0020	.;B;.;.;.;.;.;.;.;.;.;.;.;.;.
Vest4		0.50
MutPred		0.36		Loss of solvent accessibility (P = 0.0477);Loss of solvent accessibility (P = 0.0477);Loss of solvent accessibility (P = 0.0477);Loss of solvent accessibility (P = 0.0477);Loss of solvent accessibility (P = 0.0477);Loss of solvent accessibility (P = 0.0477);Loss of solvent accessibility (P = 0.0477);Loss of solvent accessibility (P = 0.0477);Loss of solvent accessibility (P = 0.0477);Loss of solvent accessibility (P = 0.0477);Loss of solvent accessibility (P = 0.0477);Loss of solvent accessibility (P = 0.0477);Loss of solvent accessibility (P = 0.0477);Loss of solvent accessibility (P = 0.0477);.;
MVP		0.75
MPC		2.3
ClinPred		0.97	D
GERP RS		5.0
Varity_R		0.26
gMVP		0.88

Splicing

Name	Calibrated prediction	Score	Prediction
SpliceAI score (max)		0.010		Details are displayed if max score is > 0.2

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

Publications

No publications associated with this variant yet.

Other links and lift over

hg19: chr19-13565952;