19-38483329-C-T

Position:

chr19-38483329-C-T

Variant summary

Our verdict is Uncertain significance. Variant got 0 ACMG points: 0P and 0B.

This summary comes from the ClinGen Evidence Repository: This pathogenicity assessment is relevant only for malignant hyperthermia susceptibility (MHS) inherited in an autosomal dominant pattern. Variants in RYR1 can also cause other myopathies inherited in an autosomal dominant pattern or in an autosomal recessive pattern. Some of these disorders may predispose individuals to malignant hyperthermia. RYR1 variants may also contribute to a malignant hyperthermia reaction in combination with other genetic and non-genetic factors and the clinician needs to consider such factors in making management decisions.This sequence variant predicts a substitution of arginine with cysteine at codon 1583 of the RYR1 protein, p.(Arg1583Cys). The maximum allele frequency (MAF) for this variant among the six major gnomAD populations is NFE: 0.000122, a frequency consistent with pathogenicity for MHS. However, the MAF in the Finnish population is 0.0014 which is higher than expected for a single pathogenic variant. This variant has been reported in two unrelated individuals who have a personal or family history of a malignant hyperthermia reaction and a positive in vitro contracture test (IVCT) or caffeine halothane contracture test (CHCT) result (if the proband was unavailable for testing, a positive diagnostic test result in a mutation-positive relative was counted); both of these individuals had a other RYR1 variants identified in cis (p.Gly248Arg and p.Glu5034Val, likely pathogenic and VUS, PMID:19346234; p.Val2102Leu, VUS, PMID:23035052). A third individual was identified with this variant and masseter muscle rigidity (PMID:30864471), a precursor to MH. The available case data combined with the high MAF in the NFE and FIN populations in gnomAD does not allow for the use of PS4. This variant segregates with MHS in two families, however, PP1 was not implemented due to the presence of other RYR1 variants in cis (PMID:19346234, PMID:23035052). Functional studies were carried out in B-lymphoblastoid cells from three family members with both the p.Arg1583Cys and p.Val2102Leu RYR1 variants (PMID:23035052). These cells were hypersensitive to agonist compared to wild type cells, however PS3 was not implemented as all cells were from the same family (two or more independent studies are required) and other variants in cis complicated the interpretation. This variant does not reside in a hotspot for pathogenic variants that contribute to MHS. A REVEL score of 0.586 supports neither a pathogenic nor a benign status for this variant. This variant has been classified as a Variant of Unknown Significance. No criteria implemented. LINK:https://erepo.genome.network/evrepo/ui/classification/CA081610/MONDO:0018493/012

Frequency

Genomes: 𝑓 0.000072 ( 0 hom., cov: 32)

Exomes 𝑓: 0.00013 ( 1 hom. )

Consequence

RYR1
NM_000540.3 missense

Scores

Clinical Significance

Uncertain significance reviewed by expert panel U:7B:4

Conservation

PhyloP100: 2.52

Variant links:

Genes affected

RYR1 (HGNC:10483): (ryanodine receptor 1) This gene encodes a ryanodine receptor found in skeletal muscle. The encoded protein functions as a calcium release channel in the sarcoplasmic reticulum but also serves to connect the sarcoplasmic reticulum and transverse tubule. Mutations in this gene are associated with malignant hyperthermia susceptibility, central core disease, and minicore myopathy with external ophthalmoplegia. Alternatively spliced transcripts encoding different isoforms have been described. [provided by RefSeq, Jul 2008]

RYR1 links:

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Uncertain_significance. Variant got 0 ACMG points.

Transcripts

RefSeq

Gene	Transcript	HGVSc	HGVSp	Effect	#exon/exons	MANE	Protein	UniProt
RYR1	NM_000540.3 linkuse as main transcript	c.4747C>T	p.Arg1583Cys	missense_variant	33/106	ENST00000359596.8	NP_000531.2

Ensembl

Gene	Transcript	HGVSc	HGVSp	Effect	#exon/exons	TSL	MANE	Protein	Appris	UniProt
RYR1	ENST00000359596.8 linkuse as main transcript	c.4747C>T	p.Arg1583Cys	missense_variant	33/106	5	NM_000540.3	ENSP00000352608	A2	P21817-1
RYR1	ENST00000355481.8 linkuse as main transcript	c.4747C>T	p.Arg1583Cys	missense_variant	33/105	1		ENSP00000347667	P4	P21817-2
RYR1	ENST00000599547.6 linkuse as main transcript	c.4747C>T	p.Arg1583Cys	missense_variant, NMD_transcript_variant	33/80	2		ENSP00000471601

Frequencies

GnomAD3 genomes

AF:

0.0000723

AC:

AN:

152182

Hom.:

Cov.:

show subpopulations

Gnomad AFR

AF:

0.0000241

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:

0.000565

Gnomad MID

AF:

0.00

Gnomad NFE

AF:

