NM_005033.3:c.41T>C
Variant summary
Our verdict is Pathogenic. Variant got 10 ACMG points: 10P and 0B. PM2PP5_Very_Strong
The NM_005033.3(EXOSC9):c.41T>C(p.Leu14Pro) variant causes a missense change. The variant allele was found at a frequency of 0.0000483 in 1,614,210 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Likely pathogenic (★★).
Frequency
Consequence
NM_005033.3 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Pathogenic. Variant got 10 ACMG points.
Transcripts
RefSeq
Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt |
---|---|---|---|---|---|---|---|---|
EXOSC9 | NM_005033.3 | c.41T>C | p.Leu14Pro | missense_variant | Exon 1 of 12 | ENST00000243498.10 | NP_005024.2 | |
EXOSC9 | NM_001034194.2 | c.41T>C | p.Leu14Pro | missense_variant | Exon 1 of 13 | NP_001029366.1 | ||
EXOSC9 | XM_011532035.4 | c.41T>C | p.Leu14Pro | missense_variant | Exon 1 of 11 | XP_011530337.1 | ||
EXOSC9 | XR_007057929.1 | n.143T>C | non_coding_transcript_exon_variant | Exon 1 of 12 |
Ensembl
Frequencies
GnomAD3 genomes AF: 0.000243 AC: 37AN: 152214Hom.: 0 Cov.: 33
GnomAD3 exomes AF: 0.0000597 AC: 15AN: 251418Hom.: 0 AF XY: 0.0000221 AC XY: 3AN XY: 135900
GnomAD4 exome AF: 0.0000280 AC: 41AN: 1461878Hom.: 0 Cov.: 31 AF XY: 0.0000165 AC XY: 12AN XY: 727240
GnomAD4 genome AF: 0.000243 AC: 37AN: 152332Hom.: 0 Cov.: 33 AF XY: 0.000269 AC XY: 20AN XY: 74488
ClinVar
Submissions by phenotype
Pontocerebellar hypoplasia, type 1D Pathogenic:10
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The p.Leu14Pro variant in EXOSC9 has been previously reported in the homozygous state in 5 unrelated individuals affected with Cerebellar Atrophy With Spinal Motor Neuronopathy (PMID: 29727687, 30125339, 29878067) and in another affected individual who was compound heterozygous with another pathogenic loss of function variant in EXOSC9 (PMID: 29727687). Functional analysis of patient fibroblasts and skeletal muscle showed reduced EXOSC9 protein expression along with reduction of the whole multi-subunit exosome complex (PMID: 29727687). Furthermore, RNA sequencing of patient cells detected significant >2-fold changes in genes involved in neuronal development and cerebellar and motor neuron degeneration. Studies in zebrafish recapitulate aspects of the human phenotype (PMID: 29727687). The p.Leu14Pro variant is observed in 21/24970(0.084%; 0 homozygotes) African alleles in the Genome Aggregation Database (gnomAD). In summary this variant meets our criteria to be classified as pathogenic. This variant is found in homozygous state in the individual and heterozygous state in both the parents, who are reported to be consanguineous. The clinical features of the patient highly correlate with the reported features of other patients carrying this variant. Recessive variants in EXOSC9 are associated with Pontocerebellar hypoplasia, type 1d, a severe, early onset progressive, SMS-like motor neuronopathy and cerebellar atrophy. -
Same nucleotide change resulting in same amino acid change has been previously reported as pathogenic/likely pathogenic with strong evidence (ClinVar ID: VCV000549845, PMID:29727687). The variant has been observed in multiple (>3) similarly affected unrelated individuals (PMID: 29727687, 30125339). It has been reported to be in trans with a pathogenic variant as either compound heterozygous or homozygous in at least one similarly affected unrelated individual (PMID: 29727687) In silico tool predictions suggest damaging effect of the variant on gene or gene product (REVEL: 0.606>=0.6). It is observed at an extremely low frequency in the gnomAD v2.1.1 dataset (total allele frequency: 0.0000832). Therefore, this variant is classified as pathogenic according to the recommendation of ACMG/AMP guideline. -
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not provided Pathogenic:2
This sequence change replaces leucine, which is neutral and non-polar, with proline, which is neutral and non-polar, at codon 14 of the EXOSC9 protein (p.Leu14Pro). This variant is present in population databases (rs139632595, gnomAD 0.08%). This missense change has been observed in individual(s) with pontocerebellar hypoplasia (PMID: 29727687, 30690203). In at least one individual the data is consistent with being in trans (on the opposite chromosome) from a pathogenic variant. ClinVar contains an entry for this variant (Variation ID: 549845). 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 EXOSC9 protein function with a positive predictive value of 80%. For these reasons, this variant has been classified as Pathogenic. -
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: 34645488, 29758258, 30690203, 31130284, 33040083, 32504085, 37644014, 36703223, 33258288, 34782754, 35893425, 29878067, 29727687, 30125339) -
Cerebral atrophy Pathogenic:1
The homozygous p.Leu14Pro variant in EXOSC9 was identified by our study in an individual with pontocerebellar hypoplasia (PMID: 29727687). The p.Leu14Pro variant has also been reported in 5 additional individuals with pontocerebellar hypoplasia (PMID: 29727687, 30690203, 30125339), and has been identified in 0.084% (21/24970) of African chromosomes by the Genome Aggregation Database (gnomAD, http://gnomad.broadinstitute.org; dbSNP rs139632595). Although this variant has been seen in the general population, its frequency is not high enough to rule out a pathogenic role. This variant has been reported pathogenic by OMIM, Al Jalila Children's Genomics Center,Al Jalila Childrens Speciality Hospital, Sheikh Hamdan Award for Medical Sciences, and Mendelics in ClinVar (Variation ID: 549845). Of the 6 affected individuals, 5 of those were homozygotes and 1 was a compound heterozygote that carried a reported likely pathogenic variants in trans, which increases the likelihood that the p.Leu14Pro variant is pathogenic (PMID: 29727687, 30690203, 30125339). The phenotype of individuals homozygous for this variant is highly specific for pontocerebellar hypoplasia based on the unique phenotype consistent with disease (PMID: 29727687). In vitro functional studies provide some evidence that the p.Leu14Pro variant may impact protein function (PMID: 29727687). However, these types of assays may not accurately represent biological function. Computational prediction tools and conservation analyses do not provide strong support for or against an impact to the protein. In summary, although additional studies are required to fully establish its clinical significance, this variant is likely pathogenic for autosomal recessive pontocerebellar hypoplasia. ACMG/AMP Criteria applied: PM3_strong, PS3_moderate, PP4 (Richards 2015). -
Pontoneocerebellar hypoplasia Pathogenic:1
PM3_Strong, PS3, PP4 -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at