3-12604182-A-G
Variant summary
Our verdict is Pathogenic. Variant got 16 ACMG points: 16P and 0B. PM1PM2PM5PP2PP3PP5_Very_Strong
The NM_002880.4(RAF1):c.788T>C(p.Val263Ala) variant causes a missense change involving the alteration of a conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Likely pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. V263G) has been classified as Pathogenic.
Frequency
Consequence
NM_002880.4 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Pathogenic. Variant got 16 ACMG points.
Transcripts
RefSeq
Ensembl
Frequencies
GnomAD3 genomes Cov.: 33
GnomAD4 exome Cov.: 31
GnomAD4 genome Cov.: 33
ClinVar
Submissions by phenotype
RASopathy Pathogenic:2
Variant summary: RAF1 c.788T>C (p.Val263Ala) results in a non-conservative amino acid change in the encoded protein sequence. Three of five in-silico tools predict a damaging effect of the variant on protein function. The variant was absent in 251466 control chromosomes (gnomAD). c.788T>C has been reported in the literature in an individual affected with Noonan Syndrome (Razzaque_2007). These data suggest the variant may be associated with disease. Several publications report experimental evidence evaluating an impact on protein function (Razzaque_2007, Molzan_2010, Dhandapany_2015). The variant exhibited increased kinase activity in comparison to the WT protein and results in the constitutive activatation of the ERK/MAPK pathway. Additionally, other variants affecting the same amino acid (p.Val263Gly and p.Val263Asp) have been reported in individuals with Noonan Syndrome and have been classified as pathogenic/likely pathogenic by our laboratory. The following publications have been ascertained in the context of this evaluation (PMID: 24777450, 20679480, 17603482). ClinVar contains an entry for this variant (Variation ID: 40608). Based on the evidence outlined above, the variant was classified as likely pathogenic. -
This sequence change replaces valine, which is neutral and non-polar, with alanine, which is neutral and non-polar, at codon 263 of the RAF1 protein (p.Val263Ala). This variant is not present in population databases (gnomAD no frequency). This missense change has been observed in individual(s) with clinical features of RAF1-related conditions (PMID: 17603482; internal data). In at least one individual the variant was observed to be de novo. ClinVar contains an entry for this variant (Variation ID: 40608). Invitae Evidence Modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) indicates that this missense variant is expected to disrupt RAF1 protein function with a positive predictive value of 95%. Experimental studies have shown that this missense change affects RAF1 function (PMID: 17603482, 20679480, 24777450). This variant disrupts the p.Val263 amino acid residue in RAF1. Other variant(s) that disrupt this residue have been determined to be pathogenic (PMID: 22821648). This suggests that this residue is clinically significant, and that variants that disrupt this residue are likely to be disease-causing. For these reasons, this variant has been classified as Pathogenic. -
not provided Pathogenic:1
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; Missense variants in this gene are a common cause of disease and they are underrepresented in the general population; This variant is associated with the following publications: (PMID: 24803665, 29271604, 20679480, 24777450, 22821648, 33300679, 17603482, 38205249, 24957944, 9689060, 15520807, 29493581, 19020799, 17603483) -
Cardiovascular phenotype Pathogenic:1
The p.V263A variant (also known as c.788T>C), located in coding exon 6 of the RAF1 gene, results from a T to C substitution at nucleotide position 788. The valine at codon 263 is replaced by alanine, an amino acid with similar properties, and occurs in the conserved region 2 domain. This variant has been detected in an individual reported to have Noonan syndrome with hypertrophic cardiomyopathy (Razzaque MA et al. Nat. Genet., 2007 Aug;39:1013-7). In vitro functional studies have indicated that this variant results in increased kinase activity, increased phosphorylation of downstream effectors, and increased activation of the MAPK pathway (Razzaque MA et al. Nat. Genet., 2007 Aug;39:1013-7; Molzan M et al. Mol. Cell. Biol., 2010 Oct;30:4698-711; Dhandapany PS et al. Nat. Genet., 2014 Jun;46:635-639). Another variant affecting this codon was reported to occur de novo in a case with hypoplastic left heart syndrome considered associated with Noonan syndrome (Schulz S et al. Prenat. Diagn., 2012 Oct;32:1016-8). This amino acid position is highly conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. Based on the majority of available evidence to date, this variant is likely to be pathogenic. -
Noonan syndrome 5 Pathogenic:1
ACMG classification criteria: PS4 moderated, PM2 moderated, PM6 moderated, PP2 supporting, PP3 supporting -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at