22-42127526-C-T

Variant summary

Our verdict is Likely benign. The variant received -3 ACMG points: 1P and 4B. PP3BP4_Strong

The NM_000106.6(CYP2D6):​c.1094G>A​(p.Arg365His) variant causes a missense change involving the alteration of a conserved nucleotide. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as drug response (no stars).

Frequency

Genomes: 𝑓 0.053 ( 5 hom., cov: 34)
Exomes 𝑓: 0.051 ( 58 hom. )
Failed GnomAD Quality Control

Consequence

CYP2D6
NM_000106.6 missense

Scores

10
3
5

Clinical Significance

drug response no assertion criteria provided O:1

Conservation

PhyloP100: 7.72

Publications

50 publications found
Variant links:
Genes affected
CYP2D6 (HGNC:2625): (cytochrome P450 family 2 subfamily D member 6) This gene encodes a member of the cytochrome P450 superfamily of enzymes. The cytochrome P450 proteins are monooxygenases which catalyze many reactions involved in drug metabolism and synthesis of cholesterol, steroids and other lipids. This protein localizes to the endoplasmic reticulum and is known to metabolize as many as 25% of commonly prescribed drugs. Its substrates include antidepressants, antipsychotics, analgesics and antitussives, beta adrenergic blocking agents, antiarrythmics and antiemetics. The gene is highly polymorphic in the human population; certain alleles result in the poor metabolizer phenotype, characterized by a decreased ability to metabolize the enzyme's substrates. Some individuals with the poor metabolizer phenotype have no functional protein since they carry 2 null alleles whereas in other individuals the gene is absent. This gene can vary in copy number and individuals with the ultrarapid metabolizer phenotype can have 3 or more active copies of the gene. Alternatively spliced transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Jul 2014]
NDUFA6-DT (HGNC:45273): (NDUFA6 divergent transcript)

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Likely_benign. The variant received -3 ACMG points.

PP3
Multiple lines of computational evidence support a deleterious effect 9: BayesDel_noAF, Cadd, Dann, Eigen, MutationAssessor, phyloP100way_vertebrate, PROVEAN, REVEL, REVEL [when max_spliceai, FATHMM_MKL, MetaRNN, MutationTaster, PrimateAI was below the threshold]
BP4
Computational evidence support a benign effect (MetaRNN=0.018501878).

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
CYP2D6NM_000106.6 linkc.1094G>A p.Arg365His missense_variant Exon 7 of 9 ENST00000645361.2 NP_000097.3 P10635-1C1ID52Q5Y7H2
CYP2D6NM_001025161.3 linkc.941G>A p.Arg314His missense_variant Exon 6 of 8 NP_001020332.2 P10635-2Q5Y7H2

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
CYP2D6ENST00000645361.2 linkc.1094G>A p.Arg365His missense_variant Exon 7 of 9 NM_000106.6 ENSP00000496150.1 P10635-1

