NM_001130004.2:c.137G>A

Variant names:

• chr14-68925641-C-T
• rs387907348
• NM_001130004.2:c.137G>A

Variant summary

Our verdict is Pathogenic. The variant received 16 ACMG points: 16P and 0B. PM1 PM2 PM5 PP3_Moderate PP5_Very_Strong

The NM_001130004.2(ACTN1):​c.137G>A​(p.Arg46Gln) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.00000274 in 1,460,800 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 Likely pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R46W) has been classified as Likely pathogenic.

• Frequency:
  • Genomes: not found (cov: 32)
  • Exomes 𝑓: 0.0000027 (0 hom.)
• Consequence: ACTN1 NM_001130004.2 missense
• Clinical Significance: Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:6
• Conservation: PhyloP100: 7.75
• Publications: 13 publications found

Genes affected

ACTN1 (HGNC:163): (actinin alpha 1) Alpha actinins belong to the spectrin gene superfamily which represents a diverse group of cytoskeletal proteins, including the alpha and beta spectrins and dystrophins. Alpha actinin is an actin-binding protein with multiple roles in different cell types. In nonmuscle cells, the cytoskeletal isoform is found along microfilament bundles and adherens-type junctions, where it is involved in binding actin to the membrane. In contrast, skeletal, cardiac, and smooth muscle isoforms are localized to the Z-disc and analogous dense bodies, where they help anchor the myofibrillar actin filaments. This gene encodes a nonmuscle, cytoskeletal, alpha actinin isoform and maps to the same site as the structurally similar erythroid beta spectrin gene. Three transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Jul 2008]

ACTN1 Gene-Disease associations (from GenCC):

• platelet-type bleeding disorder 15

  Inheritance: AD Classification: DEFINITIVE, STRONG, MODERATE Submitted by: Labcorp Genetics (formerly Invitae), Ambry Genetics, ClinGen
• autosomal dominant macrothrombocytopenia

  Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet

ACMG classification

Our verdict: Pathogenic. The variant received 16 ACMG points.

• PM1: In a domain Calponin-homology (CH) 1 (size 104) in uniprot entity ACTN1_HUMAN there are 8 pathogenic changes around while only 1 benign (89%) in NM_001130004.2
• PM2: Very rare variant in population databases, with high coverage
• PM5: Other missense variant is known to change same aminoacid residue: Variant chr14-68925642-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 626995.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
• PP3: MetaRNN computational evidence supports a deleterious effect, 0.89
• PP5: Variant 14-68925641-C-T is Pathogenic according to our data. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-68925641-C-T is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 42031.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
ACTN1	NM_001130004.2	c.137G>A	p.Arg46Gln	missense_variant	Exon 2 of 22	ENST00000394419.9	NP_001123476.1

Ensembl

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	TSL	MANE	Protein	Appris	UniProt
ACTN1	ENST00000394419.9	c.137G>A	p.Arg46Gln	missense_variant	Exon 2 of 22	1	NM_001130004.2	ENSP00000377941.4

Frequencies

GnomAD3 genomes Cov.: 32

GnomAD4 exome AF: 0.00000274 AC: 4 AN: 1460800 Hom.: 0 Cov.: 32 AF XY: 0.00000413 AC XY: 3 AN XY: 726692

African (AFR) AF: 0.00 AC: 0 AN: 33444

American (AMR) AF: 0.00 AC: 0 AN: 44586

Ashkenazi Jewish (ASJ) AF: 0.00 AC: 0 AN: 26104

East Asian (EAS) AF: 0.00 AC: 0 AN: 39616

South Asian (SAS) AF: 0.00 AC: 0 AN: 86064

European-Finnish (FIN) AF: 0.00 AC: 0 AN: 53394

Middle Eastern (MID) AF: 0.00 AC: 0 AN: 5762

European-Non Finnish (NFE) AF: 0.00000360 AC: 4 AN: 1111480

Other (OTH) AF: 0.00 AC: 0 AN: 60350

GnomAD4 genome Cov.: 32

Alfa AF: 0.00 Hom.: 0

ClinVar

Significance: Pathogenic/Likely pathogenic

Submissions summary: Pathogenic:6

Revision: criteria provided, multiple submitters, no conflicts

Submissions by phenotype

Platelet-type bleeding disorder 15 Pathogenic:4

Mar 07, 2013

OMIM

Significance: Pathogenic

Review Status: no assertion criteria provided

Collection Method: literature only

- -

-

ISTH-SSC Genomics in Thrombosis and Hemostasis, KU Leuven, Center for Molecular and Vascular Biology

