20-63350038-G-T

Variant summary

Our verdict is Uncertain significance. The variant received 0 ACMG points: 2P and 2B. PM2BP4_Moderate

The NM_000744.7(CHRNA4):​c.1373C>A​(p.Pro458Gln) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.00000132 in 1,515,576 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. 15/22 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Uncertain significance (★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. P458L) has been classified as Likely benign.

Frequency

Genomes: 𝑓 0.0000066 ( 0 hom., cov: 33)
Exomes 𝑓: 7.3e-7 ( 0 hom. )

Consequence

CHRNA4
NM_000744.7 missense

Scores

3
15

Clinical Significance

Uncertain significance criteria provided, single submitter U:1

Conservation

PhyloP100: 0.165

Publications

2 publications found
Variant links:
Genes affected
CHRNA4 (HGNC:1958): (cholinergic receptor nicotinic alpha 4 subunit) This gene encodes a nicotinic acetylcholine receptor, which belongs to a superfamily of ligand-gated ion channels that play a role in fast signal transmission at synapses. These pentameric receptors can bind acetylcholine, which causes an extensive change in conformation that leads to the opening of an ion-conducting channel across the plasma membrane. This protein is an integral membrane receptor subunit that can interact with either nAChR beta-2 or nAChR beta-4 to form a functional receptor. Mutations in this gene cause nocturnal frontal lobe epilepsy type 1. Polymorphisms in this gene that provide protection against nicotine addiction have been described. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Feb 2012]
CHRNA4 Gene-Disease associations (from GenCC):
  • autosomal dominant nocturnal frontal lobe epilepsy 1
    Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: G2P, Labcorp Genetics (formerly Invitae)
  • familial sleep-related hypermotor epilepsy
    Inheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
  • autosomal dominant nocturnal frontal lobe epilepsy
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Uncertain_significance. The variant received 0 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
BP4
Computational evidence support a benign effect (MetaRNN=0.165589).

Variant Effect in Transcripts

ACMG analysis was done for transcript: NM_000744.7. You can select a different transcript below to see updated ACMG assignments.

RefSeq Transcripts

Sel.
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
CHRNA4
NM_000744.7
MANE Select
c.1373C>Ap.Pro458Gln
missense
Exon 5 of 6NP_000735.1P43681-1
CHRNA4
NM_001256573.2
c.845C>Ap.Pro282Gln
missense
Exon 5 of 6NP_001243502.1Q4VAQ3
CHRNA4
NR_046317.2
n.1582C>A
non_coding_transcript_exon
Exon 5 of 6

Ensembl Transcripts

Sel.
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
CHRNA4
ENST00000370263.9
TSL:1 MANE Select
c.1373C>Ap.Pro458Gln
missense
Exon 5 of 6ENSP00000359285.4P43681-1
CHRNA4
ENST00000463705.5
TSL:1
n.2021C>A
non_coding_transcript_exon
Exon 4 of 5
CHRNA4
ENST00000467563.3
TSL:1
n.1443C>A
non_coding_transcript_exon
Exon 5 of 6

Frequencies

GnomAD3 genomes
AF:
0.00000657
AC:
1
AN:
152268
Hom.:
0
Cov.:
33
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.0000654
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:
0.00
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.00000750
AC:
1
AN:
133420
AF XY:
0.0000141
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:
0.0000174
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
7.34e-7
AC:
1
AN:
1363308
Hom.:
0
Cov.:
83
AF XY:
0.00000150
AC XY:
1
AN XY:
667702
show subpopulations
⚠️ The allele balance in gnomAD version 4 Exomes is significantly skewed from the expected value of 0.5.
African (AFR)
AF:
0.00
AC:
0
AN:
30984
American (AMR)
AF:
0.00
AC:
0
AN:
31908
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
21536
East Asian (EAS)
AF:
0.00
AC:
0
AN:
37212
South Asian (SAS)
AF:
0.00
AC:
0
AN:
71364
European-Finnish (FIN)
AF:
0.0000220
AC:
1
AN:
45440
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5168
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
1063512
Other (OTH)
AF:
0.00
AC:
0
AN:
56184
⚠️ The allele balance in gnomAD4 Exomes is highly skewed from 0.5 (p-value = 0), which strongly suggests a high chance of mosaicism in these individuals.
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.225
Heterozygous variant carriers
0
0
1
1
2
2
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance
GnomAD4 genome
AF:
0.00000657
AC:
1
AN:
152268
Hom.:
0
Cov.:
33
AF XY:
0.0000134
AC XY:
1
AN XY:
74390
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
41480
American (AMR)
AF:
0.0000654
AC:
1
AN:
15294
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3472
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5196
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4838
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10628
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
68038
Other (OTH)
AF:
0.00
AC:
0
AN:
2094
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.525
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

Genome 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
Alfa
AF:
0.00
Hom.:
0
Bravo
AF:
0.00000378
ExAC
AF:
0.0000171
AC:
2

ClinVar

ClinVar submissions
Significance:Uncertain significance
Revision:criteria provided, single submitter
View on ClinVar
Pathogenic
VUS
Benign
Condition
-
1
-
Autosomal dominant nocturnal frontal lobe epilepsy (1)

Computational scores

Source: dbNSFP v4.9

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.075
BayesDel_addAF
Benign
-0.10
T
BayesDel_noAF
Benign
-0.37
CADD
Benign
8.4
DANN
Benign
0.93
DEOGEN2
Benign
0.32
T
Eigen
Benign
-0.66
Eigen_PC
Benign
-0.73
FATHMM_MKL
Benign
0.22
N
LIST_S2
Benign
0.69
T
M_CAP
Uncertain
0.16
D
MetaRNN
Benign
0.17
T
MetaSVM
Benign
-0.77
T
MutationAssessor
Uncertain
2.3
M
PhyloP100
0.17
PrimateAI
Benign
0.36
T
PROVEAN
Benign
-0.38
N
REVEL
Benign
0.23
Sift
Uncertain
0.012
D
Sift4G
Benign
0.23
T
Polyphen
0.047
B
Vest4
0.24
MutPred
0.38
Gain of MoRF binding (P = 0.0348)
MVP
0.77
MPC
0.66
ClinPred
0.10
T
GERP RS
2.8
Varity_R
0.11
gMVP
0.26
Mutation Taster
=99/1
polymorphism

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

Other links and lift over

dbSNP: rs121912277; hg19: chr20-61981390; COSMIC: COSV105921849; COSMIC: COSV105921849; API