7-117611650-G-A

Variant summary

Our verdict is Likely pathogenic. Variant got 7 ACMG points: 8P and 1B. PM1PM5PP5_StrongBP4

The NM_000492.4(CFTR):​c.3209G>A​(p.Arg1070Gln) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.000307 in 1,613,422 control chromosomes in the GnomAD database, including 6 homozygotes. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as drug response (★★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R1070W) has been classified as Pathogenic.

Frequency

Genomes: 𝑓 0.00030 ( 0 hom., cov: 31)
Exomes 𝑓: 0.00031 ( 6 hom. )

Consequence

CFTR
NM_000492.4 missense

Scores

9
5
5

Clinical Significance

drug response reviewed by expert panel P:19U:4O:1

Conservation

PhyloP100: 9.94
Variant links:
Genes affected
CFTR (HGNC:1884): (CF transmembrane conductance regulator) This gene encodes a member of the ATP-binding cassette (ABC) transporter superfamily. The encoded protein functions as a chloride channel, making it unique among members of this protein family, and controls ion and water secretion and absorption in epithelial tissues. Channel activation is mediated by cycles of regulatory domain phosphorylation, ATP-binding by the nucleotide-binding domains, and ATP hydrolysis. Mutations in this gene cause cystic fibrosis, the most common lethal genetic disorder in populations of Northern European descent. The most frequently occurring mutation in cystic fibrosis, DeltaF508, results in impaired folding and trafficking of the encoded protein. Multiple pseudogenes have been identified in the human genome. [provided by RefSeq, Aug 2017]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Likely_pathogenic. Variant got 7 ACMG points.

PM1
In a topological_domain Cytoplasmic (size 60) in uniprot entity CFTR_HUMAN there are 21 pathogenic changes around while only 1 benign (95%) in NM_000492.4
PM5
Other missense variant is known to change same aminoacid residue: Variant chr7-117611649-C-T is described in Lovd as [Pathogenic].
PP5
Variant 7-117611650-G-A is Pathogenic according to our data. Variant chr7-117611650-G-A is described in ClinVar as [drug_response]. Clinvar id is 35866.Status of the report is reviewed_by_expert_panel, 3 stars. We mark this variant Likely_pathogenic, oryginal submissions are: {Likely_pathogenic=4, drug_response=1, Uncertain_significance=4, Pathogenic=13}. Variant chr7-117611650-G-A is described in Lovd as [Pathogenic]. Variant chr7-117611650-G-A is described in Lovd as [Pathogenic]. Variant chr7-117611650-G-A is described in Lovd as [Pathogenic]. Variant chr7-117611650-G-A is described in Lovd as [Likely_pathogenic]. Variant chr7-117611650-G-A is described in Lovd as [Likely_pathogenic].
BP4
Computational evidence support a benign effect (MetaRNN=0.019629806). . Strength limited to SUPPORTING due to the PP5.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
CFTRNM_000492.4 linkuse as main transcriptc.3209G>A p.Arg1070Gln missense_variant 20/27 ENST00000003084.11 NP_000483.3

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
CFTRENST00000003084.11 linkuse as main transcriptc.3209G>A p.Arg1070Gln missense_variant 20/271 NM_000492.4 ENSP00000003084 P2P13569-1
ENST00000456270.1 linkuse as main transcriptn.177+4579C>T intron_variant, non_coding_transcript_variant 3

Frequencies

GnomAD3 genomes
AF:
0.000296
AC:
45
AN:
151944
Hom.:
0
Cov.:
31
show subpopulations
Gnomad AFR
AF:
0.000145
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00767
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0000294
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.000610
AC:
153
AN:
250926
Hom.:
3
AF XY:
0.000782
AC XY:
106
AN XY:
135614
show subpopulations
Gnomad AFR exome
AF:
0.000246
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.0000544
Gnomad SAS exome
AF:
0.00467
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000441
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.000309
AC:
451
AN:
1461360
Hom.:
6
Cov.:
31
AF XY:
0.000432
AC XY:
314
AN XY:
726980
show subpopulations
Gnomad4 AFR exome
AF:
0.000269
Gnomad4 AMR exome
AF:
0.0000224
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.000176
Gnomad4 SAS exome
AF:
0.00451
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.0000225
Gnomad4 OTH exome
AF:
0.000298
GnomAD4 genome
AF:
0.000296
AC:
45
AN:
152062
Hom.:
0
Cov.:
31
AF XY:
0.000471
AC XY:
35
AN XY:
74332
show subpopulations
Gnomad4 AFR
AF:
0.000145
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00767
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.0000294
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.000106
Hom.:
0
Bravo
AF:
0.0000945
ESP6500AA
AF:
0.000227
AC:
1
ESP6500EA
AF:
0.00
AC:
0
ExAC
AF:
0.000799
AC:
97
Asia WGS
AF:
0.00231
AC:
8
AN:
3478
EpiCase
AF:
0.0000546
EpiControl
AF:
0.00

