NM_021971.4:c.760G>A

Variant names:

Variant summary

Our verdict is Pathogenic. The variant received 12 ACMG points: 12P and 0B. PM2PP3_ModeratePP5_Very_Strong

The NM_021971.4(GMPPB):c.760G>A(p.Val254Met) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0000167 in 1,613,134 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. V254G) has been classified as Uncertain significance.

Frequency

Genomes: 𝑓 0.000013 ( 0 hom., cov: 33)

Exomes 𝑓: 0.000017 ( 0 hom. )

Consequence

GMPPB
NM_021971.4 missense

Scores

Clinical Significance

Likely pathogenic criteria provided, multiple submitters, no conflicts P:3

Conservation

PhyloP100: 7.67

Publications

8 publications found

Variant links:

Genes affected

GMPPB (HGNC:22932): (GDP-mannose pyrophosphorylase B) This gene is thought to encode a GDP-mannose pyrophosphorylase. The encoded protein catalyzes the conversion of mannose-1-phosphate and GTP to GDP-mannose, a reaction involved in the production of N-linked oligosaccharides. Alternatively spliced transcript variants encoding distinct isoforms have been described. [provided by RefSeq, Jan 2009]

GMPPB Gene-Disease associations (from GenCC):

muscular dystrophy-dystroglycanopathy (congenital with brain and eye anomalies), type A14
Inheritance: AR Classification: DEFINITIVE, STRONG Submitted by: Ambry Genetics, Labcorp Genetics (formerly Invitae), G2P
myopathy caused by variation in GMPPB
Inheritance: AR Classification: DEFINITIVE Submitted by: ClinGen
autosomal recessive limb-girdle muscular dystrophy type 2T
Inheritance: AR Classification: STRONG, MODERATE, SUPPORTIVE Submitted by: Ambry Genetics, Labcorp Genetics (formerly Invitae), Orphanet, PanelApp Australia
congenital myasthenic syndrome
Inheritance: AR Classification: STRONG Submitted by: Genomics England PanelApp
congenital muscular dystrophy with cerebellar involvement
Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
congenital muscular dystrophy with intellectual disability
Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
congenital myasthenic syndromes with glycosylation defect
Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
muscle-eye-brain disease
Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet

GMPPB links:

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Pathogenic. The variant received 12 ACMG points.

PM2

Very rare variant in population databases, with high coverage;

PP3

MetaRNN computational evidence supports a deleterious effect, 0.902

PP5

Variant 3-49722239-C-T is Pathogenic according to our data. Variant chr3-49722239-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 225926.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr3-49722239-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 225926.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr3-49722239-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 225926.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr3-49722239-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 225926.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr3-49722239-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 225926.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr3-49722239-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 225926.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr3-49722239-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 225926.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr3-49722239-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 225926.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr3-49722239-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 225926.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr3-49722239-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 225926.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr3-49722239-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 225926.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr3-49722239-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 225926.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr3-49722239-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 225926.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr3-49722239-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 225926.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr3-49722239-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 225926.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr3-49722239-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 225926.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr3-49722239-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 225926.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr3-49722239-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 225926.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
GMPPB	NM_021971.4 link	c.760G>A	p.Val254Met	missense_variant	Exon 7 of 9	ENST00000308388.7	NP_068806.2	Q9Y5P6-1
GMPPB	NM_013334.4 link	c.760G>A	p.Val254Met	missense_variant	Exon 7 of 8		NP_037466.3	Q9Y5P6-2

Ensembl

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	TSL	MANE	Protein	Appris	UniProt
GMPPB	ENST00000308388.7 link	c.760G>A	p.Val254Met	missense_variant	Exon 7 of 9	1	NM_021971.4	ENSP00000311130.6		Q9Y5P6-1

Frequencies

GnomAD3 genomes

AF:

0.0000131

AC:

AN:

152210

Hom.:

Cov.:

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:

0.0000294

Gnomad OTH

AF:

0.00

GnomAD4 exome

AF:

0.0000171

AC:

AN:

1460924

Hom.:

Cov.:

AF XY:

0.0000151

AC XY:

AN XY:

726668

show subpopulations

African (AFR)

AF:

0.0000299

AC:

AN:

33470

American (AMR)

AF:

0.00

AC:

AN:

44672

Ashkenazi Jewish (ASJ)

AF:

0.00

AC:

AN:

26110

East Asian (EAS)

AF:

0.00

AC:

AN:

39676

South Asian (SAS)

AF:

0.00

AC:

AN:

86154

European-Finnish (FIN)

AF:

0.00

AC:

AN:

53132

Middle Eastern (MID)

AF:

0.00

AC:

AN:

5768

European-Non Finnish (NFE)

AF:

0.0000207

AC:

AN:

1111602

Other (OTH)

AF:

0.0000166

AC:

AN:

60340

Allele Balance Distribution

Red line indicates average allele balance

Average allele balance: 0.477

Heterozygous variant carriers

0.00

0.20

0.40

0.60

0.80

0.95

Allele balance

Age Distribution

Exome Het

Variant carriers

<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:

0.0000131

AC:

AN:

152210

Hom.:

Cov.:

AF XY:

0.00

AC XY:

AN XY:

74364

show subpopulations

African (AFR)

AF:

0.00

AC:

AN:

41444

American (AMR)

AF:

0.00

AC:

AN:

15288

Ashkenazi Jewish (ASJ)

AF:

0.00

AC:

AN:

3472

East Asian (EAS)

AF:

0.00

AC:

AN:

5192

South Asian (SAS)

AF:

0.00

AC:

AN:

4838

European-Finnish (FIN)

AF:

0.00

AC:

AN:

10630

Middle Eastern (MID)

AF:

0.00

AC:

AN:

316

European-Non Finnish (NFE)

AF:

0.0000294

AC:

AN:

68028

Other (OTH)

AF:

0.00

AC:

AN:

2092

Allele Balance Distribution

Red line indicates average allele balance

Average allele balance: 0.450

Heterozygous variant carriers

0.00

0.20

0.40

0.60

0.80

0.95

Allele balance

Age Distribution

Genome Het

Variant carriers

<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:

0.0000847

Hom.:

Bravo

AF:

0.0000113

ClinVar

Significance: Likely pathogenic

Submissions summary: Pathogenic:3

Revision: criteria provided, multiple submitters, no conflicts

LINK: link

Submissions by phenotype

Muscular dystrophy-dystroglycanopathy (congenital with brain and eye anomalies), type A14;C3809221:Muscular dystrophy-dystroglycanopathy (congenital with intellectual disability), type B14;C4518000:Autosomal recessive limb-girdle muscular dystrophy type 2T

Pathogenic:1

Jul 16, 2023

Labcorp Genetics (formerly Invitae), Labcorp

Significance:Likely pathogenic

Review Status:criteria provided, single submitter

Collection Method:clinical testing

This missense change has been observed in individuals with clinical features of GMPPB-related conditions (PMID: 26133662, 26310427, 27766311). In summary, the currently available evidence indicates that the variant is pathogenic, but additional data are needed to prove that conclusively. Therefore, this variant has been classified as Likely Pathogenic. Experimental studies have shown that this missense change affects GMPPB function (PMID: 26133662, 35006422). 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 GMPPB protein function. ClinVar contains an entry for this variant (Variation ID: 225926). This variant is present in population databases (no rsID available, gnomAD 0.007%). This sequence change replaces valine, which is neutral and non-polar, with methionine, which is neutral and non-polar, at codon 254 of the GMPPB protein (p.Val254Met). -

not provided

Pathogenic:1

Jun 01, 2023

GeneDx

Significance:Likely pathogenic

Review Status:criteria provided, single submitter

Collection Method:clinical testing

Has also reported in an individual with limb-girdle muscular dystrophy who had second pathogenic variant in the GMPPB gene (Jensen et al., 2015).; Published functional studies demonstrate that the V254M variant results in absent or reduced GMPPB protein expression (Belaya et al., 2015; Liu et al., 2021); Not observed at significant frequency in large population cohorts (gnomAD); 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: 27147698, 27766311, 35006422, 26133662, 26310427, 36833299) -

Autosomal recessive limb-girdle muscular dystrophy type 2T

Pathogenic:1

Sep 25, 2018

OMIM

Significance:Pathogenic

Review Status:no assertion criteria provided

Collection Method:literature only

- -

Computational scores

Source: dbNSFP v4.3

Name

Calibrated prediction

Score

Prediction

AlphaMissense

Pathogenic

0.87

BayesDel_addAF

Pathogenic

0.47

BayesDel_noAF

Pathogenic

0.44

CADD

Pathogenic

(source)

DANN

Uncertain

1.0

DEOGEN2

Uncertain

0.72

D;.;D

Eigen

Pathogenic

0.92

Eigen_PC

Pathogenic

0.83

FATHMM_MKL

Pathogenic

0.99

LIST_S2

Pathogenic

0.99

.;D;D

M_CAP

Pathogenic

0.85

MetaRNN

Pathogenic

0.90

D;D;D

MetaSVM

Pathogenic

1.1

MutationAssessor

Pathogenic

3.8

H;H;H

PhyloP100

7.7

PrimateAI

Uncertain

0.78

PROVEAN

Uncertain

-2.7

D;D;D

REVEL

Pathogenic

0.88

Sift

Uncertain

0.0010

D;D;D

Sift4G

Uncertain

0.0050

D;D;D

Polyphen

0.97

D;D;D

Vest4

0.95

MutPred

0.44

Gain of sheet (P = 0.0344);Gain of sheet (P = 0.0344);Gain of sheet (P = 0.0344);

MVP

0.96

MPC

1.4

ClinPred

1.0

GERP RS

4.9

Varity_R

0.62

gMVP

0.91

Mutation Taster

=1/99

disease causing (ClinVar)

(source)

Splicing

Name

Calibrated prediction

Score

Prediction

SpliceAI score (max)

0.070

Details are displayed if max score is > 0.2

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

Publications

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Variant summary

Frequency

Consequence

Scores

Clinical Significance

Conservation

Publications

ACMG classification

Transcripts

RefSeq

Ensembl

Frequencies

Age Distribution

Age Distribution

ClinVar

Submissions by phenotype

Computational scores

Splicing

Publications

Other links and lift over