NM_000719.7:c.538G>A

Variant summary

Our verdict is Likely benign. The variant received -2 ACMG points: 2P and 4B. PP3_ModerateBS2

The NM_000719.7(CACNA1C):​c.538G>A​(p.Ala180Thr) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0000325 in 1,601,328 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Uncertain significance (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. A180G) has been classified as Uncertain significance.

Frequency

Genomes: 𝑓 0.000020 ( 0 hom., cov: 33)
Exomes 𝑓: 0.000034 ( 0 hom. )

Consequence

CACNA1C
NM_000719.7 missense

Scores

12
6
1

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:4

Conservation

PhyloP100: 9.95

Publications

2 publications found
Variant links:
Genes affected
CACNA1C (HGNC:1390): (calcium voltage-gated channel subunit alpha1 C) This gene encodes an alpha-1 subunit of a voltage-dependent calcium channel. Calcium channels mediate the influx of calcium ions into the cell upon membrane polarization. The alpha-1 subunit consists of 24 transmembrane segments and forms the pore through which ions pass into the cell. The calcium channel consists of a complex of alpha-1, alpha-2/delta, beta, and gamma subunits in a 1:1:1:1 ratio. There are multiple isoforms of each of these proteins, either encoded by different genes or the result of alternative splicing of transcripts. The protein encoded by this gene binds to and is inhibited by dihydropyridine. Alternative splicing results in many transcript variants encoding different proteins. Some of the predicted proteins may not produce functional ion channel subunits. [provided by RefSeq, Oct 2012]
CACNA1C Gene-Disease associations (from GenCC):
  • Timothy syndrome
    Inheritance: AD Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Ambry Genetics, Orphanet, G2P, Labcorp Genetics (formerly Invitae)
  • neurodevelopmental disorder with hypotonia, language delay, and skeletal defects with or without seizures
    Inheritance: AD Classification: STRONG Submitted by: Ambry Genetics
  • long QT syndrome
    Inheritance: AD Classification: MODERATE Submitted by: ClinGen
  • long QT syndrome 8
    Inheritance: AD Classification: MODERATE Submitted by: Ambry Genetics
  • Brugada syndrome
    Inheritance: AD Classification: SUPPORTIVE, NO_KNOWN Submitted by: Orphanet, ClinGen
  • Brugada syndrome 3
    Inheritance: AD Classification: LIMITED, NO_KNOWN Submitted by: Ambry Genetics, Genomics England PanelApp, Labcorp Genetics (formerly Invitae)
  • intellectual disability
    Inheritance: AD Classification: LIMITED Submitted by: Ambry Genetics
  • short QT syndrome
    Inheritance: AD Classification: LIMITED, NO_KNOWN Submitted by: Ambry Genetics, ClinGen

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Likely_benign. The variant received -2 ACMG points.

PP3
MetaRNN computational evidence supports a deleterious effect, 0.886
BS2
High AC in GnomAdExome4 at 49 AD gene.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
CACNA1CNM_000719.7 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 47 ENST00000399655.6 NP_000710.5 Q13936-12
CACNA1CNM_001167623.2 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 47 ENST00000399603.6 NP_001161095.1 Q13936-37