ClinVar

Significance: drug response
Submissions summary: Pathogenic:19Uncertain:4Other:1
Revision: reviewed by expert panel
LINK: link

Submissions by phenotype

Cystic fibrosis Pathogenic:7Uncertain:3
Uncertain significance, criteria provided, single submitterclinical testingMendelicsNov 05, 2018- -
Pathogenic, criteria provided, single submitterclinical testingNeuberg Centre For Genomic Medicine, NCGM-The observed missense c.3209G>A(p.Arg1070Gln) variant in CFTR gene has been observed in the compound heterozygous state in multiple individuals affected with cystic fibrosis (Feldmann et al., 2003, Krasnov et al., 2008). Experimental studies have shown that this missense change affects CFTR function (Van Goor et al., 2014). The p.Arg1070Gln variant has been reported with allele frequency of 0.06% in gnomAD Exomes. This variant has been submitted to the ClinVar database as Uncertain Significance / Likely Pathogenic / Pathogenic (multiple submissions). The amino acid change p.Arg1070Gln in CFTR is predicted as conserved by GERP++ and PhyloP across 100 vertebrates. For these reasons, this variant has been classified as Pathogenic. In absence of another reportable variant in CFTR gene, the molecular diagnosis is not confirmed. -
Likely pathogenic, criteria provided, single submitterclinical testingWomen's Health and Genetics/Laboratory Corporation of America, LabCorpAug 27, 2024Variant summary: CFTR c.3209G>A (p.Arg1070Gln) results in a conservative amino acid change located in the ABC transporter type 1, transmembrane domain (IPR011527) of the encoded protein sequence. Three of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 0.00061 in 251348 control chromosomes in the gnomAD database, including 3 homozygotes. This frequency is not significantly higher than estimated for a pathogenic variant in CFTR causing Non-Classic Cystic Fibrosis (0.00061 vs 0.013), allowing no conclusion about variant significance. This variant has been reported in several patients with classic CF, non-classic CF, or CBAVD and in several patients it was observed in cis with p.S466X forming a complex allele (example, Krasnov_2008, Mercier_1994, Kanavakis_1005, Savov_1994, Tzetis_2007, Feldmann_2003, Sosnay_2013, Furlan_2016, Lucarelli_2015, Palermo_2016, Behar_2017, Ivanov_2018, Salvatore_2019, Frentescu_2008, Noni_2023). Available patient data suggests that in compound heterozygotes, this variant typically results in mild disease such as CF/NC and/or CBAVD, while in cis with p.S466X variant, it causes classic CF (Krasnov_2008). However, the variant has also been reported in trans with F508del in a CF patient with sweat chloride levels >60 mmol/L (without p.S466X in cis; Noni_2023). Although this variant is able to mature and reach the cell surface and was found to have no significant effect on chloride transport, it was found to cause relatively subtle channel defects with functional consequences of a lower open probability of the channel, lower cyclic AMP-stimulated iodide efflux, and lower bicarbonate transport (Seibert_1996, Krasnov_2008, Sosnay_2013, Choi_2001). In these studies, maturation assays were performed on HEK-293, MDCK and COS cells, and channel function and channel transport assays were performed on HEK293 and CHO cells. In FRT cells, however, chloride transport as well as maturation was 20.5% of normal but increased to 32.9% of normal after Ivacaftor treatment (Van Goor_2014) and 42.64% of normal chloride channel conductance relative to wild type (Bihler_2024). These functional differences might be due to the use of different cell lines in different studies and technical backgrounds; however, all of these studies are suggestive of a mild functional impairment for the variant in isolation. A different variant affecting the same codon has been classified as pathogenic by our lab (c.3208C>T, p.Arg1070Trp), supporting the critical relevance of codon 1070 to CFTR protein function. However, due to the varying and typically mild disease phenotypes in individuals with this variant, as well as the allele frequency and presence of homozygotes in the gnomAD database, this variant likely represents a hypomorphic allele. The following publications have been ascertained in the context of this evaluation (PMID: 25910067, 1284534, 25087612, 23974870, 8662892, 16049310, 7512860, 30561903, 27171515, 36272381, 19707853, 7529319, 17489851, 23891399, 15880796, 7544320, 29504914, 30930780, 26014425, 27209008, 18467194, 12955726, 11242048, 12007216, 28546993, 18951463, 38388235). ClinVar contains an entry for this variant (Variation ID: 35866). Based on the evidence outlined above, the variant was classified as likely pathogenic. -
Pathogenic, criteria provided, single submitterclinical testingAmbry GeneticsOct 05, 2021The p.R1070Q pathogenic mutation (also known as c.3209G>A), located in coding exon 20 of the CFTR gene, results from a G to A substitution at nucleotide position 3209. The arginine at codon 1070 is replaced by glutamine, an amino acid with highly similar properties. Functional studies have shown that this mutation does not affect protein processing (Seibert FS et al. J. Biol. Chem., 1996 Jun;271:15139-45; Sosnay PR et al. Nat. Genet., 2013 Oct;45:1160-7), but it was observed to decrease the open probability of the channel (Seibert FS et al. J. Biol. Chem., 1996 Jun;271:15139-45). This mutation has been reported as a variant of varying clinical consequence (VVCC) (Sosnay PR et al. Pediatr. Clin. North Am., 2016 08;63:585-98; The Clinical and Functional TRanslation of CFTR (CFTR2); available at http://cftr2.org. Accessed March 30, 2018); when in trans with a second disease causing mutation it may result in cystic fibrosis, CFTR-related disorders, or no phenotype (Bombieri C et al. Semin Respir Crit Care Med, 2015 Apr;36:180-93; Girardet A et al. Eur. J. Hum. Genet., 2016 Apr;24:469-78). Of note, this mutation has also been observed as part of a complex allele with p.S466* (Krasnov KV et al. Hum. Mutat., 2008 Nov;29:1364-72; Lucarelli M et al. Mol. Med., 2015 Apr;21:257-75). Based on the supporting evidence, this alteration is interpreted as a disease-causing mutation. -
