NM_000558.5:c.358C>T

Variant summary

Our verdict is Pathogenic. Variant got 12 ACMG points: 12P and 0B. PP3_StrongPP5_Very_Strong

The NM_000558.5(HBA1):​c.358C>T​(p.Pro120Ser) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.000031 in 1,613,180 control chromosomes in the GnomAD database, including 2 homozygotes. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Pathogenic (★★).

Frequency

Genomes: 𝑓 0.000039 ( 1 hom., cov: 32)
Exomes 𝑓: 0.000030 ( 1 hom. )

Consequence

HBA1
NM_000558.5 missense

Scores

7
6
5

Clinical Significance

Pathogenic criteria provided, multiple submitters, no conflicts P:8

Conservation

PhyloP100: 3.35
Variant links:
Genes affected
HBA1 (HGNC:4823): (hemoglobin subunit alpha 1) The human alpha globin gene cluster located on chromosome 16 spans about 30 kb and includes seven loci: 5'- zeta - pseudozeta - mu - pseudoalpha-1 - alpha-2 - alpha-1 - theta - 3'. The alpha-2 (HBA2) and alpha-1 (HBA1) coding sequences are identical. These genes differ slightly over the 5' untranslated regions and the introns, but they differ significantly over the 3' untranslated regions. Two alpha chains plus two beta chains constitute HbA, which in normal adult life comprises about 97% of the total hemoglobin; alpha chains combine with delta chains to constitute HbA-2, which with HbF (fetal hemoglobin) makes up the remaining 3% of adult hemoglobin. Alpha thalassemias result from deletions of each of the alpha genes as well as deletions of both HBA2 and HBA1; some nondeletion alpha thalassemias have also been reported. [provided by RefSeq, Jul 2008]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 12 ACMG points.

PP3
MetaRNN computational evidence supports a deleterious effect, 0.972
PP5
Variant 16-177340-C-T is Pathogenic according to our data. Variant chr16-177340-C-T is described in ClinVar as [Pathogenic]. Clinvar id is 811900.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
HBA1NM_000558.5 linkc.358C>T p.Pro120Ser missense_variant Exon 3 of 3 ENST00000320868.9 NP_000549.1 P69905D1MGQ2

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
HBA1ENST00000320868.9 linkc.358C>T p.Pro120Ser missense_variant Exon 3 of 3 1 NM_000558.5 ENSP00000322421.5 P69905

Frequencies

GnomAD3 genomes
AF:
0.0000394
AC:
6
AN:
152202
Hom.:
1
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.000131
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:
0.0000294
Gnomad OTH
AF:
0.000955
GnomAD3 exomes
AF:
0.0000566
AC:
14
AN:
247332
Hom.:
0
AF XY:
0.0000447
AC XY:
6
AN XY:
134312
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.000175
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000628
Gnomad OTH exome
AF:
0.000166
GnomAD4 exome
AF:
0.0000301
AC:
44
AN:
1460978
Hom.:
1
Cov.:
32
AF XY:
0.0000275
AC XY:
20
AN XY:
726802
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.000157
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.00
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.0000189
Gnomad4 OTH exome
AF:
0.000133
GnomAD4 genome
AF:
0.0000394
AC:
6
AN:
152202
Hom.:
1
Cov.:
32
AF XY:
0.0000672
AC XY:
5
AN XY:
74352
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.000131
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.0000294
Gnomad4 OTH
AF:
0.000955
Alfa
AF:
0.000102
Hom.:
0
Bravo
AF:
0.0000529
ExAC
AF:
0.0000330
AC:
4
EpiCase
AF:
0.0000545
EpiControl
AF:
0.000119

ClinVar

Significance: Pathogenic
Submissions summary: Pathogenic:8
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

alpha Thalassemia Pathogenic:3
Oct 09, 2023
Zotz-Klimas Genetics Lab, MVZ Zotz Klimas
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

Jun 22, 2022
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Variant summary: HBA1 c.358C>T (p.Pro120Ser) results in a non-conservative amino acid change located in the Globin domain (IPR000971) of the encoded protein sequence. Five of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 5.7e-05 in 247332 control chromosomes (gnomAD). This frequency is not significantly higher than expected for a pathogenic variant in HBA1 causing Alpha Thalassemia (5.7e-05 vs 0.0056), allowing no conclusion about variant significance. c.358C>T has been reported in the literature in multiple compound heterozygous and homozygous individuals affected with Alpha Thalassemia (e.g. Giordano_2007, Zanella-Cleon_2008, Joly_2014). These data indicate that the variant is very likely to be associated with disease. In vitro binding assays indicate that while the variant protein is capable of forming dimers, it does not interact with alpha hemoglobin stabilizing proteins or beta subunits, leading to destabilization and increased proteolytic degredation (Yu_2009). Four ClinVar submitters have assessed the variant since 2014: two classified the variant as likely pathogenic, and two as pathogenic. Based on the evidence outlined above, the variant was classified as pathogenic. -

May 20, 2019
Natera, Inc.
Significance: Likely pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

not provided Pathogenic:3
Nov 11, 2022
GeneDx
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Also reported as Hb Groene Hart [119(H2)Pro>Ser (1); HBA1: c.358C>T]; Observed in the heterozygous state in alpha thalassemia carriers or patients with mild phenotypes (Giambona A et al., 2008; Cardiero G et al., 2020); Published functional studies demonstrate a damaging effect on the interaction with alpha hemoglobin stabilizing protein and the beta subunit (Yu X et al., 2009; Wajcman H et al., 2011); 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: 21950764, 12403490, 25130136, 18603555, 23806011, 17486500, 19349619, 24111644, 32751969, 31553106, 26485748) -