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
CACNA1CENST00000399603.6 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 47 5 NM_001167623.2 ENSP00000382512.1 Q13936-37
CACNA1CENST00000399655.6 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 47 1 NM_000719.7 ENSP00000382563.1 Q13936-12
CACNA1CENST00000682544.1 linkc.628G>A p.Ala210Thr missense_variant Exon 4 of 50 ENSP00000507184.1 A0A804HIR0
CACNA1CENST00000406454.8 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 48 5 ENSP00000385896.3 F5GY28
CACNA1CENST00000399634.6 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 47 5 ENSP00000382542.2 E9PDI6
CACNA1CENST00000683824.1 linkc.628G>A p.Ala210Thr missense_variant Exon 4 of 48 ENSP00000507867.1 A0A804HKC4
CACNA1CENST00000347598.9 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 49 1 ENSP00000266376.6 Q13936-11
CACNA1CENST00000344100.7 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 47 1 ENSP00000341092.3 Q13936-14
CACNA1CENST00000327702.12 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 48 1 ENSP00000329877.7 A0A0A0MR67
CACNA1CENST00000399617.6 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 48 5 ENSP00000382526.1 A0A0A0MSA1
CACNA1CENST00000682462.1 linkc.628G>A p.Ala210Thr missense_variant Exon 4 of 47 ENSP00000507105.1 A0A804HIJ8
CACNA1CENST00000683781.1 linkc.628G>A p.Ala210Thr missense_variant Exon 4 of 47 ENSP00000507434.1 A0A804HJB6
CACNA1CENST00000683840.1 linkc.628G>A p.Ala210Thr missense_variant Exon 4 of 47 ENSP00000507612.1 A0A804HJR1
CACNA1CENST00000683956.1 linkc.628G>A p.Ala210Thr missense_variant Exon 4 of 47 ENSP00000506882.1 A0A804HI37
CACNA1CENST00000399638.5 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 48 1 ENSP00000382547.1 Q13936-31
CACNA1CENST00000335762.10 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 48 5 ENSP00000336982.5 F5H522
CACNA1CENST00000399606.5 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 48 1 ENSP00000382515.1 Q13936-30
CACNA1CENST00000399621.5 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 47 1 ENSP00000382530.1 Q13936-24
CACNA1CENST00000399637.5 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 47 1 ENSP00000382546.1 Q13936-27
CACNA1CENST00000402845.7 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 47 1 ENSP00000385724.3 Q13936-13
CACNA1CENST00000399629.5 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 47 1 ENSP00000382537.1 Q13936-32
CACNA1CENST00000682336.1 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 47 ENSP00000507898.1 A0A804HKE9
CACNA1CENST00000399591.5 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 46 1 ENSP00000382500.1 Q13936-29
CACNA1CENST00000399595.5 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 46 1 ENSP00000382504.1 Q13936-25
CACNA1CENST00000399649.5 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 46 1 ENSP00000382557.1 Q13936-15
CACNA1CENST00000399597.5 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 47 1 ENSP00000382506.1 Q13936-22
CACNA1CENST00000399601.5 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 47 1 ENSP00000382510.1 Q13936-20
CACNA1CENST00000399641.6 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 47 1 ENSP00000382549.1 Q13936-23
CACNA1CENST00000399644.5 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 47 1 ENSP00000382552.1 Q13936-21
CACNA1CENST00000682835.1 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 47 ENSP00000507282.1 A0A804HIZ0
CACNA1CENST00000683482.1 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 47 ENSP00000507169.1 Q13936-35
CACNA1CENST00000682686.1 linkc.538G>A p.Ala180Thr missense_variant Exon 4 of 46 ENSP00000507309.1 Q13936-19
CACNA1CENST00000682152.1 linkc.487G>A p.Ala163Thr missense_variant Exon 3 of 6 ENSP00000506759.1 A0A804HHT8
CACNA1CENST00000480911.6 linkn.538G>A non_coding_transcript_exon_variant Exon 4 of 27 5 ENSP00000437936.2 F5H638

Frequencies

GnomAD3 genomes
AF:
0.0000197
AC:
3
AN:
152000
Hom.:
0
Cov.:
33
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:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0000441
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.00000849
AC:
2
AN:
235502
AF XY:
0.00000786
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.0000587
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00000949
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000338
AC:
49
AN:
1449328
Hom.:
0
Cov.:
28
AF XY:
0.0000278
AC XY:
20
AN XY:
720510
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
33334
American (AMR)
AF:
0.00
AC:
0
AN:
43562
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
25904
East Asian (EAS)
AF:
0.0000253
AC:
1
AN:
39576
South Asian (SAS)
AF:
0.00
AC:
0
AN:
84708
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
53072
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5752
European-Non Finnish (NFE)
AF:
0.0000417
AC:
46
AN:
1103418
Other (OTH)
AF:
0.0000333
AC:
2
AN:
60002
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.463
Heterozygous variant carriers
0
3
6
9
12
15
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
AF:
0.0000197
AC:
3
AN:
152000
Hom.:
0
Cov.:
33
AF XY:
0.0000269
AC XY:
2
AN XY:
74232
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
41360
American (AMR)
AF:
0.00
AC:
0
AN:
15260
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3470
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5198
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4812
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10578
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.0000441
AC:
3
AN:
68006
Other (OTH)
AF:
0.00
AC:
0
AN:
2090
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.592
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:
0.0000564
Hom.:
0
Bravo
AF:
0.0000151

