NM_000394.4:c.145C>T

Variant summary

Our verdict is Likely pathogenic. The variant received 9 ACMG points: 9P and 0B. PM1PP2PP3_StrongPP5_Moderate

The NM_000394.4(CRYAA):​c.145C>T​(p.Arg49Cys) variant causes a missense change involving the alteration of a non-conserved nucleotide. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Pathogenic (★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R49H) has been classified as Uncertain significance.

Frequency

Genomes: 𝑓 0.000026 ( 0 hom., cov: 9)
Exomes 𝑓: 0.0000026 ( 0 hom. )
Failed GnomAD Quality Control

Consequence

CRYAA
NM_000394.4 missense

Scores

8
8
2

Clinical Significance

Pathogenic criteria provided, single submitter P:2

Conservation

PhyloP100: 1.68

Publications

57 publications found
Variant links:
Genes affected
CRYAA (HGNC:2388): (crystallin alpha A) Mammalian lens crystallins are divided into alpha, beta, and gamma families. Alpha crystallins are composed of two gene products: alpha-A and alpha-B, for acidic and basic, respectively. Alpha crystallins can be induced by heat shock and are members of the small heat shock protein (HSP20) family. They act as molecular chaperones although they do not renature proteins and release them in the fashion of a true chaperone; instead they hold them in large soluble aggregates. Post-translational modifications decrease the ability to chaperone. These heterogeneous aggregates consist of 30-40 subunits; the alpha-A and alpha-B subunits have a 3:1 ratio, respectively. Two additional functions of alpha crystallins are an autokinase activity and participation in the intracellular architecture. The encoded protein has been identified as a moonlighting protein based on its ability to perform mechanistically distinct functions. Alpha-A and alpha-B gene products are differentially expressed; alpha-A is preferentially restricted to the lens and alpha-B is expressed widely in many tissues and organs. Defects in this gene cause autosomal dominant congenital cataract (ADCC). [provided by RefSeq, Jan 2014]
CRYAA Gene-Disease associations (from GenCC):
  • cataract 9 multiple types
    Inheritance: AR, AD Classification: DEFINITIVE, STRONG Submitted by: G2P, Labcorp Genetics (formerly Invitae), Ambry Genetics
  • cataract - microcornea syndrome
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • early-onset anterior polar cataract
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • early-onset lamellar cataract
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • early-onset nuclear cataract
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • total early-onset cataract
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Likely_pathogenic. The variant received 9 ACMG points.

PM1
In a hotspot region, there are 3 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 1 benign, 3 uncertain in NM_000394.4
PP2
Missense variant in the gene, where a lot of missense mutations are associated with disease in ClinVar. The gene has 11 curated pathogenic missense variants (we use a threshold of 10). The gene has 0 curated benign missense variants. Gene score misZ: 0.34778 (below the threshold of 3.09). Trascript score misZ: NaN (below the threshold of 3.09). GenCC associations: The gene is linked to early-onset lamellar cataract, cataract - microcornea syndrome, early-onset nuclear cataract, early-onset anterior polar cataract, total early-onset cataract, cataract 9 multiple types.
PP3
MetaRNN computational evidence supports a deleterious effect, 0.951
PP5
Variant 21-43169244-C-T is Pathogenic according to our data. Variant chr21-43169244-C-T is described in ClinVar as Pathogenic. ClinVar VariationId is 16959.Status of the report is criteria_provided_single_submitter, 1 stars.

Variant Effect in Transcripts

ACMG analysis was done for transcript: NM_000394.4. You can select a different transcript below to see updated ACMG assignments.