Feb 13, 2024
Quest Diagnostics Nichols Institute San Juan Capistrano
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The HBA1 c.358C>T (p.Pro120Ser) variant has been reported in the heterozygous and compound heterozygous state in individuals with mild alpha-thalassemia phenotype (PMIDs: 26485748 (2016), 24111644 (2014), 16370486 (2005), 12403490 (2002)). Individuals who are homozygous for this variant present with microcytic hypochromic anemia (PMIDs: 24111644 (2014), 17486500 (2007)). Experimental studies indicate this variant disrupts binding of the alpha globin chains to the AHSP (alpha hemoglobin stabilizing protein) and results in an unstable hemoglobin complex (PMIDs: 21950764 (2011), 19349619 (2009), 17052927(2006)). Based on the available information, this variant is classified as pathogenic. -

Aug 28, 2024
ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The HBA1 c.358C>T; p.Pro120Ser variant (Hb Groene Hart, also known as Pro119Ser when numbered from the mature protein, rs63750751, HbVar ID: 1123) has been described in the compound heterozygous or homozygous state in individuals affected with alpha thalassemia, and in the heterozygous state in individuals with microcytosis and hypochromia (see link to HbVar, Giordano 2007, Harteveld 2002, Joly 2014, Yu 2009, Zanella-Cleon 2008). This variant is found in the general population with an overall allele frequency of 0.0057% (16/278694 alleles) in the Genome Aggregation Database. Functional studies of the variant protein demonstrate impaired binding to alpha hemoglobin stabilizing protein and beta globin, leading to destabilization and increased proteolytic degradation (Yu 2009). Based on available information, this variant is considered pathogenic. REFERENCES Link to HbVar: https://globin.bx.psu.edu/hbvar/menu.html Giordano P et al. The first case of Hb Groene Hart (alpha119(H2)Pro-->Ser, CCT-->TCT (alpha1)) homozygosity confirms that a thalassemia phenotype is associated with this abnormal hemoglobin variant. Hemoglobin. 2007;31(2):179-82. PMID: 17486500. Harteveld C et al. Hb Groene Hart: a new Pro-->Ser amino acid substitution at position 119 of the alpha1-globin chain is associated with a mild alpha-thalassemia phenotype. Hemoglobin. 2002 Aug;26(3):255-60. PMID: 12403490. Joly P et al. Description of the phenotypes of 63 heterozygous, homozygous and compound heterozygous patients carrying the Hb Groene Hart (alpha119(H2)Pro->Ser; HBA1: c.358C>T) variant. Hemoglobin. 2014;38(1):64-6. PMID: 24111644. Yu X et al. Analysis of human alpha globin gene mutations that impair binding to the alpha hemoglobin stabilizing protein. Blood. 2009 Jun 4;113(23):5961-9. PMID: 19349619. Zanella-Cleon I et al. Detection of a thalassemic alpha-chain variant (Hemoglobin Groene Hart) by reversed-phase liquid chromatography. Clin Chem. 2008 Jun;54(6):1053-9. PMID: 18420733. -

HBA1-related disorder Pathogenic:1
Sep 25, 2024
PreventionGenetics, part of Exact Sciences
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

The HBA1 c.358C>T variant is predicted to result in the amino acid substitution p.Pro120Ser. This variant is also referred to as p.Pro119Ser or Hb Groene Hart. This variant has been reported in the heterozygous state in a father and son with microcytic hypochromic anemia (Harteveld et al. 2002. PubMed ID: 12403490) and in the homozygous state and in the heterozygous state along with an -α3.7 deletion in patients with alpha thalassemia (Joly et al. 2013. PubMed ID: 24111644; Giordano et al. 2007. PubMed ID: 174865000). This variant is reported in 0.020% of alleles in individuals of Latino descent in gnomAD. This variant is interpreted as pathogenic. -

alpha Thalassemia;C0700299:Heinz body anemia;C3161174:Hemoglobin H disease;C4693798:Methemoglobinemia, alpha type;C4693823:Erythrocytosis, familial, 7 Pathogenic:1
Jan 20, 2022
Fulgent Genetics, Fulgent Genetics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Uncertain
0.43
BayesDel_addAF
Pathogenic
0.28
D
BayesDel_noAF
Pathogenic
0.43
CADD
Benign
22
DANN
Benign
0.97
DEOGEN2
Uncertain
0.72
D;.
Eigen
Benign
-0.21
Eigen_PC
Benign
-0.30
FATHMM_MKL
Uncertain
0.79
D
LIST_S2
Uncertain
0.87
D;D
M_CAP
Pathogenic
0.66
D
MetaRNN
Pathogenic
0.97
D;D
MetaSVM
Uncertain
0.39
D
PrimateAI
Benign
0.44
T
PROVEAN
Pathogenic
-6.1
D;D
REVEL
Pathogenic
0.72
Sift
Pathogenic
0.0
D;D
Sift4G
Uncertain
0.017
D;D
Vest4
0.69
MutPred
0.88
Loss of phosphorylation at T119 (P = 0.1015);.;
MVP
1.0
ClinPred
0.53
D
GERP RS
0.94
Varity_R
0.90
gMVP
0.94

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

LitVar

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs63750751; hg19: chr16-227339; API