2-178727647-T-C
Variant names: 
Variant summary
Our verdict is Uncertain significance. The variant received 2 ACMG points: 2P and 0B. PM2
The NM_001267550.2(TTN):c.19931A>G(p.Tyr6644Cys) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.00000186 in 1,610,600 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Uncertain significance (★★).
Frequency
 Genomes: 𝑓 0.0000066   (  0   hom.,  cov: 33) 
 Exomes 𝑓:  0.0000014   (  0   hom.  ) 
Consequence
 TTN
NM_001267550.2 missense
NM_001267550.2 missense
Scores
 8
 6
 2
Clinical Significance
Conservation
 PhyloP100:  8.02  
Publications
0 publications found 
Genes affected
 TTN  (HGNC:12403):  (titin) This gene encodes a large abundant protein of striated muscle. The product of this gene is divided into two regions, a N-terminal I-band and a C-terminal A-band. The I-band, which is the elastic part of the molecule, contains two regions of tandem immunoglobulin domains on either side of a PEVK region that is rich in proline, glutamate, valine and lysine. The A-band, which is thought to act as a protein-ruler, contains a mixture of immunoglobulin and fibronectin repeats, and possesses kinase activity. An N-terminal Z-disc region and a C-terminal M-line region bind to the Z-line and M-line of the sarcomere, respectively, so that a single titin molecule spans half the length of a sarcomere. Titin also contains binding sites for muscle associated proteins so it serves as an adhesion template for the assembly of contractile machinery in muscle cells. It has also been identified as a structural protein for chromosomes. Alternative splicing of this gene results in multiple transcript variants. Considerable variability exists in the I-band, the M-line and the Z-disc regions of titin. Variability in the I-band region contributes to the differences in elasticity of different titin isoforms and, therefore, to the differences in elasticity of different muscle types. Mutations in this gene are associated with familial hypertrophic cardiomyopathy 9, and autoantibodies to titin are produced in patients with the autoimmune disease scleroderma. [provided by RefSeq, Feb 2012] 
Genome browser will be placed here
ACMG classification
Classification was made for transcript
Our verdict: Uncertain_significance. The variant received 2 ACMG points.
PM2
Very rare variant in population databases, with high coverage; 
Transcripts
RefSeq
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt | 
|---|---|---|---|---|---|---|---|---|
| TTN | NM_001267550.2 | c.19931A>G | p.Tyr6644Cys | missense_variant | Exon 68 of 363 | ENST00000589042.5 | NP_001254479.2 | 
Ensembl
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt | 
|---|---|---|---|---|---|---|---|---|---|---|
| TTN | ENST00000589042.5 | c.19931A>G | p.Tyr6644Cys | missense_variant | Exon 68 of 363 | 5 | NM_001267550.2 | ENSP00000467141.1 | 
Frequencies
GnomAD3 genomes  0.00000658  AC: 1AN: 152090Hom.:  0  Cov.: 33 show subpopulations 
GnomAD3 genomes 
 AF: 
AC: 
1
AN: 
152090
Hom.: 
Cov.: 
33
Gnomad AFR 
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Gnomad AMI 
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Gnomad AMR 
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Gnomad ASJ 
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Gnomad EAS 
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Gnomad SAS 
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Gnomad FIN 
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Gnomad MID 
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Gnomad NFE 
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Gnomad OTH 
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GnomAD2 exomes  AF:  0.00000406  AC: 1AN: 246064 AF XY:  0.00   show subpopulations 
GnomAD2 exomes 
 AF: 
AC: 
1
AN: 
246064
 AF XY: 
Gnomad AFR exome 
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Gnomad AMR exome 
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Gnomad ASJ exome 
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Gnomad EAS exome 
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Gnomad FIN exome 
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Gnomad NFE exome 
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Gnomad OTH exome 
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GnomAD4 exome  AF:  0.00000137  AC: 2AN: 1458510Hom.:  0  Cov.: 31 AF XY:  0.00  AC XY: 0AN XY: 725330 show subpopulations  ⚠️ The allele balance in gnomAD version 4 Exomes is significantly skewed from the expected value of 0.5. 
GnomAD4 exome 
 AF: 
AC: 
2
AN: 
1458510
Hom.: 
Cov.: 
31
 AF XY: 
AC XY: 
0
AN XY: 
725330
show subpopulations 
 ⚠️ The allele balance in gnomAD version 4 Exomes is significantly skewed from the expected value of 0.5. 
