NM_000527.5:c.1060+10G>A
Variant summary
Our verdict is Uncertain significance. The variant received 3 ACMG points: 3P and 0B. PP3_ModeratePP5
The NM_000527.5(LDLR):c.1060+10G>A variant causes a intron change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.00000616 in 1,460,120 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 Conflicting classifications of pathogenicity (no stars).
Frequency
Consequence
NM_000527.5 intron
Scores
Clinical Significance
Conservation
Publications
- hypercholesterolemia, familial, 1Inheritance: AD, SD Classification: DEFINITIVE, STRONG Submitted by: Genomics England PanelApp, Labcorp Genetics (formerly Invitae), Laboratory for Molecular Medicine, ClinGen
- homozygous familial hypercholesterolemiaInheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
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ACMG classification
Our verdict: Uncertain_significance. The variant received 3 ACMG points.
Transcripts
RefSeq
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt |
|---|---|---|---|---|---|---|---|---|
| LDLR | NM_000527.5 | c.1060+10G>A | intron_variant | Intron 7 of 17 | ENST00000558518.6 | NP_000518.1 |
Ensembl
Frequencies
GnomAD3 genomes Cov.: 32
GnomAD2 exomes AF: 0.0000120 AC: 3AN: 249942 AF XY: 0.0000222 show subpopulations
GnomAD4 exome AF: 0.00000616 AC: 9AN: 1460120Hom.: 0 Cov.: 45 AF XY: 0.00000688 AC XY: 5AN XY: 726478 show subpopulations
Age Distribution
GnomAD4 genome Cov.: 32
ClinVar
Submissions by phenotype
Hypercholesterolemia, familial, 1 Pathogenic:2Uncertain:4
subjects mutated among 2600 FH index cases screened = 6 , family member = 1 -
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The c.1060+10G>A variant in LDLR has been reported in 6 individuals (including 3 French and 2 Italian individuals) with Familial Hypercholesterolemia, segregated with disease in 2 affected relatives from 1 family (PMID: 12436241, 23375686, 28965616), and has been identified in 0.01088% (2/18376) of East Asian chromosomes and 0.003267% (1/30608) of South Asian chromosomes by the Genome Aggregation Database (gnomAD, http://gnomad.broadinstitute.org; dbSNP rs12710260). This variant has also been reported as a VUS, a likely benign variant, and a likely pathogenic variant in ClinVar (Variation ID: 251625). Please note that for diseases with clinical variability, or reduced penetrance, pathogenic variants may be present at a low frequency in the general population. Computational prediction tools and conservation analyses do not provide strong support for or against an impact to the protein. In summary, the clinical significance of the c.1060+10G>A variant is uncertain. ACMG/AMP Criteria applied: PS4_Supporting (Richards 2015). -
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Familial hypercholesterolemia Pathogenic:2Uncertain:2
This variant causes a G to A nucleotide substitution at the +10 position of intron 7 of the LDLR gene. Splice site prediction tools predict that this variant may have a significant impact on RNA splicing. To our knowledge, RNA studies have not been performed for this variant. This variant has been reported in several heterozygous individuals affected with familial hypercholesterolemia (PMID: 12436241, 15823288, 23375686, 28965616, 32633265, 34297352, 33807407, 36991406). Some of these individuals also carried additional pathogenic variants in the same gene (PMID: 32633265, 33807407). This variant has been identified in 3/249942 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -
At least 7 reports of c.1060+10G>A in confirmed unrelated FH cases have been made (PMID: 12436241; 16542394; 23375686; 28965616; 36991406) allowing PS4_moderate to be scored. A further 3 three reports have also been published, but without a confirmed diagnosis (PMID: 15823288; 26332594; 34456049). PM2 and PP4 can also be scored, allowing a Uncertain significance classification to be made. -
Variant summary: LDLR c.1060+10G>A alters a non-conserved nucleotide located at a position not widely known to affect splicing. Several computational tools predict a significant impact on normal splicing: Three predict the variant strengthens a cryptic 5' donor site. One predicts the variant creates a 5' donor site. However, these predictions have yet to be confirmed by functional studies. The variant allele was found at a frequency of 1.2e-05 in 249942 control chromosomes. c.1060+10G>A has been observed in multiple heterozygous and at least 1 homozygous individual(s) affected with autosomal dominant and autosomal recessive Familial Hypercholesterolemia (example, Marco_2022, Zhang_2023, Huang_2024, Labcorp Genetics (formerly Invitae)). These data indicate that the variant is very likely to be associated with disease. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. The following publications have been ascertained in the context of this evaluation (PMID: 12436241, 23375686, 16542394, 34456049, 28965616, 36991406, 39731075, 15823288). ClinVar contains an entry for this variant (Variation ID: 251625). Based on the evidence outlined above, the variant was classified as pathogenic for autosomal dominant and autosomal recessive familial hypercholesterolemia. -
This sequence change falls in intron 7 of the LDLR gene. It does not directly change the encoded amino acid sequence of the LDLR protein. This variant is present in population databases (rs12710260, gnomAD 0.006%). This variant has been observed in individuals with familial hypercholesterolemia (PMID: 12436241, 15823288, 23375686, 34297352, 34456049, 36991406; internal data). Invitae Evidence Modeling of clinical and family history, age, sex, and reported ancestry of multiple individuals with this LDLR variant has been performed. This variant is expected to be pathogenic with a positive predictive value of at least 99%. This is a validated machine learning model that incorporates the clinical features of 363,995 individuals referred to our laboratory for LDLR testing. ClinVar contains an entry for this variant (Variation ID: 251625). Algorithms developed to predict the effect of sequence changes on RNA splicing suggest that this variant may disrupt the consensus splice site. For these reasons, this variant has been classified as Pathogenic. -
not provided Uncertain:2
Identified in both heterozygous and homozygous states in several unrelated individuals with a clinical diagnosis of FH (PMID: 12436241, 23375686, 15823288, 34297352, 34456049, 28965616, 36991406); Not observed at significant frequency in large population cohorts (gnomAD); In silico analysis supports a deleterious effect on splicing; This variant is associated with the following publications: (PMID: 26332594, 15823288, 23375686, 28965616, 12436241, 34297352, 36991406, 34456049) -
The frequency of this variant in the general population, 0.000012 (3/249942 chromosomes, http://gnomad.broadinstitute.org), is uninformative in assessment of its pathogenicity. In the published literature, the variant has been reported in individuals with familial hypercholesterolemia (PMIDs: 28965616 (2017), 23375686 (2013), 15823288 (2005), 12436241 (2002)). Analysis of this variant using software algorithms for the prediction of the effect of nucleotide changes on LDLR mRNA splicing yielded predictions that this variant may result in the gain of a cryptic splice site without affecting the natural splice sites . Based on the available information, we are unable to determine the clinical significance of this variant. -
Cardiovascular phenotype Uncertain:1
The c.1060+10G>A intronic alteration consists of a G to A substitution 10 nucleotides after exon 7 of the LDLR gene. Based on insufficient or conflicting evidence, the clinical significance of this alteration remains unclear. -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at