NM_004387.4:c.827C>G

Variant summary

Our verdict is Likely benign. The variant received -6 ACMG points: 0P and 6B. BP4_ModerateBS2

The NM_004387.4(NKX2-5):​c.827C>G​(p.Ala276Gly) variant causes a missense change. The variant allele was found at a frequency of 0.0000634 in 1,608,152 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. 13/22 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. A276T) has been classified as Likely benign.

Frequency

Genomes: 𝑓 0.000020 ( 0 hom., cov: 32)
Exomes 𝑓: 0.000068 ( 0 hom. )

Consequence

NKX2-5
NM_004387.4 missense

Scores

5
13

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications U:4B:1

Conservation

PhyloP100: 4.83

Publications

1 publications found
Variant links:
Genes affected
NKX2-5 (HGNC:2488): (NK2 homeobox 5) This gene encodes a homeobox-containing transcription factor. This transcription factor functions in heart formation and development. Mutations in this gene cause atrial septal defect with atrioventricular conduction defect, and also tetralogy of Fallot, which are both heart malformation diseases. Mutations in this gene can also cause congenital hypothyroidism non-goitrous type 5, a non-autoimmune condition. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Oct 2009]
NKX2-5 Gene-Disease associations (from GenCC):
  • atrial septal defect 7
    Inheritance: AD Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Genomics England PanelApp, G2P, Ambry Genetics, Labcorp Genetics (formerly Invitae), Laboratory for Molecular Medicine, Orphanet
  • hypothyroidism, congenital, nongoitrous, 5
    Inheritance: AD, Unknown Classification: DEFINITIVE, MODERATE, LIMITED Submitted by: G2P, Labcorp Genetics (formerly Invitae), Ambry Genetics
  • NKX2.5-related congenital, conduction and myopathic heart disease
    Inheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
  • tetralogy of fallot
    Inheritance: AD Classification: DEFINITIVE Submitted by: G2P
  • conotruncal heart malformations
    Inheritance: SD, AD Classification: DEFINITIVE, STRONG Submitted by: Ambry Genetics, Labcorp Genetics (formerly Invitae)
  • athyreosis
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • familial atrial fibrillation
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • familial bicuspid aortic valve
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • familial isolated congenital asplenia
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • dilated cardiomyopathy
    Inheritance: AD Classification: LIMITED Submitted by: ClinGen

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Likely_benign. The variant received -6 ACMG points.

BP4
Computational evidence support a benign effect (MetaRNN=0.21705896).
BS2
High AC in GnomAdExome4 at 99 AD,Unknown,SD gene.

Variant Effect in Transcripts

ACMG analysis was done for transcript: NM_004387.4. You can select a different transcript below to see updated ACMG assignments.

RefSeq Transcripts

Selected
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
NKX2-5
NM_004387.4
MANE Select
c.827C>Gp.Ala276Gly
missense
Exon 2 of 2NP_004378.1
NKX2-5
NM_001166176.2
c.*626C>G
3_prime_UTR
Exon 2 of 2NP_001159648.1
NKX2-5
NM_001166175.2
c.*780C>G
3_prime_UTR
Exon 2 of 2NP_001159647.1

Ensembl Transcripts

Selected
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
NKX2-5
ENST00000329198.5
TSL:1 MANE Select
c.827C>Gp.Ala276Gly
missense
Exon 2 of 2ENSP00000327758.4
NKX2-5
ENST00000424406.2
TSL:1
c.*780C>G
downstream_gene
N/AENSP00000395378.2
NKX2-5
ENST00000521848.1
TSL:2
c.*626C>G
downstream_gene
N/AENSP00000427906.1

Frequencies

GnomAD3 genomes
AF:
0.0000197
AC:
3
AN:
152274
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.0000654
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:
0.00
GnomAD2 exomes
AF:
0.0000421
AC:
10
AN:
237644
AF XY:
0.0000306
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.0000591
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000666
Gnomad OTH exome
AF:
0.000172
GnomAD4 exome
AF:
0.0000680
AC:
99
AN:
1455878
Hom.:
0
Cov.:
34
AF XY:
0.0000760
AC XY:
55
AN XY:
723500
show subpopulations
African (AFR)
AF:
0.0000300
AC:
1
AN:
33384
American (AMR)
AF:
0.0000677
AC:
3
AN:
44292
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26046
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39560
South Asian (SAS)
AF:
0.00
AC:
0
AN:
86034
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
51794
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5750
European-Non Finnish (NFE)
AF:
0.0000821
AC:
91
AN:
1108978
Other (OTH)
AF:
0.0000666
AC:
4
AN:
60040
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.498
Heterozygous variant carriers
0
9
17
26
34
43
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Variant carriers
0
4
8
12
16
20
<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:
152274
Hom.:
0
Cov.:
32
AF XY:
0.00
AC XY:
0
AN XY:
74402
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
41474
American (AMR)
AF:
0.0000654
AC:
1
AN:
15290
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3472
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5196
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4838
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10630
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.0000294
AC:
2
AN:
68052
Other (OTH)
AF:
0.00
AC:
0
AN:
2094
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.608
Heterozygous variant carriers
0
1
1
2
2
3
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:
0.0000283
Hom.:
0
Bravo
AF:
0.0000378
ExAC
AF:
0.0000496
AC:
6

ClinVar

ClinVar submissions as Germline

Significance:Conflicting classifications of pathogenicity
Revision:criteria provided, conflicting classifications
View on ClinVar
Pathogenic
VUS
Benign
Condition
-
2
-
not provided (2)
-
-
1
Atrial septal defect 7 (1)
-
1
-
Cardiovascular phenotype (1)
-
1
-
Tetralogy of Fallot;C1857586:Conotruncal heart malformations;C2673630:Hypothyroidism, congenital, nongoitrous, 5;C3276096:Atrial septal defect 7;C3280785:Ventricular septal defect 3;C3280795:Hypoplastic left heart syndrome 2 (1)

Computational scores

Source: dbNSFP v4.9

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.070
BayesDel_addAF
Benign
-0.19
T
BayesDel_noAF
Benign
-0.32
CADD
Benign
21
DANN
Uncertain
0.99
DEOGEN2
Benign
0.37
T
Eigen
Benign
-0.46
Eigen_PC
Benign
-0.35
FATHMM_MKL
Uncertain
0.94
D
LIST_S2
Benign
0.35
T
M_CAP
Uncertain
0.23
D
MetaRNN
Benign
0.22
T
MetaSVM
Benign
-0.35
T
MutationAssessor
Benign
0.69
N
PhyloP100
4.8
PrimateAI
Uncertain
0.69
T
PROVEAN
Benign
-0.74
N
REVEL
Benign
0.26
Sift
Uncertain
0.022
D
Sift4G
Benign
0.064
T
Polyphen
0.0020
B
Vest4
0.16
MutPred
0.12
Gain of loop (P = 0.1081)
MVP
0.75
MPC
0.50
ClinPred
0.11
T
GERP RS
3.3
Varity_R
0.16
gMVP
0.56
Mutation Taster
=75/25
polymorphism

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: rs751564052; hg19: chr5-172659720; API