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:4
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Uncertain:2
Jun 21, 2017
GeneDx
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The Ala180Thr variant in the CACNA1C gene has not been reported previously as a disease-causing mutation nor is it known to be a common benign polymorphism, to our knowledge. Ala180Thr represents a non-conservative amino acid substitution of a non-polar Alanine residue with a polar Threonine residue in an evolutionarily highly conserved position of the protein. In addition, Ala180Thr was not observed in up to 600 chromosomes of Caucasian and African American individuals tested at GeneDx, indicating it is not a common benign polymorphism in these populations. Thus, with the clinical and molecular information available at this time, we cannot conclude unequivocally that Ala180Thr is a disease-causing mutation associated with arrhythmia. The variant is found in BRUGADA panel(s). -

Feb 10, 2022
AiLife Diagnostics, AiLife Diagnostics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Long QT syndrome Uncertain:1
Jul 26, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence change replaces alanine, which is neutral and non-polar, with threonine, which is neutral and polar, at codon 180 of the CACNA1C protein (p.Ala180Thr). The frequency data for this variant in the population databases is considered unreliable, as metrics indicate poor data quality at this position in the gnomAD database. This variant has not been reported in the literature in individuals affected with CACNA1C-related conditions. ClinVar contains an entry for this variant (Variation ID: 190690). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is expected to disrupt CACNA1C protein function with a positive predictive value of 80%. In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. -

Cardiovascular phenotype Uncertain:1
Oct 24, 2019
Ambry Genetics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The p.A180T variant (also known as c.538G>A), located in coding exon 4 of the CACNA1C gene, results from a G to A substitution at nucleotide position 538. The alanine at codon 180 is replaced by threonine, an amino acid with similar properties. This amino acid position is highly conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.95
CardioboostArm
Pathogenic
0.98
BayesDel_addAF
Pathogenic
0.51
D
BayesDel_noAF
Pathogenic
0.50
CADD
Pathogenic
33
DANN
Uncertain
1.0
DEOGEN2
Uncertain
0.79
D;.;.;.;.;.;.;.;.;.;.;.;.;.;.;.;T;.;.;.;.;T;.
Eigen
Pathogenic
0.83
Eigen_PC
Pathogenic
0.80
FATHMM_MKL
Pathogenic
0.98
D
M_CAP
Pathogenic
0.77
D
MetaRNN
Pathogenic
0.89
D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D
MetaSVM
Pathogenic
1.1
D
MutationAssessor
Pathogenic
3.1
.;M;.;M;M;M;M;M;M;M;M;M;M;M;M;M;.;M;M;M;.;.;.
PhyloP100
10
PrimateAI
Uncertain
0.78
T
PROVEAN
Uncertain
-3.4
D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D
REVEL
Pathogenic
0.89
Sift
Uncertain
0.029
D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D
Sift4G
Uncertain
0.013
D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D
Polyphen
1.0, 1.0, 0.98, 0.64, 0.99, 0.88, 0.74, 0.64
.;D;.;D;D;D;D;P;D;D;D;P;D;D;P;D;.;D;P;.;.;.;.
Vest4
0.85
MutPred
0.69
Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);Gain of catalytic residue at F185 (P = 0.002);
MVP
0.94
MPC
2.2
ClinPred
0.95
D
GERP RS
4.9
gMVP
0.87
Mutation Taster
=38/62
disease causing

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: rs786205769; hg19: chr12-2558202; COSMIC: COSV100215278; API