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

- -

Apr 04, 2024

Genomic Medicine Center of Excellence, King Faisal Specialist Hospital and Research Centre

Significance: Likely pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

- -

Nov 27, 2019

Baylor Genetics

Significance: Likely pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

This variant was determined to be likely pathogenic according to ACMG Guidelines, 2015 [PMID:25741868]. -

not provided Pathogenic:1

Dec 07, 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 46 of the ACTN1 protein (p.Arg46Gln). This variant is not present in population databases (gnomAD no frequency). This missense change has been observed in individual(s) with macrothrombocytopenia (PMID: 23434115, 24069336). It has also been observed to segregate with disease in related individuals. ClinVar contains an entry for this variant (Variation ID: 42031). 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 expected to disrupt ACTN1 protein function with a positive predictive value of 80%. This variant disrupts the p.Arg46 amino acid residue in ACTN1. Other variant(s) that disrupt this residue have been determined to be pathogenic (PMID: 25361813). This suggests that this residue is clinically significant, and that variants that disrupt this residue are likely to be disease-causing. For these reasons, this variant has been classified as Pathogenic. -

Macrothrombocytopenia Pathogenic:1

Feb 01, 2019

NIHR Bioresource Rare Diseases, University of Cambridge

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: research

- -

Computational scores

Source: dbNSFP v4.3

Name	Calibrated prediction	Score	Prediction
AlphaMissense	Pathogenic	0.85
BayesDel_addAF	Pathogenic	0.34	D
BayesDel_noAF	Pathogenic	0.25
CADD	Pathogenic	34
DANN	Pathogenic	1.0
DEOGEN2	Uncertain	0.76	D;.;.;.;D;D;D
Eigen	Uncertain	0.62
Eigen_PC	Uncertain	0.64
FATHMM_MKL	Pathogenic	1.0	D
LIST_S2	Pathogenic	0.98	D;D;D;D;D;D;D
M_CAP	Pathogenic	0.77	D
MetaRNN	Pathogenic	0.89	D;D;D;D;D;D;D
MetaSVM	Pathogenic	0.88	D
MutationAssessor	Benign	1.6	L;L;L;L;.;.;.
PhyloP100		7.7
PrimateAI	Pathogenic	0.86	D
PROVEAN	Uncertain	-3.5	D;D;D;D;D;D;D
REVEL	Pathogenic	0.79
Sift	Uncertain	0.017	D;D;D;D;T;T;T
Sift4G	Uncertain	0.022	D;D;D;D;.;.;D
Polyphen		0.99	D;.;D;.;.;.;.
Vest4		0.89
MutPred		0.54		Gain of catalytic residue at C41 (P = 0);Gain of catalytic residue at C41 (P = 0);Gain of catalytic residue at C41 (P = 0);Gain of catalytic residue at C41 (P = 0);.;.;.;
MVP		0.95
MPC		2.0
ClinPred		1.0	D
GERP RS		4.8
RBP_binding_hub_radar		0.0
RBP_regulation_power_radar		2.9
Varity_R		0.81
gMVP		0.78
Mutation Taster		=2/98	disease causing (ClinVar)

Splicing

Name	Calibrated prediction	Score	Prediction
SpliceAI score (max)		0.010		Details are displayed if max score is > 0.2

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Other links and lift over

dbSNP: rs387907348; hg19: chr14-69392358; COSMIC: COSV51993463; COSMIC: COSV51993463;