chr1-201361314-C-T

Variant summary

Our verdict is Likely benign. Variant got -2 ACMG points: 2P and 4B. PM1BS2

The NM_001276345.2(TNNT2):​c.775G>A​(p.Asp259Asn) variant causes a missense change. The variant allele was found at a frequency of 0.00000991 in 1,614,080 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Uncertain significance (★★). Synonymous variant affecting the same amino acid position (i.e. D259D) has been classified as Benign.

Frequency

Genomes: 𝑓 0.000020 ( 0 hom., cov: 32)
Exomes 𝑓: 0.0000089 ( 0 hom. )

Consequence

TNNT2
NM_001276345.2 missense

Scores

4
14
2

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:13

Conservation

PhyloP100: 5.93
Variant links:
Genes affected
TNNT2 (HGNC:11949): (troponin T2, cardiac type) This gene encodes the cardiac isoform of troponin T. The encoded protein is the tropomyosin-binding subunit of the troponin complex, which is located on the thin filament of striated muscles and regulates muscle contraction in response to alterations in intracellular calcium ion concentration. Mutations in this gene have been associated with familial hypertrophic cardiomyopathy as well as with dilated cardiomyopathy. [provided by RefSeq, May 2022]

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ACMG classification

Classification made for transcript

Verdict is Likely_benign. Variant got -2 ACMG points.

PM1
In a chain Troponin T, cardiac muscle (size 296) in uniprot entity TNNT2_HUMAN there are 88 pathogenic changes around while only 9 benign (91%) in NM_001276345.2
BS2
High AC in GnomAdExome4 at 13 AD gene.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
TNNT2NM_001276345.2 linkuse as main transcriptc.775G>A p.Asp259Asn missense_variant 15/17 ENST00000656932.1 NP_001263274.1

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
TNNT2ENST00000656932.1 linkuse as main transcriptc.775G>A p.Asp259Asn missense_variant 15/17 NM_001276345.2 ENSP00000499593 A2P45379-1

Frequencies

GnomAD3 genomes
AF:
0.0000197
AC:
3
AN:
152100
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.000131
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.000193
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.00
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000199
AC:
5
AN:
251474
Hom.:
0
AF XY:
0.0000221
AC XY:
3
AN XY:
135910
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.000145
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.00000889
AC:
13
AN:
1461862
Hom.:
0
Cov.:
31
AF XY:
0.00000963
AC XY:
7
AN XY:
727240
show subpopulations
Gnomad4 AFR exome
AF:
0.0000597
Gnomad4 AMR exome
AF:
0.000112
Gnomad4 ASJ exome
AF:
0.0000383
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.0000116
Gnomad4 FIN exome
AF:
0.0000187
Gnomad4 NFE exome
AF:
0.00000180
Gnomad4 OTH exome
AF:
0.0000166
GnomAD4 genome
AF:
0.0000197
AC:
3
AN:
152218
Hom.:
0
Cov.:
32
AF XY:
0.0000269
AC XY:
2
AN XY:
74434
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.000131
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.000193
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.00
Gnomad4 OTH
AF:
0.00
Bravo
AF:
0.0000189
ESP6500AA
AF:
0.000227
AC:
1
ESP6500EA
AF:
0.00
AC:
0
ExAC
AF:
0.0000165
AC:
2

