7-155802938-C-T

Variant summary

Our verdict is Uncertain significance. The variant received 1 ACMG points: 3P and 2B. PM2PP2BP4_Moderate

The NM_000193.4(SHH):​c.1351G>A​(p.Ala451Thr) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.00000209 in 1,436,852 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 (★★).

Frequency

Genomes: 𝑓 0.0000067 ( 0 hom., cov: 32)
Exomes 𝑓: 0.0000016 ( 0 hom. )

Consequence

SHH
NM_000193.4 missense

Scores

2
1
16

Clinical Significance

Uncertain significance criteria provided, single submitter U:1

Conservation

PhyloP100: 0.137

Publications

0 publications found
Variant links:
Genes affected
SHH (HGNC:10848): (sonic hedgehog signaling molecule) This gene encodes a protein that is instrumental in patterning the early embryo. It has been implicated as the key inductive signal in patterning of the ventral neural tube, the anterior-posterior limb axis, and the ventral somites. Of three human proteins showing sequence and functional similarity to the sonic hedgehog protein of Drosophila, this protein is the most similar. The protein is made as a precursor that is autocatalytically cleaved; the N-terminal portion is soluble and contains the signalling activity while the C-terminal portion is involved in precursor processing. More importantly, the C-terminal product covalently attaches a cholesterol moiety to the N-terminal product, restricting the N-terminal product to the cell surface and preventing it from freely diffusing throughout the developing embryo. Defects in this protein or in its signalling pathway are a cause of holoprosencephaly (HPE), a disorder in which the developing forebrain fails to correctly separate into right and left hemispheres. HPE is manifested by facial deformities. It is also thought that mutations in this gene or in its signalling pathway may be responsible for VACTERL syndrome, which is characterized by vertebral defects, anal atresia, tracheoesophageal fistula with esophageal atresia, radial and renal dysplasia, cardiac anomalies, and limb abnormalities. Additionally, mutations in a long range enhancer located approximately 1 megabase upstream of this gene disrupt limb patterning and can result in preaxial polydactyly. [provided by RefSeq, Jul 2008]
SHH Gene-Disease associations (from GenCC):
  • holoprosencephaly 3
    Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: G2P, Ambry Genetics, Labcorp Genetics (formerly Invitae)
  • microphthalmia, isolated, with coloboma 5
    Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: G2P, PanelApp Australia
  • polydactyly of a triphalangeal thumb
    Inheritance: AD Classification: DEFINITIVE, SUPPORTIVE Submitted by: G2P, Orphanet
  • solitary median maxillary central incisor syndrome
    Inheritance: AD Classification: DEFINITIVE, MODERATE Submitted by: G2P, Ambry Genetics
  • skeletal system disorder
    Inheritance: AD Classification: MODERATE Submitted by: Ambry Genetics
  • autosomal dominant preaxial polydactyly-upperback hypertrichosis syndrome
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • hypoplastic tibiae-postaxial polydactyly syndrome
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • microphthalmia, isolated, with coloboma
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • syndactyly type 4
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • triphalangeal thumb-polysyndactyly syndrome
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • holoprosencephaly
    Inheritance: AR 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 1 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
PP2
Missense variant in the gene, where a lot of missense mutations are associated with disease in ClinVar. The gene has 26 curated pathogenic missense variants (we use a threshold of 10). The gene has 8 curated benign missense variants. Gene score misZ: 2.9479 (below the threshold of 3.09). Trascript score misZ: 0.49525 (below the threshold of 3.09). GenCC associations: The gene is linked to polydactyly of a triphalangeal thumb, microphthalmia, isolated, with coloboma 5, solitary median maxillary central incisor syndrome, holoprosencephaly 3, skeletal system disorder, hypoplastic tibiae-postaxial polydactyly syndrome, holoprosencephaly, syndactyly type 4, microphthalmia, isolated, with coloboma, autosomal dominant preaxial polydactyly-upperback hypertrichosis syndrome, triphalangeal thumb-polysyndactyly syndrome.
BP4
Computational evidence support a benign effect (MetaRNN=0.20097345).

