Our verdict is Likely pathogenic. The variant received 8 ACMG points: 8P and 0B. PM1PM2PM5PP3_Moderate
The NM_000368.5(TSC1):c.647T>A(p.Phe216Tyr) 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. No clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar. Another variant affecting the same amino acid position, but resulting in a different missense (i.e. F216S) has been classified as Likely pathogenic.
TSC1 (HGNC:12362): (TSC complex subunit 1) This gene is a tumor suppressor gene that encodes the growth inhibitory protein hamartin. The encoded protein interacts with and stabilizes the GTPase activating protein tuberin. This hamartin-tuberin complex negatively regulates mammalian target of rapamycin complex 1 (mTORC1) signaling which is a major regulator of anabolic cell growth. This protein also functions as a co-chaperone for Hsp90 that inhibits its ATPase activity. This protein functions as a facilitator of Hsp90-mediated folding of kinase and non-kinase clients, including TSC2 and thereby preventing their ubiquitination and proteasomal degradation. Mutations in this gene have been associated with tuberous sclerosis and lymphangioleiomyomatosis. [provided by RefSeq, May 2022]
TSC1 Gene-Disease associations (from GenCC):
tuberous sclerosis
Inheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
tuberous sclerosis 1
Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: Ambry Genetics, PanelApp Australia, Genomics England PanelApp, G2P, Labcorp Genetics (formerly Invitae)
lung lymphangioleiomyomatosis
Inheritance: AD Classification: STRONG Submitted by: Genomics England PanelApp
tuberous sclerosis complex
Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
Our verdict: Likely_pathogenic. The variant received 8 ACMG points.
PM1
In a hotspot region, there are 2 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 4 benign, 32 uncertain in NM_000368.5
PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chr9-132921835-A-G is described in ClinVar as Pathogenic/Likely_pathogenic. ClinVar VariationId is 49073.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
PP3
MetaRNN computational evidence supports a deleterious effect, 0.894
Gain of phosphorylation at F216 (P = 0.0311);.;Gain of phosphorylation at F216 (P = 0.0311);Gain of phosphorylation at F216 (P = 0.0311);Gain of phosphorylation at F216 (P = 0.0311);Gain of phosphorylation at F216 (P = 0.0311);Gain of phosphorylation at F216 (P = 0.0311);Gain of phosphorylation at F216 (P = 0.0311);Gain of phosphorylation at F216 (P = 0.0311);.;.;Gain of phosphorylation at F216 (P = 0.0311);Gain of phosphorylation at F216 (P = 0.0311);Gain of phosphorylation at F216 (P = 0.0311);Gain of phosphorylation at F216 (P = 0.0311);Gain of phosphorylation at F216 (P = 0.0311);.;Gain of phosphorylation at F216 (P = 0.0311);.;Gain of phosphorylation at F216 (P = 0.0311);