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:13
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Uncertain:3
Uncertain significance, criteria provided, single submitterclinical testingGeneDxSep 11, 2023Identified as a variant of uncertain significance in cohorts of individuals with arrhythmia and cardiomyopathy in the literature; however, specific information was not provided about the number of individuals with the variant, their phenotype, or presence/absence of other variants (PMID: 23861362; 30847666; 30165862); 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: 30847666, 30165862, 23861362) -
Uncertain significance, criteria provided, single submitterresearchBiesecker Lab/Clinical Genomics Section, National Institutes of HealthJun 24, 2013- -
Uncertain significance, criteria provided, single submitterclinical testingARUP Laboratories, Molecular Genetics and Genomics, ARUP LaboratoriesNov 17, 2023The TNNT2 c.745G>A; p.Asp249Asn variant (rs141805127) is reported in the literature in one individual with noncompaction cardiomyopathy, one individual from a cardiomyopathy cohort, and as a secondary variant from an exome cohort (Lu 2018, Ng 2013, van Lint 2019). This variant is also reported in ClinVar (Variation ID: 181630). This variant is found in the Admixed American population with an allele frequency of 0.01% (5/35426 alleles) in the Genome Aggregation Database. Computational analyses are uncertain whether this variant is neutral or deleterious (REVEL: 0.658). Due to limited information, the clinical significance of this variant is uncertain at this time. References: Lu C et al. Molecular analysis of inherited cardiomyopathy using next generation semiconductor sequencing technologies. J Transl Med. 2018 Aug 30;16(1):241. PMID: 30165862. Ng D et al. Interpreting secondary cardiac disease variants in an exome cohort. Circ Cardiovasc Genet. 2013 Aug;6(4):337-46. PMID: 23861362. van Lint FHM et al. Large next-generation sequencing gene panels in genetic heart disease: yield of pathogenic variants and variants of unknown significance. Neth Heart J. 2019 Jun;27(6):304-309. PMID: 30847666. -
Dilated cardiomyopathy 1D Uncertain:2
Uncertain significance, criteria provided, single submitterclinical testingGenome-Nilou LabApr 11, 2023- -
Uncertain significance, criteria provided, single submitterclinical testingInstitute of Immunology and Genetics KaiserslauternMar 26, 2024ACMG Criteria: PM2_P, PP3; Variant was found in heterozygous state -
Cardiomyopathy Uncertain:2
Uncertain significance, criteria provided, single submitterclinical testingCHEO Genetics Diagnostic Laboratory, Children's Hospital of Eastern OntarioNov 07, 2019- -
Uncertain significance, criteria provided, single submitterclinical testingColor Diagnostics, LLC DBA Color HealthNov 20, 2023This missense variant replaces aspartic acid with asparagine at codon 249 of the TNNT2 protein. Computational prediction tools indicate that this variant's impact on protein structure and function is inconclusive. To our knowledge, functional studies have not been reported for this variant. This variant has been reported in one individual affected with noncompaction cardiomyopathy (PMID: 30847666) and in one individual affected with an unspecified cardiomyopathy (PMID: 30165862). This variant has been identified in 6/282830 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -
Hypertrophic cardiomyopathy 2 Uncertain:2
Uncertain significance, criteria provided, single submitterclinical testingGenome-Nilou LabApr 11, 2023- -
Uncertain significance, criteria provided, single submitterclinical testingMendelicsMay 28, 2019- -
Dilated cardiomyopathy 1D;C1861864:Hypertrophic cardiomyopathy 2;C2676271:Cardiomyopathy, familial restrictive, 3 Uncertain:2
Uncertain significance, criteria provided, single submitterclinical testingFulgent Genetics, Fulgent GeneticsAug 20, 2021- -
Uncertain significance, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpJan 02, 2024This sequence change replaces aspartic acid, which is acidic and polar, with asparagine, which is neutral and polar, at codon 249 of the TNNT2 protein (p.Asp249Asn). This variant is present in population databases (rs141805127, gnomAD 0.01%). This missense change has been observed in individual(s) with TNNT2-related conditions (PMID: 30165862, 30847666). This variant is also known as p.Asp256Asn. ClinVar contains an entry for this variant (Variation ID: 181630). 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 TNNT2 protein function with a positive predictive value of 95%. In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. -
Cardiomyopathy, familial restrictive, 3 Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingGenome-Nilou LabApr 11, 2023- -
Cardiovascular phenotype Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingAmbry GeneticsOct 21, 2021The p.D249N variant (also known as c.745G>A), located in coding exon 13 of the TNNT2 gene, results from a G to A substitution at nucleotide position 745. The aspartic acid at codon 249 is replaced by asparagine, an amino acid with highly similar properties. This variant has been reported in one individual from a cardiomyopathy cohort and as a secondary cardiac variant in an exome cohort; however clinical details were limited (Ng D et al. Circ Cardiovasc Genet, 2013 Aug;6:337-46; Lu C et al. J Transl Med, 2018 08;16:241). This amino acid position is well 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: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Uncertain
0.55
CardioboostCm
Uncertain
0.13
BayesDel_addAF
Benign
-0.055
T
BayesDel_noAF
Uncertain
-0.060
CADD
Pathogenic
30
DANN
Pathogenic
1.0
DEOGEN2
Pathogenic
0.96
.;.;.;.;D;.;.;.;.;.;D
Eigen
Uncertain
0.54
Eigen_PC
Uncertain
0.47
FATHMM_MKL
Uncertain
0.97
D
LIST_S2
Uncertain
0.95
.;D;D;D;D;D;D;.;.;D;.
M_CAP
Pathogenic
0.56
D
MetaRNN
Uncertain
0.54
D;D;D;D;D;D;D;D;D;D;D
MetaSVM
Uncertain
0.58
D
MutationAssessor
Uncertain
2.5
.;.;.;.;M;.;.;.;.;.;.
MutationTaster
Benign
1.0
D;D;D;D;D;D;D;D;D;D
PrimateAI
Uncertain
0.59
T
PROVEAN
Uncertain
-3.3
D;D;.;.;.;.;.;.;D;D;D
REVEL
Pathogenic
0.66
Sift
Uncertain
0.0010
D;D;.;.;.;.;.;.;D;D;D
Sift4G
Uncertain
0.0030
D;D;D;T;D;T;D;T;T;D;.
Polyphen
0.96
.;.;.;.;D;.;.;.;.;.;.
Vest4
0.54
MVP
0.95
MPC
0.77
ClinPred
0.84
D
GERP RS
3.7
Varity_R
0.65
gMVP
0.91

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

LitVar

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs141805127; hg19: chr1-201330442; API