NM_001267550.2:c.42958A>G

Variant summary

Our verdict is Benign. The variant received -20 ACMG points: 0P and 20B. BP4_StrongBP6_Very_StrongBA1

The NM_001267550.2(TTN):​c.42958A>G​(p.Lys14320Glu) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0976 in 1,612,778 control chromosomes in the GnomAD database, including 8,427 homozygotes. In-silico tool predicts a benign outcome for this variant. 12/19 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Likely benign (★★).

Frequency

Genomes: 𝑓 0.072 ( 511 hom., cov: 32)
Exomes 𝑓: 0.10 ( 7916 hom. )

Consequence

TTN
NM_001267550.2 missense

Scores

3
2
11

Clinical Significance

Benign/Likely benign criteria provided, multiple submitters, no conflicts B:23

Conservation

PhyloP100: 7.97

Publications

24 publications found
Variant links:
Genes affected
TTN (HGNC:12403): (titin) This gene encodes a large abundant protein of striated muscle. The product of this gene is divided into two regions, a N-terminal I-band and a C-terminal A-band. The I-band, which is the elastic part of the molecule, contains two regions of tandem immunoglobulin domains on either side of a PEVK region that is rich in proline, glutamate, valine and lysine. The A-band, which is thought to act as a protein-ruler, contains a mixture of immunoglobulin and fibronectin repeats, and possesses kinase activity. An N-terminal Z-disc region and a C-terminal M-line region bind to the Z-line and M-line of the sarcomere, respectively, so that a single titin molecule spans half the length of a sarcomere. Titin also contains binding sites for muscle associated proteins so it serves as an adhesion template for the assembly of contractile machinery in muscle cells. It has also been identified as a structural protein for chromosomes. Alternative splicing of this gene results in multiple transcript variants. Considerable variability exists in the I-band, the M-line and the Z-disc regions of titin. Variability in the I-band region contributes to the differences in elasticity of different titin isoforms and, therefore, to the differences in elasticity of different muscle types. Mutations in this gene are associated with familial hypertrophic cardiomyopathy 9, and autoantibodies to titin are produced in patients with the autoimmune disease scleroderma. [provided by RefSeq, Feb 2012]
TTN-AS1 (HGNC:44124): (TTN antisense RNA 1) This gene encodes a non-coding RNA transcribed from the opposite strand to the titin gene. [provided by RefSeq, Aug 2016]

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Benign. The variant received -20 ACMG points.

BP4
Computational evidence support a benign effect (MetaRNN=0.001886487).
BP6
Variant 2-178633315-T-C is Benign according to our data. Variant chr2-178633315-T-C is described in CliVar as Benign/Likely_benign. Clinvar id is 46963.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178633315-T-C is described in CliVar as Benign/Likely_benign. Clinvar id is 46963.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178633315-T-C is described in CliVar as Benign/Likely_benign. Clinvar id is 46963.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178633315-T-C is described in CliVar as Benign/Likely_benign. Clinvar id is 46963.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178633315-T-C is described in CliVar as Benign/Likely_benign. Clinvar id is 46963.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178633315-T-C is described in CliVar as Benign/Likely_benign. Clinvar id is 46963.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178633315-T-C is described in CliVar as Benign/Likely_benign. Clinvar id is 46963.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178633315-T-C is described in CliVar as Benign/Likely_benign. Clinvar id is 46963.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178633315-T-C is described in CliVar as Benign/Likely_benign. Clinvar id is 46963.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178633315-T-C is described in CliVar as Benign/Likely_benign. Clinvar id is 46963.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178633315-T-C is described in CliVar as Benign/Likely_benign. Clinvar id is 46963.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178633315-T-C is described in CliVar as Benign/Likely_benign. Clinvar id is 46963.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178633315-T-C is described in CliVar as Benign/Likely_benign. Clinvar id is 46963.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178633315-T-C is described in CliVar as Benign/Likely_benign. Clinvar id is 46963.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178633315-T-C is described in CliVar as Benign/Likely_benign. Clinvar id is 46963.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178633315-T-C is described in CliVar as Benign/Likely_benign. Clinvar id is 46963.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178633315-T-C is described in CliVar as Benign/Likely_benign. Clinvar id is 46963.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178633315-T-C is described in CliVar as Benign/Likely_benign. Clinvar id is 46963.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178633315-T-C is described in CliVar as Benign/Likely_benign. Clinvar id is 46963.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178633315-T-C is described in CliVar as Benign/Likely_benign. Clinvar id is 46963.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
BA1
GnomAd4 highest subpopulation (NFE) allele frequency at 95% confidence interval = 0.105 is higher than 0.05.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
TTNNM_001267550.2 linkc.42958A>G p.Lys14320Glu missense_variant Exon 233 of 363 ENST00000589042.5 NP_001254479.2 A0A0A0MTS7

