NM_000026.4:c.569G>A

Variant names:

Variant summary

Our verdict is Pathogenic. The variant received 11 ACMG points: 12P and 1B. PM1PM5PP5_Very_StrongBP4

The NM_000026.4(ADSL):c.569G>A(p.Arg190Gln) variant causes a missense change. The variant allele was found at a frequency of 0.0000217 in 1,614,198 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Likely pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R190G) has been classified as Likely pathogenic.

Frequency

Genomes: 𝑓 0.000059 ( 0 hom., cov: 32)

Exomes 𝑓: 0.000018 ( 0 hom. )

Consequence

ADSL
NM_000026.4 missense

Scores

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:3

Conservation

PhyloP100: 3.61

Publications

9 publications found

Variant links:

Genes affected

ADSL (HGNC:291): (adenylosuccinate lyase) The protein encoded by this gene belongs to the lyase 1 family. It is an essential enzyme involved in purine metabolism, and catalyzes two non-sequential reactions in the de novo purine biosynthetic pathway: the conversion of succinylaminoimidazole carboxamide ribotide (SAICAR) to aminoimidazole carboxamide ribotide (AICAR) and the conversion of adenylosuccinate (S-AMP) to adenosine monophosphate (AMP). Mutations in this gene are associated with adenylosuccinase deficiency (ADSLD), a disorder marked with psychomotor retardation, epilepsy or autistic features. Alternatively spliced transcript variants have been found for this gene. [provided by RefSeq, Dec 2015]

ADSL Gene-Disease associations (from GenCC):

adenylosuccinate lyase deficiency
Inheritance: AR Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: ClinGen, G2P, Orphanet, Labcorp Genetics (formerly Invitae)

ADSL links:

ENSG00000284431 (HGNC:):

ENSG00000284431 links:

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Pathogenic. The variant received 11 ACMG points.

PM1

In a hotspot region, there are 3 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 2 benign, 7 uncertain in NM_000026.4

PM5

Other missense variant is known to change same aminoacid residue: Variant chr22-40358949-C-G is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 2725586.

PP5

Variant 22-40358950-G-A is Pathogenic according to our data. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-40358950-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

BP4

Computational evidence support a benign effect (MetaRNN=0.07161367). . Strength limited to SUPPORTING due to the PP5.

Transcripts

RefSeq

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	MANE	Protein	UniProt
ADSL	NM_000026.4 link	c.569G>A	p.Arg190Gln	missense_variant	Exon 5 of 13	ENST00000623063.3	NP_000017.1	P30566-1X5D8S6

Ensembl

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	TSL	MANE	Protein	UniProt
ADSL	ENST00000623063.3 link	c.569G>A	p.Arg190Gln	missense_variant	Exon 5 of 13	1	NM_000026.4	ENSP00000485525.1	P30566-1
ENSG00000284431	ENST00000639722.1 link	n.*265G>A		non_coding_transcript_exon_variant	Exon 4 of 31	5		ENSP00000492828.1	A0A1W2PRX2
ENSG00000284431	ENST00000639722.1 link	n.*265G>A		3_prime_UTR_variant	Exon 4 of 31	5		ENSP00000492828.1	A0A1W2PRX2

Frequencies

GnomAD3 genomes

AF:

0.0000591

AC:

AN:

152192

Hom.:

Cov.:

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:

0.00135

Gnomad SAS

AF:

0.00

Gnomad FIN

AF:

0.00

Gnomad MID

AF:

0.00

Gnomad NFE

AF:

0.0000294

Gnomad OTH

AF:

0.00

GnomAD2 exomes

AF:

0.0000318

AC:

AN:

251460

AF XY:

0.0000441

show subpopulations

Gnomad AFR exome

AF:

0.00

Gnomad AMR exome

AF:

0.00

Gnomad ASJ exome

AF:

0.00

Gnomad EAS exome

AF:

0.000217

Gnomad FIN exome

AF:

0.00

Gnomad NFE exome

AF:

0.0000352

Gnomad OTH exome

AF:

0.00

GnomAD4 exome

AF:

0.0000178

AC:

AN:

1461888

Hom.:

Cov.:

AF XY:

0.0000179

AC XY:

AN XY:

727246

show subpopulations

African (AFR)

AF:

0.00

AC:

AN:

33480

American (AMR)

AF:

0.0000224

AC:

AN:

44724

Ashkenazi Jewish (ASJ)

AF:

0.00

AC:

AN:

26136

East Asian (EAS)

AF:

0.000126

AC:

AN:

39700

South Asian (SAS)

AF:

0.0000348

AC:

AN:

86258

European-Finnish (FIN)

AF:

0.00

AC:

AN:

53420

Middle Eastern (MID)

AF:

0.000173

AC:

AN:

5768

European-Non Finnish (NFE)

AF:

0.0000144

AC:

AN:

1112006

Other (OTH)

AF:

0.00

AC:

AN:

60396

Allele Balance Distribution

Red line indicates average allele balance

Average allele balance: 0.498

Heterozygous variant carriers

0.00

0.20

0.40

0.60

0.80

0.95

Allele balance

Age Distribution

Exome Het

Variant carriers

<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:

0.0000591

AC:

AN:

152310

Hom.:

Cov.:

AF XY:

0.0000537

AC XY:

AN XY:

74482

show subpopulations

African (AFR)

AF:

0.00

AC:

AN:

41560

American (AMR)

AF:

0.00

AC:

AN:

15298

Ashkenazi Jewish (ASJ)

AF:

0.00

AC:

AN:

3472

East Asian (EAS)

AF:

0.00135

AC:

AN:

5182

South Asian (SAS)

AF:

0.00

AC:

AN:

4826

European-Finnish (FIN)

AF:

0.00

AC:

AN:

10618

Middle Eastern (MID)

AF:

0.00

AC:

AN:

294

European-Non Finnish (NFE)

AF:

0.0000294

AC:

AN:

68038

Other (OTH)

AF:

0.00

AC:

AN:

2110

Allele Balance Distribution

Red line indicates average allele balance

Average allele balance: 0.486

Heterozygous variant carriers

0.00

0.20

0.40

0.60

0.80

0.95

Allele balance

Age Distribution

Genome Het

Variant carriers

<30

30-35

35-40

40-45

45-50

50-55

55-60

60-65

65-70

70-75

75-80

>80

Age

Alfa

AF:

0.0000488

Hom.:

Bravo

AF:

0.0000340

ExAC

AF:

0.0000659

AC:

Asia WGS

AF:

0.000289

AC:

AN:

3478

EpiCase

AF:

0.00

EpiControl

AF:

0.0000593

ClinVar

Significance: Pathogenic/Likely pathogenic

Submissions summary: Pathogenic:3

Revision: criteria provided, multiple submitters, no conflicts

LINK: link

Submissions by phenotype

Adenylosuccinate lyase deficiency

Pathogenic:2

Dec 28, 2024

Labcorp Genetics (formerly Invitae), Labcorp

Significance:Pathogenic

Review Status:criteria provided, single submitter

Collection Method:clinical testing

This sequence change replaces arginine, which is basic and polar, with glutamine, which is neutral and polar, at codon 190 of the ADSL protein (p.Arg190Gln). This variant is present in population databases (rs28941471, gnomAD 0.03%). This missense change has been observed in individual(s) with deficiency of adenylosuccinate lyase (PMID: 10090474, 10888601). ClinVar contains an entry for this variant (Variation ID: 2465). Invitae Evidence Modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) indicates that this missense variant is not expected to disrupt ADSL protein function with a negative predictive value of 80%. Experimental studies are conflicting or provide insufficient evidence to determine the effect of this variant on ADSL function (PMID: 20127976, 22180458). For these reasons, this variant has been classified as Pathogenic. -

Jan 01, 1999

OMIM

Significance:Pathogenic

Review Status:no assertion criteria provided

Collection Method:literature only

- -

not provided

Pathogenic:1

Oct 02, 2024

GeneDx

Significance:Likely pathogenic

Review Status:criteria provided, single submitter

Collection Method:clinical testing

Published functional studies demonstrate a damaging effect as this variant decreases enzyme stability (PMID: 20127976, 10888601); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; This variant is associated with the following publications: (PMID: 10888601, 10090474, 37842880, 36338215, 22180458, 20127976) -

Computational scores

Source: dbNSFP v4.3

Name

Calibrated prediction

Score

Prediction

AlphaMissense

Benign

0.15

BayesDel_addAF

Uncertain

0.10

BayesDel_noAF

Pathogenic

0.22

CADD

Benign

(source)

DANN

Uncertain

0.99

DEOGEN2

Benign

0.033

T;D;.;T;T;T;T;.

Eigen

Benign

-0.29

Eigen_PC

Benign

-0.24

FATHMM_MKL

Uncertain

0.96

LIST_S2

Uncertain

0.93

D;D;D;D;D;D;D;D

M_CAP

Pathogenic

0.31

MetaRNN

Benign

0.072

T;T;T;T;T;T;T;T

MetaSVM

Pathogenic

1.1

MutationAssessor

Uncertain

2.8

.;M;M;.;.;.;.;.

PhyloP100

3.6

PrimateAI

Benign

0.37

PROVEAN

Uncertain

-2.7

.;.;D;.;.;.;.;.

REVEL

Pathogenic

0.68

Sift

Benign

0.26

.;.;T;.;.;.;.;.

Sift4G

Benign

0.55

T;T;T;.;T;T;.;.

Polyphen

0.017, 0.69

.;B;P;.;.;.;.;.

Vest4

0.43, 0.55, 0.77

MutPred

0.68

.;.;.;.;Loss of helix (P = 0.028);.;.;.;

MVP

0.95

MPC

0.34

ClinPred

0.24

GERP RS

2.8

Varity_R

0.58

gMVP

0.91

Mutation Taster

=9/91

disease causing (ClinVar)

(source)

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

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Variant summary

Frequency

Consequence

Scores

Clinical Significance

Conservation

Publications

ACMG classification

Transcripts

RefSeq

Ensembl

Frequencies

Age Distribution

Age Distribution

ClinVar

Submissions by phenotype

Computational scores

Splicing

Publications

Other links and lift over