Frequencies

GnomAD3 genomes
AF:
0.0535
AC:
7199
AN:
134436
Hom.:
5
Cov.:
34
show subpopulations
Gnomad AFR
AF:
0.0136
Gnomad AMI
AF:
0.140
Gnomad AMR
AF:
0.0419
Gnomad ASJ
AF:
0.0642
Gnomad EAS
AF:
0.000389
Gnomad SAS
AF:
0.0338
Gnomad FIN
AF:
0.0395
Gnomad MID
AF:
0.0324
Gnomad NFE
AF:
0.0915
Gnomad OTH
AF:
0.0564
GnomAD2 exomes
AF:
0.0917
AC:
21064
AN:
229594
AF XY:
0.0934
show subpopulations
Gnomad AFR exome
AF:
0.0244
Gnomad AMR exome
AF:
0.0548
Gnomad ASJ exome
AF:
0.113
Gnomad EAS exome
AF:
0.000819
Gnomad FIN exome
AF:
0.0808
Gnomad NFE exome
AF:
0.139
Gnomad OTH exome
AF:
0.0931
GnomAD4 exome
Data not reliable, filtered out with message: AS_VQSR
AF:
0.0511
AC:
62100
AN:
1214264
Hom.:
58
Cov.:
64
AF XY:
0.0509
AC XY:
30816
AN XY:
605814
show subpopulations
⚠️ The allele balance in gnomAD version 4 Exomes is significantly skewed from the expected value of 0.5.
African (AFR)
AF:
0.00602
AC:
194
AN:
32222
American (AMR)
AF:
0.0125
AC:
516
AN:
41256
Ashkenazi Jewish (ASJ)
AF:
0.0362
AC:
766
AN:
21182
East Asian (EAS)
AF:
0.000278
AC:
11
AN:
39596
South Asian (SAS)
AF:
0.0180
AC:
1407
AN:
78310
European-Finnish (FIN)
AF:
0.0307
AC:
1462
AN:
47570
Middle Eastern (MID)
AF:
0.0328
AC:
170
AN:
5178
European-Non Finnish (NFE)
AF:
0.0619
AC:
55580
AN:
897914
Other (OTH)
AF:
0.0391
AC:
1994
AN:
51036
⚠️ The allele balance in gnomAD4 Exomes is highly skewed from 0.5 (p-value = 0.000000), which strongly suggests a high chance of mosaicism in these individuals.
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.273
Heterozygous variant carriers
0
6513
13027
19540
26054
32567
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Exome Hom
Variant carriers
0
2060
4120
6180
8240
10300
<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
Data not reliable, filtered out with message: AS_VQSR
AF:
0.0535
AC:
7198
AN:
134560
Hom.:
5
Cov.:
34
AF XY:
0.0497
AC XY:
3285
AN XY:
66160
show subpopulations
⚠️ The allele balance in gnomAD version 4 Genomes is significantly skewed from the expected value of 0.5.
African (AFR)
AF:
0.0136
AC:
540
AN:
39686
American (AMR)
AF:
0.0419
AC:
577
AN:
13782
Ashkenazi Jewish (ASJ)
AF:
0.0642
AC:
177
AN:
2756
East Asian (EAS)
AF:
0.000389
AC:
2
AN:
5138
South Asian (SAS)
AF:
0.0333
AC:
146
AN:
4382
European-Finnish (FIN)
AF:
0.0395
AC:
379
AN:
9586
Middle Eastern (MID)
AF:
0.0310
AC:
8
AN:
258
European-Non Finnish (NFE)
AF:
0.0916
AC:
5157
AN:
56324
Other (OTH)
AF:
0.0557
AC:
105
AN:
1886
⚠️ The allele balance in gnomAD version 4 Genomes is significantly skewed from the expected value of 0.5. (p-value = 0.000000), which strongly suggests a high chance of mosaicism in these individuals.
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.288
Heterozygous variant carriers
0
605
1210
1814
2419
3024
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Genome Het
Genome Hom
Variant carriers
0
90
180
270
360
450
<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:
0.123
Hom.:
91
ExAC
AF:
0.120
AC:
14572

ClinVar

Significance: drug response
Submissions summary: Other:1
Revision: no assertion criteria provided
LINK: link

Submissions by phenotype

Tramadol response Other:1
Apr 28, 2018
Bruce Budowle Laboratory, University of North Texas Health Science Center
Significance:drug response
Review Status:no assertion criteria provided
Collection Method:research

- T:M1 = postmortem ratio or tramadol to O-desmethyltramadol; t-MP = model-based clustered metabolizer phenotype inferred from T:M1

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Uncertain
0.54
BayesDel_addAF
Uncertain
0.15
D
BayesDel_noAF
Pathogenic
0.58
CADD
Pathogenic
28
DANN
Pathogenic
1.0
DEOGEN2
Benign
0.24
T;T;T;T;.
Eigen
Pathogenic
1.0
Eigen_PC
Pathogenic
0.90
FATHMM_MKL
Pathogenic
0.99
D
LIST_S2
Uncertain
0.87
.;.;D;D;D
MetaRNN
Benign
0.019
T;T;T;T;T
MetaSVM
Benign
-0.89
T
MutationAssessor
Pathogenic
4.7
H;H;H;.;.
PhyloP100
7.7
PrimateAI
Benign
0.47
T
PROVEAN
Pathogenic
-4.5
.;.;D;.;D
REVEL
Pathogenic
0.98
Sift
Pathogenic
0.0
.;.;D;.;D
Sift4G
Pathogenic
0.0010
.;.;D;D;D
Vest4
0.34, 0.49, 0.53
MPC
0.61
ClinPred
0.11
T
GERP RS
4.9
Varity_R
0.69
gMVP
0.85
Mutation Taster
=91/9
polymorphism

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.020
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: rs1058172; hg19: chr22-42523528; COSMIC: COSV62242932; COSMIC: COSV62242932; API