X-153743023-C-T

Variant summary

Our verdict is Pathogenic. The variant received 16 ACMG points: 16P and 0B. PM1PM2PP3_StrongPP5_Very_Strong

The NM_000033.4(ABCD1):​c.1817C>T​(p.Ser606Leu) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.00000888 in 112,628 control chromosomes in the GnomAD database, with no homozygous occurrence. There are no hemizygote samples in GnomAD. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. S606P) has been classified as Uncertain significance.

Frequency

Genomes: 𝑓 0.0000089 ( 0 hom., 0 hem., cov: 25)
Exomes 𝑓: 0.0 ( 0 hom. 0 hem. )
Failed GnomAD Quality Control

Consequence

ABCD1
NM_000033.4 missense

Scores

15
1
1

Clinical Significance

Pathogenic criteria provided, multiple submitters, no conflicts P:9

Conservation

PhyloP100: 7.91

Publications

20 publications found
Variant links:
Genes affected
ABCD1 (HGNC:61): (ATP binding cassette subfamily D member 1) The protein encoded by this gene is a member of the superfamily of ATP-binding cassette (ABC) transporters. ABC proteins transport various molecules across extra- and intra-cellular membranes. ABC genes are divided into seven distinct subfamilies (ABC1, MDR/TAP, MRP, ALD, OABP, GCN20, White). This protein is a member of the ALD subfamily, which is involved in peroxisomal import of fatty acids and/or fatty acyl-CoAs in the organelle. All known peroxisomal ABC transporters are half transporters which require a partner half transporter molecule to form a functional homodimeric or heterodimeric transporter. This peroxisomal membrane protein is likely involved in the peroxisomal transport or catabolism of very long chain fatty acids. Defects in this gene have been identified as the underlying cause of adrenoleukodystrophy, an X-chromosome recessively inherited demyelinating disorder of the nervous system. [provided by RefSeq, Jul 2008]
PLXNB3-AS1 (HGNC:40454): (PLXNB3 antisense RNA 1)

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Pathogenic. The variant received 16 ACMG points.

PM1
In a hotspot region, there are 9 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 3 benign, 3 uncertain in NM_000033.4
PM2
Very rare variant in population databases, with high coverage;
PP3
MetaRNN computational evidence supports a deleterious effect, 0.995
PP5
Variant X-153743023-C-T is Pathogenic according to our data. Variant chrX-153743023-C-T is described in ClinVar as Pathogenic. ClinVar VariationId is 11310.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
ABCD1NM_000033.4 linkc.1817C>T p.Ser606Leu missense_variant Exon 8 of 10 ENST00000218104.6 NP_000024.2

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
ABCD1ENST00000218104.6 linkc.1817C>T p.Ser606Leu missense_variant Exon 8 of 10 1 NM_000033.4 ENSP00000218104.3
PLXNB3-AS1ENST00000434284.1 linkn.72-4445G>A intron_variant Intron 1 of 2 3

Frequencies

GnomAD3 genomes
AF:
0.00000888
AC:
1
AN:
112628
Hom.:
0
Cov.:
25
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:
0.0000188
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.00
AC:
0
AN:
162474
AF XY:
0.00
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
Data not reliable, filtered out with message: AC0;AS_VQSR
AF:
0.00
AC:
0
AN:
1087278
Hom.:
0
Cov.:
31
AF XY:
0.00
AC XY:
0
AN XY:
356298
African (AFR)
AF:
0.00
AC:
0
AN:
26228
American (AMR)
AF:
0.00
AC:
0
AN:
34067
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
19044
East Asian (EAS)
AF:
0.00
AC:
0
AN:
29968
South Asian (SAS)
AF:
0.00
AC:
0
AN:
52682
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
39627
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
2885
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
837195
Other (OTH)
AF:
0.00
AC:
0
AN:
45582
GnomAD4 genome
AF:
0.00000888
AC:
1
AN:
112628
Hom.:
0
Cov.:
25
AF XY:
0.00
AC XY:
0
AN XY:
34784
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
31023
American (AMR)
AF:
0.00
AC:
0
AN:
10750
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
2648
East Asian (EAS)
AF:
0.00
AC:
0
AN:
3564
South Asian (SAS)
AF:
0.00
AC:
0
AN:
2739
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
6276
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
239
European-Non Finnish (NFE)
AF:
0.0000188
AC:
1
AN:
53190
Other (OTH)
AF:
0.00
AC:
0
AN:
1517
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.425
Heterozygous variant carriers
0
0
1
1
2
2
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:
0.0000389
Hom.:
0

ClinVar

Significance: Pathogenic
Submissions summary: Pathogenic:9
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Adrenoleukodystrophy Pathogenic:4
Jul 05, 2019
Johns Hopkins Genomics, Johns Hopkins University
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This previously reported variant (rs128624225) has been identified in multiple patients with clinical and biochemical findings consistent with ABCD1 related disease. Four submitters in ClinVar classify this variant as pathogenic. Additionally, functional analysis supports the deleterious effect of this this variant on protein function. This variant is considered pathogenic. -