Uncertain significance, criteria provided, single submittercurationInstitute of Human Genetics, University of Leipzig Medical CenterSep 05, 2022This variant was identified in 1 patient with a clinically confirmed diagnosis of cystic fibrosis. The variant was classified in the context of a project re-classifying variants in the German Cystic Fibrosis Registry (Muko.e.V.). Link: https://www.muko.info/angebote/qualitaetsmanagement/register/cf-einrichtungen/mukoweb. Criteria applied: PS3, PM3, PM5, PP3, PP4, BS2 -
Likely pathogenic, criteria provided, single submitterliterature onlyCounsylMay 18, 2014- -
Uncertain significance, criteria provided, single submitterclinical testingGenome Diagnostics Laboratory, The Hospital for Sick ChildrenAug 29, 2019- -
Likely pathogenic, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpJan 25, 2024This sequence change replaces arginine, which is basic and polar, with glutamine, which is neutral and polar, at codon 1070 of the CFTR protein (p.Arg1070Gln). This variant is present in population databases (rs78769542, gnomAD 0.5%), including at least one homozygous and/or hemizygous individual. This missense change has been observed in individual(s) with cystic fibrosis or congenital bilateral absence of the vas deferens. While this variant is commonly found in cis with p.Ser466*, it has also been observed without p.Ser466* in affected individuals and is expected to be causative for CFTR-related conditions whether p.Ser466* is present or not (PMID: 12955726, 18467194, 18951463, Invitae). Some individuals with this variant may present with milder symptoms. ClinVar contains an entry for this variant (Variation ID: 35866). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is not expected to disrupt CFTR protein function with a negative predictive value of 80%. Experimental studies have shown that this missense change affects CFTR function (PMID: 8662892, 8702904, 11242048, 23891399). This variant disrupts the p.Arg1070 amino acid residue in CFTR. Other variant(s) that disrupt this residue have been determined to be pathogenic (PMID: 7539342, 16189704, 21520337, 23974870). This suggests that this residue is clinically significant, and that variants that disrupt this residue are likely to be disease-causing. In summary, the currently available evidence indicates that the variant is pathogenic, but additional data are needed to prove that conclusively. Therefore, this variant has been classified as Likely Pathogenic. -
Pathogenic, criteria provided, single submitterclinical testingCentogene AG - the Rare Disease Company-- -
Likely pathogenic, criteria provided, single submitterclinical testingGenome-Nilou LabJul 22, 2021- -
not provided Pathogenic:5Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingBlueprint GeneticsJul 24, 2018- -
Pathogenic, criteria provided, single submitterclinical testingQuest Diagnostics Nichols Institute San Juan CapistranoJul 07, 2023The CFTR c.3209G>A (p.Arg1070Gln) variant has been reported in the published literature in individuals with cystic fibrosis (PMID: 7683628 (1993), 22658665 (2012), 30561903 (2019), 18951463 (2008), 29504914 (2018), 36272381 (2023)) and congenital bilateral absence of the vas deferens (CBAVD) (PMID: 12955726 (2003)). It was also found to cause a mild phenotype in the compound heterozygous state with a second CF-causing variant and was often associated with pancreatic insufficient CF in the presence of S466* variant in cis (PMID: 18951463 (2008), 22658665 (2012)). Published functional studies indicate that this variant affects chloride channel gating causing lower open probability of the channel and lower bicarbonate transport (PMID: 8662892 (1996), 11242048 (2001)). The frequency of this variant in the general population, 0.0047 (143/30596 chromosomes (Genome Aggregation Database, http://gnomad.broadinstitute.org)), is uninformative in the assessment of its pathogenicity. Based on the available information, this variant is classified as pathogenic. -
Pathogenic, criteria provided, single submitterclinical testingARUP Laboratories, Molecular Genetics and Genomics, ARUP LaboratoriesApr 22, 2018The c.3209G>A; p.Arg1070Gln variant (rs78769542) has been observed in the compound heterozygous state in patients diagnosed with cystic fibrosis with pancreatic insufficiency (see link to CFTR2 database), or mild and atypical CFTR-related disorders, such as chronic pancreatitis and congenital absence of vas deferens (Feldmann 2003, Krasnov 2008), but its effects in the homozygous state are unknown. It is reported as pathogenic or likely pathogenic by several laboratories in Clinvar (Variation ID: 35866) and is observed in the South Asian population at an overall frequency of 0.46% (141/ 30766 alleles, 3 homozygotes) in the Genome Aggregation Database. The arginine at codon 1070 is highly conserved and computational algorithms (PolyPhen-2, SIFT) predict that the variant has an impact on the protein. Functional characterization of the variant protein is inconclusive on the expression level of the mature protein (Cotten 1996, Seibert 1996, Sosnay 2013, Van Goor 2014), but indicates an observable decrease in anion transport activity (Choi 2001, Seibert 1996, Sosnay 2013, Van Goor 2014). Based on available information, the p.Arg1070Gln variant is classified as pathogenic, with a variable presentation of clinical phenotypes. References: Link to CFTR2 database: https://www.cftr2.org/ Choi J et al. Aberrant CFTR-dependent HCO3- transport in mutations associated with cystic fibrosis. Nature. 