chr15-63062219-C-T

Variant summary

Our verdict is Pathogenic. Variant got 15 ACMG points: 15P and 0B. PM1PM2PP2PP3_ModeratePP5_Very_Strong

The NM_001018005.2(TPM1):​c.644C>T​(p.Ser215Leu) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.00000124 in 1,613,842 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 (★★).

Frequency

Genomes: 𝑓 0.0000066 ( 0 hom., cov: 33)
Exomes 𝑓: 6.8e-7 ( 0 hom. )

Consequence

TPM1
NM_001018005.2 missense

Scores

13
4
3

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:9O:1

Conservation

PhyloP100: 7.81
Variant links:
Genes affected
TPM1 (HGNC:12010): (tropomyosin 1) This gene is a member of the tropomyosin family of highly conserved, widely distributed actin-binding proteins involved in the contractile system of striated and smooth muscles and the cytoskeleton of non-muscle cells. Tropomyosin is composed of two alpha-helical chains arranged as a coiled-coil. It is polymerized end to end along the two grooves of actin filaments and provides stability to the filaments. The encoded protein is one type of alpha helical chain that forms the predominant tropomyosin of striated muscle, where it also functions in association with the troponin complex to regulate the calcium-dependent interaction of actin and myosin during muscle contraction. In smooth muscle and non-muscle cells, alternatively spliced transcript variants encoding a range of isoforms have been described. Mutations in this gene are associated with type 3 familial hypertrophic cardiomyopathy and dilated cardiomyopathy 1Y. [provided by RefSeq, Jun 2022]

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ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 15 ACMG points.

PM1
In a chain Tropomyosin alpha-1 chain (size 283) in uniprot entity TPM1_HUMAN there are 61 pathogenic changes around while only 1 benign (98%) in NM_001018005.2
PM2
Very rare variant in population databases, with high coverage;
PP2
Missense variant in the TPM1 gene, where missense mutations are typically associated with disease (based on misZ statistic). The gene has 42 curated pathogenic missense variants (we use a threshold of 10). The gene has 25 curated benign missense variants. Gene score misZ: 2.8677 (below the threshold of 3.09). Trascript score misZ: 3.9402 (above the threshold of 3.09). GenCC associations: The gene is linked to dilated cardiomyopathy, left ventricular noncompaction, hypertrophic cardiomyopathy, hypertrophic cardiomyopathy 3, arrhythmogenic right ventricular cardiomyopathy, familial isolated dilated cardiomyopathy, dilated cardiomyopathy 1Y.
PP3
MetaRNN computational evidence supports a deleterious effect, 0.885
PP5
Variant 15-63062219-C-T is Pathogenic according to our data. Variant chr15-63062219-C-T is described in ClinVar as [Likely_pathogenic]. Clinvar id is 31883.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr15-63062219-C-T is described in Lovd as [Pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
TPM1NM_001018005.2 linkc.644C>T p.Ser215Leu missense_variant Exon 7 of 10 ENST00000403994.9 NP_001018005.1 P09493-1D9YZV4

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
TPM1ENST00000403994.9 linkc.644C>T p.Ser215Leu missense_variant Exon 7 of 10 1 NM_001018005.2 ENSP00000385107.4 P09493-1

Frequencies

GnomAD3 genomes
AF:
0.00000657
AC:
1
AN:
152094
Hom.:
0
Cov.:
33
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:
0.0000147
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.00000398
AC:
1
AN:
251270
Hom.:
0
AF XY:
0.00000736
AC XY:
1
AN XY:
135792
show subpopulations
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 SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00000881
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
6.84e-7
AC:
1
AN:
1461748
Hom.:
0
Cov.:
31
AF XY:
0.00
AC XY:
0
AN XY:
727182
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.0000224
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.00
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.00
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
AF:
0.00000657
AC:
1
AN:
152094
Hom.:
0
Cov.:
33
AF XY:
0.00
AC XY:
0
AN XY:
74270
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.0000147
Gnomad4 OTH
AF:
0.00
ExAC
AF:
0.00000824
AC:
1

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:9Other:1
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Pathogenic:2Other:1
Aug 12, 2024
GeneDx
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Not observed at significant frequency in large population cohorts (gnomAD); Published in vitro functional studies demonstrated that p.(S215L) caused significantly reduced actin binding and increased calcium sensitivity, thus affecting the contractile properties of the tropomyosin protein (PMID: 25548289, 36896133); 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: 18403758, 23204897, 23700264, 26936621, 27600940, 25607779, 27532257, 29121657, 25548289, 31737537, 33673806, 36896133, 38958565, 37652022, 34011823, 36158814) -

Apr 15, 2012
Leiden Muscular Dystrophy (TPM1)
Significance: not provided
Review Status: no classification provided
Collection Method: curation

- -

Aug 17, 2016
Stanford Center for Inherited Cardiovascular Disease, Stanford University
Significance: Likely pathogenic
Review Status: no assertion criteria provided
Collection Method: provider interpretation

- -

Cardiomyopathy Pathogenic:2
Aug 01, 2017
CHEO Genetics Diagnostic Laboratory, Children's Hospital of Eastern Ontario
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

-
Evolutionary and Medical Genetics Laboratory, Centre for Cellular and Molecular Biology
Significance: Likely pathogenic
Review Status: no assertion criteria provided
Collection Method: literature only