Apr 01, 2024
Kasturba Medical College, Manipal, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Nov 07, 2021
Genome-Nilou Lab
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Jan 07, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence change replaces serine, which is neutral and polar, with leucine, which is neutral and non-polar, at codon 606 of the ABCD1 protein (p.Ser606Leu). The frequency data for this variant in the population databases is considered unreliable, as metrics indicate poor data quality at this position in the gnomAD database. This missense change has been observed in individuals with various forms of X-linked adrenoleukodystrophy including Addison's disease and adrenomyeloneuropathy (PMID: 7581394, 8040304, 10190819, 12624723, 14767898, 15811009, 22479560). ClinVar contains an entry for this variant (Variation ID: 11310). 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 ABCD1 protein function with a positive predictive value of 95%. Experimental studies have shown that this missense change affects ABCD1 function (PMID: 11248239, 12530690, 17542813). This variant disrupts the p.Ser606 amino acid residue in ABCD1. Other variant(s) that disrupt this residue have been determined to be pathogenic (PMID: 8651290, 21700483, 21966424, 22479560). This suggests that this residue is clinically significant, and that variants that disrupt this residue are likely to be disease-causing. For these reasons, this variant has been classified as Pathogenic. -

not provided Pathogenic:4
Aug 07, 2014
Eurofins Ntd Llc (ga)
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Dec 03, 2020
ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The ABCD1 c.1817C>T; p.Ser606Leu variant is reported in the literature in at least 30 individuals affected with various forms of adrenoleukodystrophy including adrenomyeloneuropathy (see ALD database link, Pan 2004, Li 2019). In vitro functional analyses demonstrate that this variant reduces the ATP-binding capacity of the ALDP protein (Gartner 2002, Roerig 2001), and results in the degradation of the protein post translation (Takahashi 2007). This variant is found on a single chromosome in the non-Finnish European population (1/184572 alleles) in the Genome Aggregation Database. The serine at codon 606 is located in the ATP-binding domain and is highly conserved among ABC transporter superfamily genes (Fanen 1994), and computational analyses predict that this variant is deleterious (REVEL: 0.935). Based on available information, this variant is considered to be pathogenic. References: ALD ABCD1 Mutation Database: https://adrenoleukodystrophy.info/mutations-and-variants-in-abcd1 Fanen P et al. Identification of mutations in the putative ATP-binding domain of the adrenoleukodystrophy gene. J Clin Invest. 1994 Aug;94(2):516-20. Gartner J et al. Functional characterization of the adrenoleukodystrophy protein (ALDP) and disease pathogenesis. Endocr Res. 2002 Nov;28(4):741-8. Pan H et al. ABCD1 gene mutations in Chinese patients with X-linked adrenoleukodystrophy. Pediatr Neurol. 2005 Aug;33(2):114-20. doi: 10.1016/j.pediatrneurol.2005.03.006. PMID: 16087056. Li J et al. Clinical, neuroimaging, biochemical, and genetic features in six Chinese patients with Adrenomyeloneuropathy. BMC Neurol. 2019 Sep 16;19(1):227. Roerig P et al. Characterization and functional analysis of the nucleotide binding fold in human peroxisomal ATP binding cassette transporters. FEBS Lett. 2001 Mar 9;492(1-2):66-72. Takahashi N et al. Adrenoleukodystrophy: subcellular localization and degradation of adrenoleukodystrophy protein (ALDP/ABCD1) with naturally occurring missense mutations. J Neurochem. 2007 Jun;101(6):1632-43. -

Jul 24, 2020
GeneDx
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Functional analysis has shown that S606L decreases ATP-binding affinity of the protein; and expression studies of the mutant S606L protein in ALDP negative fibroblasts show very low expression of S606L compared with wild type expression controls (Roerig et al., 2001; Takahashi et al., 2007); 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: 11248239, 16087056, 7581394, 12530690, 12624723, 30343438, 8040304, 15811009, 17973979, 17092750, 22479560, 10190819, 11748843, 17542813, 21476988, 31526374) -

Jul 24, 2017
Athena Diagnostics
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Primary adrenocortical insufficiency Pathogenic:1
Aug 01, 1994
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
0.98
BayesDel_addAF
Pathogenic
0.73
D
BayesDel_noAF
Pathogenic
0.81
CADD
Uncertain
25
DANN
Pathogenic
1.0
DEOGEN2
Pathogenic
0.99
D
FATHMM_MKL
Pathogenic
0.97
D
LIST_S2
Pathogenic
1.0
D
M_CAP
Pathogenic
0.97
D
MetaRNN
Pathogenic
1.0
D
MetaSVM
Pathogenic
0.97
D
MutationAssessor
Pathogenic
4.6
H
PhyloP100
7.9
PrimateAI
Uncertain
0.57
T
PROVEAN
Pathogenic
-4.8
D
REVEL
Pathogenic
0.94
Sift
Pathogenic
0.0
D
Sift4G
Pathogenic
0.0010
D
Polyphen
1.0
D
Vest4
0.92
MutPred
0.97
Loss of disorder (P = 0.0205);
MVP
1.0
MPC
1.4
ClinPred
1.0
D
GERP RS
5.5
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.7
Varity_R
0.97
gMVP
0.99
Mutation Taster
=0/100
disease causing (ClinVar)

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: rs128624225; hg19: chrX-153008477; API