2001;410(6824):94-7. Cotten J et al. Effect of cystic fibrosis-associated mutations in the fourth intracellular loop of cystic fibrosis transmembrane conductance regulator. J Biol Chem. 1996;271(35):21279-84. Feldmann D et al. CFTR genotypes in patients with normal or borderline sweat chloride levels. Hum Mutat. 2003;22(4):340. Krasnov K et al. Localization studies of rare missense mutations in cystic fibrosis transmembrane conductance regulator (CFTR) facilitate interpretation of genotype-phenotype relationships. Hum Mutat. 2008;29(11):1364-72. Seibert F et al. Disease-associated mutations in the fourth cytoplasmic loop of cystic fibrosis transmembrane conductance regulator compromise biosynthetic processing and chloride channel activity. J Biol Chem. 1996;271(25):15139-45. Sosnay PR et al. Defining the disease liability of variants in the cystic fibrosis transmembrane conductance regulator gene. Nat Genet. 2013;45(10):1160-7. Van Goor F et al. Effect of ivacaftor on CFTR forms with missense mutations associated with defects in protein processing or function. J Cyst Fibros. 2014;13(1):29-36. -
Pathogenic, criteria provided, single submitterclinical testingRevvity Omics, RevvityJun 21, 2023- -
Pathogenic, criteria provided, single submitterclinical testingCeGaT Center for Human Genetics TuebingenOct 01, 2022CFTR: PS3, PS4, PP4:Moderate, PP3 -
Pathogenic, criteria provided, single submitterclinical testingEurofins Ntd Llc (ga)Apr 28, 2015- -
CFTR-related disorder Pathogenic:2
Pathogenic, no assertion criteria providedclinical testingPreventionGenetics, part of Exact SciencesDec 05, 2023The CFTR c.3209G>A variant is predicted to result in the amino acid substitution p.Arg1070Gln. This variant has been reported to be causative for cystic fibrosis (Mercier et al. 1993. PubMed ID: 7683628; Krasnov et al. 2008. PubMed ID: 18951463; Mickle et al. 2000. PubMed: 10762539; www.CFTR2.org). This variant is reported in 0.47% of alleles in individuals of South Asian descent in gnomAD. This variant is interpreted as pathogenic. -
Pathogenic, no assertion criteria providedclinical testingGenome Diagnostics Laboratory, The Hospital for Sick ChildrenAug 29, 2019- -
Obstructive azoospermia Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingInstitute of Reproductive Genetics, University of MünsterMar 16, 2022- -
Cystic fibrosis;C0403814:Congenital bilateral aplasia of vas deferens from CFTR mutation Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingBaylor Genetics-- -
Cystic fibrosis;na:CFTR-related disorder Pathogenic:1
Pathogenic, criteria provided, single submittercurationCFTR-FranceJul 03, 2015when the variant is in trans with another CF-causing variation, can either result in CF or in a CFTR-RD -
Hereditary pancreatitis Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingNeuberg Centre For Genomic Medicine, NCGMMay 20, 2023The missense c.3209G>A (p.Arg1070Gln) variant in CFTR gene has been observed in multiple individuals affected with CFTR-related disorders (Feldmann et al., 2003, Frenţescu et al., 2008; Krasnov et al., 2008). Experimental studies showed that this variant cause relatively subtle channel defects with functional consequences of a lower open probability of the channel, lower cyclic AMP-stimulated iodide efflux, lower bicarbonate and anion transport (Seibert et al., 1996; Cotten et al., 1996; Krasnov et al., 2008; Sosnay et al., 2013). The p.Arg1070Gln variant is present with allele frequency of 0.06% in gnomAD Exomes. This variant has been submitted to the ClinVar database as Uncertain Significance / Likely Pathogenic / Pathogenic (multiple submissions). Computational evidence (Polyphen - Probably damaging, SIFT - Tolerated and MutationTaster - Disease causing) predicts conflicting evidence on protein structure and function for this variant. The reference amino acid of p.Arg1070Gln in CFTR is predicted as conserved by GERP++ and PhyloP across 100 vertebrates. The amino acid Arg at position 1070 is changed to a Gln changing protein sequence and it might alter its composition and physico-chemical properties. For these reasons, this variant has been classified as Pathogenic. -
Bronchiectasis with or without elevated sweat chloride 1 Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingBaylor GeneticsMar 28, 2024- -
ivacaftor response - Efficacy Other:1
drug response, reviewed by expert panelcurationPharmGKBMar 24, 2021PharmGKB Level of Evidence 1A: Level 1A clinical annotations describe variant-drug combinations that have variant-specific prescribing guidance available in a current clinical guideline annotation or an FDA-approved drug label annotation. Annotations of drug labels or clinical guidelines must give prescribing guidance for specific variants (e.g. CYP2C9*3, HLA-B*57:01) or provide mapping from defined allele functions to diplotypes and phenotypes to be used as supporting evidence for a level 1A clinical annotation. Level 1A clinical annotations must also be supported by at least one publication in addition to a clinical guideline or drug label with variant-specific prescribing guidance. Drug-variant association: Efficacy