- -

Hypertrophic cardiomyopathy Pathogenic:2
Nov 02, 2020
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The p.Ser215Leu variant in TPM1 has been reported in at least 7 individuals with HCM and segregated with disease in 6 individuals from 3 families (Morita 2008 PMID: 18403758, Rangaraju 2012 PMID: 23204897, Selvi Rani 2015 PMID: 25607779, Cecconi 2016 PMID: 27600940, Walsh 2017 PMID: 27532257, Viswanathan 2017 PMID: 29121657, Bales 2016 PMID: 26936621). In at least three families with early onset disease, this variant was identified in conjunction with a second pathogenic variant associated to cardiomyopathy, and one individual had cardiomyopathy while only harboring the second variant and not the p.Ser215Leu variant. This variant has also been reported by other clinical laboratories in ClinVar (Variation ID 31883) and has also been identified in 0.0009% (1/113564) of European chromosomes by gnomAD (https://gnomad.broadinstitute.org/). In vitro functional studies provide some evidence that this variant impacts protein function (Gupte 2015 PMID: 25548289); and computational prediction tools and conservation analyses suggest that this variant may impact the protein. In summary, although additional studies are required to fully establish its clinical significance, this variant meets criteria to be classified as likely pathogenic for autosomal dominant hypertrophic cardiomyopathy. ACMG/AMP Criteria applied: PM2_supporting, PS4_Moderate, PP3, PS3_Supporting, PP1_Moderate. -

Jan 29, 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 215 of the TPM1 protein (p.Ser215Leu). This variant is present in population databases (rs199476316, gnomAD 0.0009%). This missense change has been observed in individuals with hypertrophic cardiomyopathy (HCM) (PMID: 18403758, 23204897, 25607779, 27600940). It has also been observed to segregate with disease in related individuals. ClinVar contains an entry for this variant (Variation ID: 31883). An algorithm developed to predict the effect of missense changes on protein structure and function (PolyPhen-2) suggests that this variant is likely to be disruptive. Experimental studies have shown that this missense change affects TPM1 function (PMID: 23700264, 25548289). For these reasons, this variant has been classified as Pathogenic. -

Dilated cardiomyopathy 1Y Pathogenic:1
-
KTest Genetics, KTest
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Primary familial hypertrophic cardiomyopathy Pathogenic:1
Sep 28, 2015
Blueprint Genetics
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Cardiovascular phenotype Pathogenic:1
Apr 24, 2024
Ambry Genetics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The p.S215L pathogenic mutation (also known as c.644C>T), located in coding exon 7 of the TPM1 gene, results from a C to T substitution at nucleotide position 644. The serine at codon 215 is replaced by leucine, an amino acid with dissimilar properties. This variant has been reported in multiple individuals with hypertrophic cardiomyopathy, and has been found to co-segregate with disease (Morita H et al. N. Engl. J. Med. 2008;358:1899-908, Rangaraju A et al. Exp Clin. Cardiol. 2012;17:26-9, Selvi Rani D et al. DNA Cell Biol. 2015;34:350-9, Bales ND et al. Pediatr. Cardiol. 2016;37:845-51). Patients who harbored this variant in the compound heterozygous state were noted to be more severely affected (Selvi Rani D et al. DNA Cell Biol. 2015;34:350-9). In an assay testing TPM1 function, this variant showed a functionally abnormal result (Gupte TM et al. J. Biol. Chem. 2015;290:7003-15). This amino acid position is highly conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. This variant is considered to be rare based on population cohorts in the Genome Aggregation Database (gnomAD). Based on the supporting evidence, this alteration is interpreted as a disease-causing mutation. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Uncertain
0.41
CardioboostCm
Pathogenic
0.96
BayesDel_addAF
Pathogenic
0.57
D
BayesDel_noAF
Pathogenic
0.58
CADD
Pathogenic
32
DANN
Pathogenic
1.0
DEOGEN2
Pathogenic
0.97
.;.;D;D;.;.;.;.;.;.;D;.;.;.;D;D
Eigen
Pathogenic
0.81
Eigen_PC
Pathogenic
0.81
FATHMM_MKL
Pathogenic
0.98
D
LIST_S2
Uncertain
0.97
D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D
M_CAP
Uncertain
0.24
D
MetaRNN
Pathogenic
0.88
D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D
MetaSVM
Pathogenic
1.1
D
MutationAssessor
Pathogenic
3.2
M;M;M;.;M;M;M;M;.;.;.;.;.;.;.;.
PrimateAI
Uncertain
0.70
T
PROVEAN
Pathogenic
-4.4
D;D;D;D;D;D;D;.;.;D;D;.;D;D;D;D
REVEL
Pathogenic
0.87
Sift
Benign
0.047
D;D;D;D;D;D;D;.;.;D;D;.;D;D;D;D
Sift4G
Benign
0.13
T;T;T;T;T;T;T;.;.;T;T;.;T;T;T;T
Polyphen
0.91, 0.99, 0.74, 1.0
.;.;P;D;.;.;.;P;.;.;.;.;.;D;.;.
Vest4
0.90
MutPred
0.67
.;.;.;Loss of phosphorylation at S257 (P = 0.0094);.;.;.;.;.;.;.;.;.;.;.;.;
MVP
0.97
MPC
2.2
ClinPred
0.99
D
GERP RS
6.0
RBP_binding_hub_radar
1.0
RBP_regulation_power_radar
2.7
Varity_R
0.49
gMVP
0.90

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.030
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: rs199476316; hg19: chr15-63354418; API