Our verdict is Likely pathogenic. The variant received 8 ACMG points: 8P and 0B. PVS1
The NM_001322011.2(PMS2):c.1_3delATGinsCTA(p.Met1?) variant causes a start lost change involving the alteration of a non-conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. It is difficult to determine the true allele frequency of this variant because it is of type MNV, and the frequency of such variant types in population databases may be underestimated and unreliable. No clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar. The gene PMS2 is included in the ClinGen Criteria Specification Registry.
PMS2 (HGNC:9122): (PMS1 homolog 2, mismatch repair system component) The protein encoded by this gene is a key component of the mismatch repair system that functions to correct DNA mismatches and small insertions and deletions that can occur during DNA replication and homologous recombination. This protein forms heterodimers with the gene product of the mutL homolog 1 (MLH1) gene to form the MutL-alpha heterodimer. The MutL-alpha heterodimer possesses an endonucleolytic activity that is activated following recognition of mismatches and insertion/deletion loops by the MutS-alpha and MutS-beta heterodimers, and is necessary for removal of the mismatched DNA. There is a DQHA(X)2E(X)4E motif found at the C-terminus of the protein encoded by this gene that forms part of the active site of the nuclease. Mutations in this gene have been associated with hereditary nonpolyposis colorectal cancer (HNPCC; also known as Lynch syndrome) and Turcot syndrome. [provided by RefSeq, Apr 2016]
PMS2 Gene-Disease associations (from GenCC):
Lynch syndrome
Inheritance: AD Classification: DEFINITIVE, SUPPORTIVE Submitted by: Orphanet, ClinGen
Lynch syndrome 4
Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: G2P, Genomics England PanelApp, Labcorp Genetics (formerly Invitae)
mismatch repair cancer syndrome 1
Inheritance: AR Classification: DEFINITIVE, SUPPORTIVE Submitted by: Orphanet, ClinGen
Our verdict: Likely_pathogenic. The variant received 8 ACMG points.
PVS1
Start lost variant, next in-frame start position is after 44 pathogenic variants. Next in-frame start position is after 51 codons. Genomic position: 5989860. Lost 0.091 part of the original CDS.
Variant Effect in Transcripts
ACMG analysis was done for transcript: NM_001322011.2. You can select a different transcript below to see updated ACMG assignments.
RefSeq Transcripts
Sel.
Gene
Transcript
Tags
HGVSc
HGVSp
Effect
Exon Rank
Protein
UniProt
PMS2
NM_000535.7
MANE Select
c.934_936delATGinsCTA
p.Met312Leu
missense
N/A
NP_000526.2
P54278-1
PMS2
NM_001322011.2
c.1_3delATGinsCTA
p.Met1?
start_lost
N/A
NP_001308940.1
PMS2
NM_001322012.2
c.1_3delATGinsCTA
p.Met1?
start_lost
N/A
NP_001308941.1
Ensembl Transcripts
Sel.
Gene
Transcript
Tags
HGVSc
HGVSp
Effect
Exon Rank
Protein
UniProt
PMS2
ENST00000265849.12
TSL:1 MANE Select
c.934_936delATGinsCTA
p.Met312Leu
missense
N/A
ENSP00000265849.7
P54278-1
PMS2
ENST00000382321.5
TSL:1
c.803+5299_803+5301delATGinsCTA
intron
N/A
ENSP00000371758.4
P54278-2
PMS2
ENST00000406569.8
TSL:1
n.934_936delATGinsCTA
non_coding_transcript_exon
Exon 9 of 13
ENSP00000514464.1
P54278-3
Frequencies
GnomAD3 genomes
Cov.:
31
We have no GnomAD4 exomes data on this position. Probably position not covered by the project.