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Uncertain
0.40
BayesDel_addAF
Uncertain
0.084
D
BayesDel_noAF
Pathogenic
0.35
CADD
Pathogenic
32
DANN
Pathogenic
1.0
DEOGEN2
Uncertain
0.48
T;.;.;T;.
Eigen
Pathogenic
0.73
Eigen_PC
Pathogenic
0.77
FATHMM_MKL
Pathogenic
1.0
D
LIST_S2
Pathogenic
0.99
D;D;D;D;D
M_CAP
Pathogenic
0.50
D
MetaRNN
Benign
0.020
T;T;T;T;T
MetaSVM
Uncertain
0.45
D
MutationAssessor
Benign
0.99
L;.;.;.;.
MutationTaster
Benign
1.0
A;A
PrimateAI
Uncertain
0.77
T
PROVEAN
Benign
-0.14
N;.;.;N;.
REVEL
Pathogenic
0.70
Sift
Benign
0.42
T;.;.;T;.
Sift4G
Pathogenic
0.0
D;.;.;D;.
Polyphen
1.0
D;.;.;.;.
Vest4
0.87
MVP
0.99
MPC
0.0084
ClinPred
0.068
T
GERP RS
5.7
Varity_R
0.62
gMVP
0.95

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.010
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: rs78769542; hg19: chr7-117251704; API