0.0000588

Gnomad OTH

AF:

0.00

GnomAD3 exomes

AF:

0.000192

AC:

AN:

166432

Hom.:

AF XY:

0.000181

AC XY:

AN XY:

88228

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 SAS exome

AF:

0.00

Gnomad FIN exome

AF:

0.00145

Gnomad NFE exome

AF:

0.000135

Gnomad OTH exome

AF:

0.000217

GnomAD4 exome

AF:

0.000127

AC:

179

AN:

1407652

Hom.:

Cov.:

AF XY:

0.000122

AC XY:

AN XY:

695234

show subpopulations

Gnomad4 AFR exome

AF:

0.00

Gnomad4 AMR exome

AF:

0.00

Gnomad4 ASJ exome

AF:

0.00

Gnomad4 EAS exome

AF:

0.00

Gnomad4 SAS exome

AF:

0.00

Gnomad4 FIN exome

AF:

0.00163

Gnomad4 NFE exome

AF:

0.0000747

Gnomad4 OTH exome

AF:

0.000308

GnomAD4 genome

AF:

0.0000723

AC:

AN:

152182

Hom.:

Cov.:

AF XY:

0.0000807

AC XY:

AN XY:

74344

show subpopulations

Gnomad4 AFR

AF:

0.0000241

Gnomad4 AMR

AF:

0.00

Gnomad4 ASJ

AF:

0.00

Gnomad4 EAS

AF:

0.00

Gnomad4 SAS

AF:

0.00

Gnomad4 FIN

AF:

0.000565

Gnomad4 NFE

AF:

0.0000588

Gnomad4 OTH

AF:

0.00

Alfa

AF:

0.000192

Hom.:

Bravo

AF:

0.0000529

ExAC

AF:

0.000298

AC:

ClinVar

Significance: Uncertain significance

Submissions summary: Uncertain:7Benign:4

Revision: reviewed by expert panel

LINK: link

Submissions by phenotype

not provided

Uncertain:3

Uncertain significance, criteria provided, single submitter	clinical testing	Revvity Omics, Revvity	Jul 22, 2019	- -
Uncertain significance, criteria provided, single submitter	clinical testing	Athena Diagnostics	Dec 30, 2019	- -
Uncertain significance, criteria provided, single submitter	clinical testing	PreventionGenetics, part of Exact Sciences	Aug 18, 2015	- -

Malignant hyperthermia of anesthesia

Uncertain:1Benign:1

Likely benign, criteria provided, single submitter	clinical testing	Illumina Laboratory Services, Illumina	Jun 14, 2016	- -
Uncertain significance, reviewed by expert panel	curation	ClinGen Malignant Hyperthermia Susceptibility Variant Curation Expert Panel, ClinGen	Apr 06, 2023	This pathogenicity assessment is relevant only for malignant hyperthermia susceptibility (MHS) inherited in an autosomal dominant pattern. Variants in RYR1 can also cause other myopathies inherited in an autosomal dominant pattern or in an autosomal recessive pattern. Some of these disorders may predispose individuals to malignant hyperthermia. RYR1 variants may also contribute to a malignant hyperthermia reaction in combination with other genetic and non-genetic factors and the clinician needs to consider such factors in making management decisions. This sequence variant predicts a substitution of arginine with cysteine at codon 1583 of the RYR1 protein, p.(Arg1583Cys). The maximum allele frequency (MAF) for this variant among the six major gnomAD populations is NFE: 0.000122, a frequency consistent with pathogenicity for MHS. However, the MAF in the Finnish population is 0.0014 which is higher than expected for a single pathogenic variant. This variant has been reported in two unrelated individuals who have a personal or family history of a malignant hyperthermia reaction and a positive in vitro contracture test (IVCT) or caffeine halothane contracture test (CHCT) result (if the proband was unavailable for testing, a positive diagnostic test result in a mutation-positive relative was counted); both of these individuals had a other RYR1 variants identified in cis (p.Gly248Arg and p.Glu5034Val, likely pathogenic and VUS, PMID:19346234; p.Val2102Leu, VUS, PMID:23035052). A third individual was identified with this variant and masseter muscle rigidity (PMID:30864471), a precursor to MH. The available case data combined with the high MAF in the NFE and FIN populations in gnomAD does not allow for the use of PS4. This variant segregates with MHS in two families, however, PP1 was not implemented due to the presence of other RYR1 variants in cis (PMID:19346234, PMID:23035052). Functional studies were carried out in B-lymphoblastoid cells from three family members with both the p.Arg1583Cys and p.Val2102Leu RYR1 variants (PMID:23035052). These cells were hypersensitive to agonist compared to wild type cells, however PS3 was not implemented as all cells were from the same family (two or more independent studies are required) and other variants in cis complicated the interpretation. This variant does not reside in a hotspot for pathogenic variants that contribute to MHS. A REVEL score of 0.586 supports neither a pathogenic nor a benign status for this variant. This variant has been classified as a Variant of Unknown Significance. No criteria implemented. -