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
TTNENST00000589042.5 linkc.42958A>G p.Lys14320Glu missense_variant Exon 233 of 363 5 NM_001267550.2 ENSP00000467141.1 A0A0A0MTS7

Frequencies

GnomAD3 genomes
AF:
0.0723
AC:
10990
AN:
152028
Hom.:
511
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.0179
Gnomad AMI
AF:
0.0581
Gnomad AMR
AF:
0.0590
Gnomad ASJ
AF:
0.0663
Gnomad EAS
AF:
0.00621
Gnomad SAS
AF:
0.0990
Gnomad FIN
AF:
0.103
Gnomad MID
AF:
0.0728
Gnomad NFE
AF:
0.107
Gnomad OTH
AF:
0.0774
GnomAD2 exomes
AF:
0.0824
AC:
20425
AN:
247906
AF XY:
0.0877
show subpopulations
Gnomad AFR exome
AF:
0.0169
Gnomad AMR exome
AF:
0.0421
Gnomad ASJ exome
AF:
0.0694
Gnomad EAS exome
AF:
0.00620
Gnomad FIN exome
AF:
0.101
Gnomad NFE exome
AF:
0.107
Gnomad OTH exome
AF:
0.0937
GnomAD4 exome
AF:
0.100
AC:
146375
AN:
1460632
Hom.:
7916
Cov.:
34
AF XY:
0.101
AC XY:
73474
AN XY:
726510
show subpopulations
African (AFR)
AF:
0.0144
AC:
481
AN:
33386
American (AMR)
AF:
0.0440
AC:
1963
AN:
44634
Ashkenazi Jewish (ASJ)
AF:
0.0683
AC:
1782
AN:
26108
East Asian (EAS)
AF:
0.0106
AC:
422
AN:
39646
South Asian (SAS)
AF:
0.106
AC:
9100
AN:
86002
European-Finnish (FIN)
AF:
0.0996
AC:
5321
AN:
53398
Middle Eastern (MID)
AF:
0.0947
AC:
545
AN:
5754
European-Non Finnish (NFE)
AF:
0.109
AC:
121293
AN:
1111384
Other (OTH)
AF:
0.0906
AC:
5468
AN:
60320
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.485
Heterozygous variant carriers
0
8147
16294
24442
32589
40736
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Exome Hom
Variant carriers
0
4304
8608
12912
17216
21520
<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:
0.0723
AC:
11000
AN:
152146
Hom.:
511
Cov.:
32
AF XY:
0.0724
AC XY:
5380
AN XY:
74360
show subpopulations
African (AFR)
AF:
0.0178
AC:
741
AN:
41546
American (AMR)
AF:
0.0589
AC:
900
AN:
15278
Ashkenazi Jewish (ASJ)
AF:
0.0663
AC:
230
AN:
3470
East Asian (EAS)
AF:
0.00622
AC:
32
AN:
5144
South Asian (SAS)
AF:
0.101
AC:
487
AN:
4816
European-Finnish (FIN)
AF:
0.103
AC:
1088
AN:
10610
Middle Eastern (MID)
AF:
0.0782
AC:
23
AN:
294
European-Non Finnish (NFE)
AF:
0.107
AC:
7284
AN:
67962
Other (OTH)
AF:
0.0766
AC:
162
AN:
2114
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.502
Heterozygous variant carriers
0
523
1045
1568
2090
2613
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Genome Het
Genome Hom
Variant carriers
0
142
284
426
568
710
<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:
0.0933
Hom.:
3280
Bravo
AF:
0.0654
TwinsUK
AF:
0.109
AC:
404
ALSPAC
AF:
0.105
AC:
404
ESP6500AA
AF:
0.0180
AC:
66
ESP6500EA
AF:
0.110
AC:
898
ExAC
AF:
0.0829
AC:
10009
Asia WGS
AF:
0.0520
AC:
179
AN:
3478
EpiCase
AF:
0.104
EpiControl
AF:
0.104

