NM_033409.4:c.62A>G
Variant summary
Our verdict is Uncertain significance. Variant got 3 ACMG points: 4P and 1B. PM2PP3PP5BS1_Supporting
The NM_033409.4(SLC52A3):āc.62A>Gā(p.Asn21Ser) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.000126 in 1,613,538 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 Conflicting classifications of pathogenicity (no stars).
Frequency
Consequence
NM_033409.4 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Uncertain_significance. Variant got 3 ACMG points.
Transcripts
RefSeq
Ensembl
Frequencies
GnomAD3 genomes AF: 0.0000593 AC: 9AN: 151696Hom.: 0 Cov.: 31
GnomAD3 exomes AF: 0.000161 AC: 40AN: 248370Hom.: 0 AF XY: 0.000164 AC XY: 22AN XY: 134458
GnomAD4 exome AF: 0.000133 AC: 194AN: 1461724Hom.: 0 Cov.: 36 AF XY: 0.000128 AC XY: 93AN XY: 727132
GnomAD4 genome AF: 0.0000593 AC: 9AN: 151814Hom.: 0 Cov.: 31 AF XY: 0.0000674 AC XY: 5AN XY: 74184
ClinVar
Submissions by phenotype
not provided Pathogenic:2Uncertain:1
Published functional studies demonstrate a damaging effect on protein localization; protein was retained in intracellular vesicles, leading to a reduction in riboflavin intake (Udhayabanu T et al., 2016); 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: 29501408, 27702554, 31959559, 33325104, 22718020, 33189404, 34426522, 36511838) -
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Brown-Vialetto-van Laere syndrome 1 Pathogenic:2Other:1
Variant summary: SLC52A3 (aka. C20orf54) c.62A>G (p.Asn21Ser) results in a conservative amino acid change in the encoded protein sequence. Four of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 0.00015 (i.e. 41 heterozygous carriers) in 279628 control chromosomes. This frequency doesn't allow clear conclusions about variant significance. The variant, c.62A>G, has been reported in the literature in several homozygous and compound heterozygous individuals affected with Brown-Vialetto Laere- (BVVL) and Fazio-Londe (FL) syndrome (Udhayabanu_2016, Gowda_2018, Gayathri_2021, Dezfouli_2012), and in several cases improvement after riboflavin supplementation was described (Udhayabanu_2016, Gowda_2018, Gayathri_2021). In one of these families the variant was reported in a homozygous BLLV patient, who also carried another homozygous variant in a different riboflavin transporter gene (SLC52A2 c.421C>A (p.P141T)), which could contribute to the patient's phenotype (Udhayabanu_2016). On the other hand, the variant was also reported in a family in 3 homozygotes, where one was affected with BVVL, one with isolated hearing loss, and a third homozygous family member was apparently unaffected (Khani_2021); in this family the variant was also found in 4 heterozygotes, and none of them was diagnosed with BVVL or was noted to have hearing problems. In another family, where 3 compound heterozygotes were diagnosed with BVVL, the variant was also found in 2 heterozygotes, and one of them was affected with BVVL, while the other had isolated hearing loss (Khani_2021). Authors of this study concluded that the variant might have variable expressivity and incomplete penetrance, where environmental insults and putative causative mutations in other genes may contribute to these variable presentations (Khani_2021). These data indicate that the variant is very likely to be associated with disease, although it's expressivity and penetrance may be variable. One of these publications also reported experimental evidence evaluating an impact on protein function, and demonstrated mislocalization for the variant protein when transfected into neuronal- and intestinal cell lines, in addition, riboflavin uptake was almost completely abolished, when measured in the transfected intestinal cell line (Udhayabanu_2016). Six submitters have provided clinical-significance assessments for this variant in ClinVar after 2014 mostly without evidence for independent evaluation, and classified the variant as likely pathogenic (n=1) or VUS (n=5). Based on the evidence outlined above, the variant was classified as likely pathogenic. -