not specified

Uncertain:1

Uncertain significance, criteria provided, single submitter

clinical testing

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

Dec 27, 2023

Variant summary: RYR1 c.4747C>T (p.Arg1583Cys) results in a non-conservative amino acid change in the encoded protein sequence. Four of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 0.00019 in 166432 control chromosomes (gnomAD). The observed variant frequency is approximately 2.2 fold of the estimated maximal expected allele frequency for a pathogenic variant in RYR1 causing Malignant Hyperthermia Susceptibility phenotype (8.8e-05), strongly suggesting that the variant is benign. c.4747C>T has been reported in the literature in individuals affected with Malignant Hyperthermia Susceptibility or Hypotonia without strong evidence of causality (e.g. Broman_2009, Schiemann_2013, Hudig_2019, Ek_2023). These reports do not provide unequivocal conclusions about association of the variant with Malignant Hyperthermia Susceptibility. Co-occurrence with another pathogenic variant was reported in affected individuals in one of these families (RYR1, p.Gly248Arg, Broman_2009), providing supporting evidence for a benign role. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. The following publications have been ascertained in the context of this evaluation (PMID: 19346234, 23035052, 30864471, 37510298, 37273706). Seven submitters have cited clinical-significance assessments for this variant to ClinVar after 2014. Six submitters classified it as uncertain significance, including a ClinGen expert panel, and one classified it as likely benign. Based on the evidence outlined above, the variant was classified as uncertain significance. -

RYR1-related disorder

Uncertain:1

Uncertain significance, criteria provided, single submitter

clinical testing

Labcorp Genetics (formerly Invitae), Labcorp

Feb 11, 2022

This sequence change replaces arginine, which is basic and polar, with cysteine, which is neutral and slightly polar, at codon 1583 of the RYR1 protein (p.Arg1583Cys). This variant is present in population databases (rs754476250, gnomAD 0.2%). This missense change has been observed in individual(s) with clinical features of RYR1-related conditions (PMID: 19346234, 23035052). ClinVar contains an entry for this variant (Variation ID: 329032). Algorithms developed to predict the effect of missense changes on protein structure and function are either unavailable or do not agree on the potential impact of this missense change (SIFT: "Deleterious"; PolyPhen-2: "Benign"; Align-GVGD: "Class C0"). In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. -

Congenital myopathy with fiber type disproportion;C0751951:Central core myopathy;C1840365:King Denborough syndrome;C1850674:Congenital multicore myopathy with external ophthalmoplegia;C2930980:Malignant hyperthermia, susceptibility to, 1

Uncertain:1

Uncertain significance, criteria provided, single submitter

clinical testing

Fulgent Genetics, Fulgent Genetics

Aug 10, 2021

- -

Central core myopathy

Benign:1

Likely benign, criteria provided, single submitter

clinical testing

Illumina Laboratory Services, Illumina

Jun 14, 2016

- -

Multiminicore myopathy

Benign:1

Likely benign, criteria provided, single submitter

clinical testing

Illumina Laboratory Services, Illumina

Jun 14, 2016

- -

Neuromuscular disease, congenital, with uniform type 1 fiber

Benign:1

Likely benign, criteria provided, single submitter

clinical testing

Illumina Laboratory Services, Illumina

Jun 14, 2016

- -

Computational scores

Source: dbNSFP v4.3

Name

Calibrated prediction

Score

Prediction

AlphaMissense

Benign

0.088

BayesDel_addAF

Uncertain

0.040

BayesDel_noAF

Uncertain

0.070

CADD

Benign

DANN

Uncertain

1.0

DEOGEN2

Uncertain

0.76

.;D

Eigen

Uncertain

0.22

Eigen_PC

Uncertain

0.28

FATHMM_MKL

Uncertain

0.90

LIST_S2

Uncertain

0.88

D;D

M_CAP

Uncertain

0.23

MetaRNN

Benign

0.081

T;T

MetaSVM

Uncertain

0.67

MutationAssessor

Benign

1.4

L;L

MutationTaster

Benign

1.0

D;D;D

PrimateAI

Benign

0.46

PROVEAN

Pathogenic

-4.7

D;D

REVEL

Uncertain

0.59

Sift

Benign

0.032

D;D

Polyphen

0.80

P;P

Vest4

0.72

MVP

0.92

MPC

0.67

ClinPred

0.25

GERP RS

3.9

Varity_R

0.11

gMVP

0.54

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.

Variant summary

Frequency

Consequence

Scores

Clinical Significance

Conservation

ACMG classification

Transcripts

RefSeq

Ensembl

Frequencies

ClinVar

Submissions by phenotype

Computational scores

Splicing

Publications

LitVar

Other links and lift over