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
SHHNM_000193.4 linkc.1351G>A p.Ala451Thr missense_variant Exon 3 of 3 ENST00000297261.7 NP_000184.1 Q15465

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
SHHENST00000297261.7 linkc.1351G>A p.Ala451Thr missense_variant Exon 3 of 3 1 NM_000193.4 ENSP00000297261.2 Q15465
SHHENST00000430104.5 linkc.302-2693G>A intron_variant Intron 3 of 3 1 ENSP00000396621.1 C9JC48
SHHENST00000435425.1 linkn.302-2341G>A intron_variant Intron 3 of 4 1 ENSP00000413871.1 F8WEH4
SHHENST00000441114.5 linkn.302-2271G>A intron_variant Intron 3 of 4 1 ENSP00000410546.1 F8WB84

Frequencies

GnomAD3 genomes
AF:
0.00000675
AC:
1
AN:
148190
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
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:
0.0000149
Gnomad OTH
AF:
0.00
GnomAD4 exome
AF:
0.00000155
AC:
2
AN:
1288662
Hom.:
0
Cov.:
35
AF XY:
0.00000157
AC XY:
1
AN XY:
637212
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
27380
American (AMR)
AF:
0.00
AC:
0
AN:
34214
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
21232
East Asian (EAS)
AF:
0.00
AC:
0
AN:
25980
South Asian (SAS)
AF:
0.0000136
AC:
1
AN:
73330
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
39252
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
3722
European-Non Finnish (NFE)
AF:
9.87e-7
AC:
1
AN:
1013132
Other (OTH)
AF:
0.00
AC:
0
AN:
50420
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.500
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

Exome 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
GnomAD4 genome
AF:
0.00000675
AC:
1
AN:
148190
Hom.:
0
Cov.:
32
AF XY:
0.0000139
AC XY:
1
AN XY:
72200
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
40496
American (AMR)
AF:
0.00
AC:
0
AN:
14936
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3432
East Asian (EAS)
AF:
0.00
AC:
0
AN:
4676
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4376
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
9940
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
308
European-Non Finnish (NFE)
AF:
0.0000149
AC:
1
AN:
67066
Other (OTH)
AF:
0.00
AC:
0
AN:
2060
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.475
Heterozygous variant carriers
0
0
1
1
2
2
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance
Alfa
AF:
0.00
Hom.:
0
Bravo
AF:
0.00000756

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:1
Revision: criteria provided, single submitter
LINK: link

Submissions by phenotype

Holoprosencephaly 3 Uncertain:1
Nov 10, 2022
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. This sequence change replaces alanine, which is neutral and non-polar, with threonine, which is neutral and polar, at codon 451 of the SHH protein (p.Ala451Thr). This variant is not present in population databases (gnomAD no frequency). This variant has not been reported in the literature in individuals affected with SHH-related conditions. 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 SHH protein function. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.070
BayesDel_addAF
Benign
-0.059
T
BayesDel_noAF
Benign
-0.32
CADD
Benign
19
DANN
Benign
0.94
DEOGEN2
Benign
0.38
T
Eigen
Benign
-0.67
Eigen_PC
Benign
-0.62
FATHMM_MKL
Benign
0.21
N
LIST_S2
Benign
0.74
T
M_CAP
Pathogenic
0.97
D
MetaRNN
Benign
0.20
T
MetaSVM
Pathogenic
1.0
D
MutationAssessor
Benign
0.81
L
PhyloP100
0.14
PrimateAI
Uncertain
0.63
T
PROVEAN
Benign
0.15
N
REVEL
Benign
0.25
Sift
Benign
0.47
T
Sift4G
Benign
0.42
T
Polyphen
0.0
B
Vest4
0.050
MVP
0.44
ClinPred
0.33
T
GERP RS
-0.27
Varity_R
0.069
gMVP
0.23
Mutation Taster
=94/6
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: rs1013898422; hg19: chr7-155595632; API