RefSeq Transcripts

Sel.
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
CRYAA
NM_000394.4
MANE Select
c.145C>Tp.Arg49Cys
missense
Exon 1 of 3NP_000385.1

Ensembl Transcripts

Sel.
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
CRYAA
ENST00000291554.6
TSL:1 MANE Select
c.145C>Tp.Arg49Cys
missense
Exon 1 of 3ENSP00000291554.2
CRYAA
ENST00000482775.1
TSL:5
n.158C>T
non_coding_transcript_exon
Exon 1 of 4

Frequencies

GnomAD3 genomes
AF:
0.0000260
AC:
2
AN:
76940
Hom.:
0
Cov.:
9
show subpopulations
Gnomad AFR
AF:
0.0000541
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:
0.0000290
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.00000803
AC:
2
AN:
249112
AF XY:
0.00000741
show subpopulations
Gnomad AFR exome
AF:
0.0000615
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00000880
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
Data not reliable, filtered out with message: AS_VQSR
AF:
0.00000259
AC:
2
AN:
772640
Hom.:
0
Cov.:
10
AF XY:
0.00000250
AC XY:
1
AN XY:
400204
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
17392
American (AMR)
AF:
0.00
AC:
0
AN:
36882
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
18458
East Asian (EAS)
AF:
0.00
AC:
0
AN:
38018
South Asian (SAS)
AF:
0.00
AC:
0
AN:
73038
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
30646
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
3140
European-Non Finnish (NFE)
AF:
0.00000386
AC:
2
AN:
518204
Other (OTH)
AF:
0.00
AC:
0
AN:
36862
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.475
Heterozygous variant carriers
0
1
1
2
2
3
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
Data not reliable, filtered out with message: AS_VQSR
AF:
0.0000260
AC:
2
AN:
76940
Hom.:
0
Cov.:
9
AF XY:
0.0000541
AC XY:
2
AN XY:
36992
show subpopulations
⚠️ The allele balance in gnomAD version 4 Genomes is significantly skewed from the expected value of 0.5.
African (AFR)
AF:
0.0000541
AC:
1
AN:
18498
American (AMR)
AF:
0.00
AC:
0
AN:
8288
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
1998
East Asian (EAS)
AF:
0.00
AC:
0
AN:
4026
South Asian (SAS)
AF:
0.00
AC:
0
AN:
2754
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
5188
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
174
European-Non Finnish (NFE)
AF:
0.0000290
AC:
1
AN:
34476
Other (OTH)
AF:
0.00
AC:
0
AN:
918
⚠️ The allele balance in gnomAD version 4 Genomes is significantly skewed from the expected value of 0.5. (p-value = 0), which strongly suggests a high chance of mosaicism in these individuals.
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.300
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

Genome 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
Alfa
AF:
0.0000250
Hom.:
0
ExAC
AF:
0.00000824
AC:
1

ClinVar

ClinVar submissions as Germline
Significance:Pathogenic
Revision:criteria provided, single submitter
View on ClinVar
Pathogenic
VUS
Benign
Condition
2
-
-
Cataract 9 multiple types (2)

Computational scores

Source: dbNSFP v4.9

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.75
BayesDel_addAF
Pathogenic
0.25
D
BayesDel_noAF
Pathogenic
0.28
CADD
Pathogenic
32
DANN
Pathogenic
1.0
DEOGEN2
Pathogenic
0.88
D
Eigen
Uncertain
0.62
Eigen_PC
Uncertain
0.55
FATHMM_MKL
Benign
0.74
D
LIST_S2
Pathogenic
0.98
D
M_CAP
Uncertain
0.20
D
MetaRNN
Pathogenic
0.95
D
MetaSVM
Uncertain
0.52
D
MutationAssessor
Uncertain
2.4
M
PhyloP100
1.7
PrimateAI
Uncertain
0.71
T
PROVEAN
Uncertain
-3.4
D
REVEL
Pathogenic
0.81
Sift
Uncertain
0.011
D
Sift4G
Benign
0.070
T
Polyphen
1.0
D
Vest4
0.95
MVP
0.97
MPC
1.2
ClinPred
0.94
D
GERP RS
4.0
PromoterAI
-0.032
Neutral
Varity_R
0.62
gMVP
0.81
Mutation Taster
=51/49
disease causing (ClinVar)

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: rs74315441; hg19: chr21-44589354; COSMIC: COSV52352468; COSMIC: COSV52352468; API