5-148120311-GAAA-GAAAA

Variant summary

Our verdict is Pathogenic. Variant got 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong

The NM_006846.4(SPINK5):​c.2468dupA​(p.Lys824fs) variant causes a frameshift change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.00022 in 1,361,340 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Pathogenic (★★). Variant results in nonsense mediated mRNA decay.

Frequency

Genomes: 𝑓 0.00010 ( 0 hom., cov: 32)
Exomes 𝑓: 0.00022 ( 0 hom. )
Failed GnomAD Quality Control

Consequence

SPINK5
NM_006846.4 frameshift

Scores

Not classified

Clinical Significance

Pathogenic criteria provided, multiple submitters, no conflicts P:7

Conservation

PhyloP100: 1.94
Variant links:
Genes affected
SPINK5 (HGNC:15464): (serine peptidase inhibitor Kazal type 5) This gene encodes a multidomain serine protease inhibitor that contains 15 potential inhibitory domains. The encoded preproprotein is proteolytically processed to generate multiple protein products, which may exhibit unique activities and specificities. These proteins may play a role in skin and hair morphogenesis, as well as anti-inflammatory and antimicrobial protection of mucous epithelia. Mutations in this gene may result in Netherton syndrome, a disorder characterized by ichthyosis, defective cornification, and atopy. This gene is present in a gene cluster on chromosome 5. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Oct 2015]

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ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 18 ACMG points.

PVS1
Loss of function variant, product undergoes nonsense mediated mRNA decay. LoF is a known mechanism of disease.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 5-148120311-G-GA is Pathogenic according to our data. Variant chr5-148120311-G-GA is described in ClinVar as [Pathogenic]. Clinvar id is 5268.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
SPINK5NM_006846.4 linkuse as main transcriptc.2468dupA p.Lys824fs frameshift_variant 26/33 ENST00000256084.8 NP_006837.2 Q9NQ38-1

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
SPINK5ENST00000256084.8 linkuse as main transcriptc.2468dupA p.Lys824fs frameshift_variant 26/331 NM_006846.4 ENSP00000256084.7 Q9NQ38-1

Frequencies

GnomAD3 genomes
AF:
0.00
AC:
15
AN:
146014
Hom.:
0
Cov.:
32
FAILED QC
Gnomad AFR
AF:
0.000126
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.000274
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:
0.0000906
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.00133
AC:
175
AN:
131578
Hom.:
0
AF XY:
0.00120
AC XY:
84
AN XY:
70102
show subpopulations
Gnomad AFR exome
AF:
0.00216
Gnomad AMR exome
AF:
0.00134
Gnomad ASJ exome
AF:
0.000698
Gnomad EAS exome
AF:
0.00184
Gnomad SAS exome
AF:
0.000621
Gnomad FIN exome
AF:
0.000378
Gnomad NFE exome
AF:
0.00164
Gnomad OTH exome
AF:
0.000318
GnomAD4 exome
AF:
0.000220
AC:
299
AN:
1361340
Hom.:
0
Cov.:
34
AF XY:
0.000211
AC XY:
143
AN XY:
676992
show subpopulations
Gnomad4 AFR exome
AF:
0.000358
Gnomad4 AMR exome
AF:
0.000593
Gnomad4 ASJ exome
AF:
0.000250
Gnomad4 EAS exome
AF:
0.000302
Gnomad4 SAS exome
AF:
0.000313
Gnomad4 FIN exome
AF:
0.000259
Gnomad4 NFE exome
AF:
0.000193
Gnomad4 OTH exome
AF:
0.000161
GnomAD4 genome
Data not reliable, filtered out with message: AS_VQSR
AF:
0.000103
AC:
15
AN:
146078
Hom.:
0
Cov.:
32
AF XY:
0.0000847
AC XY:
6
AN XY:
70866
show subpopulations
Gnomad4 AFR
AF:
0.000125
Gnomad4 AMR
AF:
0.000274
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.0000906
Gnomad4 OTH
AF:
0.00