African (AFR) 
 AF: 
AC: 
0
AN: 
33260
American (AMR) 
 AF: 
AC: 
2
AN: 
44260
Ashkenazi Jewish (ASJ) 
 AF: 
AC: 
0
AN: 
25958
East Asian (EAS) 
 AF: 
AC: 
0
AN: 
39666
South Asian (SAS) 
 AF: 
AC: 
0
AN: 
85508
European-Finnish (FIN) 
 AF: 
AC: 
0
AN: 
53338
Middle Eastern (MID) 
 AF: 
AC: 
0
AN: 
5744
European-Non Finnish (NFE) 
 AF: 
AC: 
0
AN: 
1110536
Other (OTH) 
 AF: 
AC: 
0
AN: 
60240
 ⚠️ The allele balance in gnomAD4 Exomes is highly skewed from 0.5 (p-value = 0.000203476), which strongly suggests a high chance of mosaicism in these individuals. 
 Allele Balance Distribution 
 Red line indicates average allele balance 
 Average allele balance: 0.375 
Heterozygous variant carriers
 0 
 0 
 1 
 1 
 2 
 2 
 0.00 
 0.20 
 0.40 
 0.60 
 0.80 
 0.95 
Allele balance
Age Distribution
Exome Het
Variant carriers
 0 
 2 
 4 
 6 
 8 
 10 
 <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  0.00000658  AC: 1AN: 152090Hom.:  0  Cov.: 33 AF XY:  0.0000135  AC XY: 1AN XY: 74288 show subpopulations 
GnomAD4 genome 
 AF: 
AC: 
1
AN: 
152090
Hom.: 
Cov.: 
33
 AF XY: 
AC XY: 
1
AN XY: 
74288
show subpopulations 
African (AFR) 
 AF: 
AC: 
0
AN: 
41438
American (AMR) 
 AF: 
AC: 
1
AN: 
15250
Ashkenazi Jewish (ASJ) 
 AF: 
AC: 
0
AN: 
3470
East Asian (EAS) 
 AF: 
AC: 
0
AN: 
5174
South Asian (SAS) 
 AF: 
AC: 
0
AN: 
4830
European-Finnish (FIN) 
 AF: 
AC: 
0
AN: 
10616
Middle Eastern (MID) 
 AF: 
AC: 
0
AN: 
316
European-Non Finnish (NFE) 
 AF: 
AC: 
0
AN: 
67992
Other (OTH) 
 AF: 
AC: 
0
AN: 
2094
 Allele Balance Distribution 
 Red line indicates average allele balance 
 Average allele balance: 0.575 
Heterozygous variant carriers
 0 
 0 
 1 
 1 
 2 
 2 
 0.00 
 0.20 
 0.40 
 0.60 
 0.80 
 0.95 
Allele balance
Alfa 
 AF: 
Hom.: 
Bravo 
 AF: 
ESP6500AA 
 AF: 
AC: 
0
ESP6500EA 
 AF: 
AC: 
1
ClinVar
Significance: Uncertain significance 
Submissions summary: Uncertain:1 
Revision: criteria provided, single submitter
LINK: link 
Submissions by phenotype
Autosomal recessive limb-girdle muscular dystrophy type 2J;C1858763:Dilated cardiomyopathy 1G    Uncertain:1 
May 29, 2017
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing
- -
Computational scores
Source: 
Name
Calibrated prediction
Score
Prediction
 AlphaMissense 
 Pathogenic 
 BayesDel_addAF 
 Pathogenic 
D 
 BayesDel_noAF 
 Uncertain 
 DANN 
 Uncertain 
 Eigen 
 Pathogenic 
 Eigen_PC 
 Pathogenic 
 FATHMM_MKL 
 Pathogenic 
D 
 LIST_S2 
 Benign 
T;D;.;T 
 M_CAP 
 Uncertain 
D 
 MetaRNN 
 Uncertain 
D;D;D;D 
 MetaSVM 
 Pathogenic 
D 
 PhyloP100 
 PrimateAI 
 Uncertain 
T 
 PROVEAN 
 Pathogenic 
D;.;.;. 
 REVEL 
 Pathogenic 
 Sift 
 Uncertain 
D;.;.;. 
 Polyphen 
 1.0 
.;.;D;D 
 Vest4 
 MVP 
 MPC 
 0.52 
 ClinPred 
D 
 GERP RS 
Splicing
Name
Calibrated prediction
Score
Prediction
 SpliceAI score (max) 
Details are displayed if max score is > 0.2
 Find out detailed SpliceAI scores and Pangolin per-transcript scores at 
Publications
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