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This sequence change replaces asparagine, which is neutral and polar, with serine, which is neutral and polar, at codon 21 of the SLC52A3 protein (p.Asn21Ser). This variant is present in population databases (rs199588390, gnomAD 0.02%). This missense change has been observed in individuals with Brown-Vialetto-Van Laere syndrome and/or Fazio Londe syndrome (PMID: 27702554, 33189404, 33325104). It has also been observed to segregate with disease in related individuals. ClinVar contains an entry for this variant (Variation ID: 210012). 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 SLC52A3 protein function with a positive predictive value of 95%. Experimental studies have shown that this missense change affects SLC52A3 function (PMID: 27702554). For these reasons, this variant has been classified as Pathogenic. -
not specified Uncertain:2
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Variant classified as Uncertain Significance - Favor Pathogenic. The p.Asn21Ser variant in SLC52A3 has been reported in 2 individuals with Brown-Vialetto-Van La ere (BVVL) syndrome, a type of riboflavin transporter deficiency neuronopathy th at causes nerve damage including sensorineural hearing loss. One individual was homozygous (Udhayabanu 2016) for this variant and the other individual was compo und heterozygous with a second variant of uncertain significance (Dezfouli 2012) . This variant has been identified in 25/124008 of European chromosomes by the G enome Aggregation Database (gnomAD, http://gnomad.broadinstitute.org; dbSNP rs19 9588390). Although this variant has been seen in the general population, its fre quency is not high enough to rule out a pathogenic role. Computational predictio n tools and conservation analysis suggest that thep.Asn21Ser variant may impact the protein, though this information is not predictive enough to determine patho genicity. In vitro functional studies provide some evidence that the p.Asn21Ser variant may impact protein function, specifically riboflavin uptake by due to im paired trafficking and membrane targeting (Udhayabanu 2016). However, these type s of assays may not accurately represent biological function. In summary, while there is some suspicion for a pathogenic role, the clinical significance of the p.Asn21Ser variant is uncertain. ACMG/AMP Criteria applied: PM2_Supporting, PP3, PS3_Supporting, PM3_P. -
SLC52A3-related disorder Pathogenic:1
The SLC52A3 c.62A>G variant is predicted to result in the amino acid substitution p.Asn21Ser. This variant has been reported in the homozygous state or compound heterozygous with a second SLC52A3 variant in multiple individuals with Brown-Vialetto-Van Laere syndrome (BVVLS) or Fazio-Londre syndrome (FLS) (gene referred to as C20orf54 in Dezfouli et al. 2012. PubMed ID: 22718020; Udhayabanu et al. 2016. PubMed ID: 27702554; Gowda et al. 2018. PubMed ID: 29501408; Khani et al. 2020. PubMed ID: 33189404; Gayathri et al. 2021. PubMed ID: 33325104). The patient reported by Udhayabanu et al. was also homozygous for a variant in the SLC52A2 gene (c.421C>A, p.Pro141Thr); however, in functional studies the SLC52A2 p.Pro141Thr substitution behaved similarly to control whereas the SLC52A3 p.Asn21Ser substitution lead to greatly reduced riboflavin uptake and absent cell surface expression (Udhayabanu et al. 2016. PubMed ID: 27702554). This variant is reported in 0.020% of alleles in individuals of East Asian descent in gnomAD (http://gnomad.broadinstitute.org/variant/20-746357-T-C). Taken together, this variant is interpreted as likely pathogenic. -
Inborn genetic diseases Uncertain:1
The p.N21S variant (also known as c.62A>G), located in coding exon 1 of the SLC52A3 gene, results from an A to G substitution at nucleotide position 62. The asparagine at codon 21 is replaced by serine, an amino acid with highly similar properties. This variant was detected in two individuals with Brown-Vialetto-Van Laere syndrome; one individual was homozygous, and the other was compound heterozygous with a second variant in SLC52A3 (p.A312V, c.935C>T) (Gowda VK et al. Brain Dev, 2018 Aug;40:582-586; Dezfouli MA et al. J Hum Genet, 2012 Sep;57:613-7). In addition, this variant was detected in the homozygous state in an individual with Fazio-Londe syndrome, who also had a homozygous alteration in SLC52A2 (p.P141T, c.421C>A) (Udhayabanu T et al. Clin Chim Acta, 2016 Nov;462:210-214). This amino acid position is highly conserved in available vertebrate species. In addition, the in silico prediction for this alteration is inconclusive. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear. -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at