ClinVar

Significance: Pathogenic
Submissions summary: Pathogenic:7
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Netherton syndrome Pathogenic:4
Pathogenic, criteria provided, single submitterclinical testingFulgent Genetics, Fulgent GeneticsFeb 29, 2024- -
Pathogenic, criteria provided, single submitterclinical testing3billionMay 22, 2022The variant is observed at an extremely low frequency in the gnomAD v2.1.1 dataset (total allele frequency: 0.113%). Frameshift: predicted to result in a loss or disruption of normal protein function through nonsense-mediated decay (NMD) or protein truncation. Multiple pathogenic variants are reported downstream of the variant. The variant has been reported at least twice as pathogenic with clinical assertions and evidence for the classification (ClinVar ID: VCV000005268 / PMID: 10835624). Therefore, this variant is classified as pathogenic according to the recommendation of ACMG/AMP guideline. -
Pathogenic, no assertion criteria providedliterature onlyOMIMJun 01, 2000- -
Pathogenic, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpJun 26, 2022This sequence change creates a premature translational stop signal (p.Lys824Glufs*4) in the SPINK5 gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in SPINK5 are known to be pathogenic (PMID: 11511292, 11841556). The frequency data for this variant in the population databases is considered unreliable, as metrics indicate poor data quality at this position in the gnomAD database. This premature translational stop signal has been observed in individuals with Netherton syndrome (PMID: 10835624, 26031502). This variant is also known as 2468insA. ClinVar contains an entry for this variant (Variation ID: 5268). For these reasons, this variant has been classified as Pathogenic. -
not provided Pathogenic:2
Pathogenic, criteria provided, single submitterclinical testingCeGaT Center for Human Genetics TuebingenFeb 01, 2021- -
Pathogenic, criteria provided, single submitterclinical testingGeneDxOct 26, 2017The c.2468dupA pathogenic variant in the SPINK5 gene has been reported previously in the homozygous state or as a single variant in patients with Netherton syndrome (Chavanas et al., 2000; Bitoun et al., 2002; Raghunath et al., 2004). It causes a frameshift starting with codon Lysine 824, changes this amino acid to a Glutamic acid residue, and creates a premature Stop codon at position 4 of the new reading frame, denoted p.Lys824GlufsX4. This variant is predicted to cause loss of normal protein function either through protein truncation or nonsense-mediated mRNA decay. The c.2468dupA variant is observed in 17/7814 (0.22%) alleles from individuals of African background, in large population cohorts, and no individuals were reported to be homozygous (Lek et al., 2016). We interpret c.2468dupA as a pathogenic variant. -
Ichthyosis linearis circumflexa Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingWomen's Health and Genetics/Laboratory Corporation of America, LabCorpDec 15, 2023Variant summary: SPINK5 c.2468dupA (p.Lys824GlufsX4) results in a premature termination codon, predicted to cause a truncation of the encoded protein or absence of the protein due to nonsense mediated decay, which are commonly known mechanisms for disease. The variant allele was found at a frequency of 0.0013 in 131578 control chromosomes (gnomAD). c.2468dupA (aka 2468insA) has been reported in the literature in multiple homozygous and compound heterozygous individuals affected with Netherton syndrome (e.g. Chavanas_2000, Bitoun_2002). These publications also reported dramatic reduction in the SPINK5 mRNA in keratinocytes derived from homozygous patients, suggestive of nonsense-mediated mRNA decay (Bitoun_2002). These data indicate that the variant is very likely to be associated with disease. The following publications have been ascertained in the context of this evaluation (PMID: 10835624, 11841556). Four submitters have cited clinical-significance assessments for this variant to ClinVar after 2014. All submitters classified the variant as pathogenic. Based on the evidence outlined above, the variant was classified as pathogenic. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction

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.

Other links and lift over

dbSNP: rs565782662; hg19: chr5-147499874; API