ClinVar

Significance: Benign/Likely benign
Submissions summary: Benign:23
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not specified Benign:11
-
Genome Diagnostics Laboratory, University Medical Center Utrecht
Significance:Benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

-
PreventionGenetics, part of Exact Sciences
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

-
Clinical Genetics DNA and cytogenetics Diagnostics Lab, Erasmus MC, Erasmus Medical Center
Significance:Benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Nov 01, 2012
GeneDx
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant is considered likely benign or benign based on one or more of the following criteria: it is a conservative change, it occurs at a poorly conserved position in the protein, it is predicted to be benign by multiple in silico algorithms, and/or has population frequency not consistent with disease. -

Jun 24, 2013
Biesecker Lab/Clinical Genomics Section, National Institutes of Health
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:research

- -

Apr 11, 2012
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Aug 15, 2013
Genetic Services Laboratory, University of Chicago
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Apr 09, 2025
Molecular Diagnostic Laboratory for Inherited Cardiovascular Disease, Montreal Heart Institute
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

-
Clinical Genetics, Academic Medical Center
Significance:Benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Aug 16, 2020
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

-
Joint Genome Diagnostic Labs from Nijmegen and Maastricht, Radboudumc and MUMC+
Significance:Benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Autosomal recessive limb-girdle muscular dystrophy type 2J Benign:2
Jan 13, 2018
Illumina Laboratory Services, Illumina
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as benign is not then subjected to further curation. The score for this variant resulted in a classification of benign for this disease. -

Sep 10, 2021
Genome-Nilou Lab
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Early-onset myopathy with fatal cardiomyopathy Benign:2
Jan 13, 2018
Illumina Laboratory Services, Illumina
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as benign is not then subjected to further curation. The score for this variant resulted in a classification of benign for this disease. -

Sep 10, 2021
Genome-Nilou Lab
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Tibial muscular dystrophy Benign:2
Jan 13, 2018
Illumina Laboratory Services, Illumina
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as benign is not then subjected to further curation. The score for this variant resulted in a classification of benign for this disease. -

Sep 10, 2021
Genome-Nilou Lab
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Myopathy, myofibrillar, 9, with early respiratory failure Benign:2
Jan 13, 2018
Illumina Laboratory Services, Illumina
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as benign is not then subjected to further curation. The score for this variant resulted in a classification of benign for this disease. -

Sep 10, 2021
Genome-Nilou Lab
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Autosomal recessive limb-girdle muscular dystrophy type 2J;C1858763:Dilated cardiomyopathy 1G Benign:1
Feb 04, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Dilated cardiomyopathy 1G Benign:1
Jan 13, 2018
Illumina Laboratory Services, Illumina
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as likely benign is not then subjected to further curation. The score for this variant resulted in a classification of likely benign for this disease. -

not provided Benign:1
-
Breakthrough Genomics, Breakthrough Genomics
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:not provided

- -

Cardiovascular phenotype Benign:1
Oct 22, 2015
Ambry Genetics
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This alteration is classified as benign based on a combination of the following: population frequency, intact protein function, lack of segregation with disease, co-occurrence, RNA analysis, in silico models, amino acid conservation, lack of disease association in case-control studies, and/or the mechanism of disease or impacted region is inconsistent with a known cause of pathogenicity. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.32
BayesDel_addAF
Benign
-0.37
T
BayesDel_noAF
Benign
-0.21
CADD
Benign
22
DANN
Benign
0.94
Eigen
Pathogenic
0.69
Eigen_PC
Pathogenic
0.73
FATHMM_MKL
Pathogenic
0.98
D
LIST_S2
Benign
0.80
T;T;T;.;T;T;T
MetaRNN
Benign
0.0019
T;T;T;T;T;T;T
MetaSVM
Benign
-0.95
T
MutationAssessor
Benign
1.8
.;.;.;L;.;.;L
PhyloP100
8.0
PrimateAI
Uncertain
0.66
T
PROVEAN
Uncertain
-2.9
D;D;.;.;D;D;.
REVEL
Benign
0.26
Sift
Benign
0.089
T;D;.;.;T;T;.
Polyphen
1.0
.;.;.;D;.;.;D
Vest4
0.30
MPC
0.54
ClinPred
0.018
T
GERP RS
6.2
Mutation Taster
=91/9
polymorphism (auto)

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.040
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: rs6723526; hg19: chr2-179498042; COSMIC: COSV59911372; COSMIC: COSV59911372; API