chr17-44350800-CGTGA-C

Variant summary

Our verdict is Pathogenic. Variant got 10 ACMG points: 10P and 0B. PVS1_ModeratePP5_Very_Strong

The NM_002087.4(GRN):​c.708+6_708+9del variant causes a splice donor, splice donor region, intron change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0000282 in 1,453,738 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Likely pathogenic (★★).

Frequency

Genomes: not found (cov: 33)
Exomes 𝑓: 0.000028 ( 0 hom. )

Consequence

GRN
NM_002087.4 splice_donor, splice_donor_region, intron

Scores

Not classified

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:6

Conservation

PhyloP100: 7.22
Variant links:
Genes affected
GRN (HGNC:4601): (granulin precursor) Granulins are a family of secreted, glycosylated peptides that are cleaved from a single precursor protein with 7.5 repeats of a highly conserved 12-cysteine granulin/epithelin motif. The 88 kDa precursor protein, progranulin, is also called proepithelin and PC cell-derived growth factor. Cleavage of the signal peptide produces mature granulin which can be further cleaved into a variety of active, 6 kDa peptides. These smaller cleavage products are named granulin A, granulin B, granulin C, etc. Epithelins 1 and 2 are synonymous with granulins A and B, respectively. Both the peptides and intact granulin protein regulate cell growth. However, different members of the granulin protein family may act as inhibitors, stimulators, or have dual actions on cell growth. Granulin family members are important in normal development, wound healing, and tumorigenesis. [provided by RefSeq, Jul 2008]

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ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 10 ACMG points.

PVS1
Splicing +-2 bp (donor or acceptor) variant, product NOT destroyed by NMD, known LOF gene, truncates exone, which is 0.06116723 fraction of the gene. Cryptic splice site detected, with MaxEntScore 5.3, offset of 0 (no position change), new splice context is: aacGTgagg. Cryptic site results in inframe change. If cryptic site found is not functional and variant results in exon loss, it results in frameshift change.
PP5
Variant 17-44350800-CGTGA-C is Pathogenic according to our data. Variant chr17-44350800-CGTGA-C is described in ClinVar as [Likely_pathogenic]. Clinvar id is 586221.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE UniProt
GRNNM_002087.4 linkuse as main transcriptc.708+6_708+9del splice_donor_variant, splice_donor_region_variant, intron_variant ENST00000053867.8

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Appris UniProt
GRNENST00000053867.8 linkuse as main transcriptc.708+6_708+9del splice_donor_variant, splice_donor_region_variant, intron_variant 1 NM_002087.4 P1P28799-1

Frequencies

GnomAD3 genomes
Cov.:
33
GnomAD3 exomes
AF:
0.00000798
AC:
2
AN:
250578
Hom.:
0
AF XY:
0.0000148
AC XY:
2
AN XY:
135550
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:
0.0000177
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000282
AC:
41
AN:
1453738
Hom.:
0
AF XY:
0.0000221
AC XY:
16
AN XY:
723766
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.00
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:
0.0000362
Gnomad4 OTH exome
AF:
0.0000166
GnomAD4 genome
Cov.:
33
Bravo
AF:
0.0000151
EpiCase
AF:
0.00
EpiControl
AF:
0.0000593

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:6
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Pathogenic:3
Likely pathogenic, criteria provided, single submitterclinical testingCeGaT Center for Human Genetics TuebingenNov 01, 2017- -
Likely pathogenic, criteria provided, single submitterclinical testingGeneDxOct 27, 2022Reported previously in a patient with Alzheimers disease; however, no further clinical information was provided (Guven et al., 2016); Published functional studies demonstrate that the variant causes aberrant RNA splicing and reduction in PGRN mRNA, most likely through NMD of the mutant mRNA (Skoglund et al., 2011); Not observed at significant frequency in large population cohorts (gnomAD); This variant is associated with the following publications: (PMID: 31914217, 20975516, 30475763, 30739198, 27859661, 24709683, 29256051, 32742620, 36264717, 27632209) -
Likely pathogenic, criteria provided, single submitterclinical testingAthena DiagnosticsJun 08, 2018- -
Inborn genetic diseases Pathogenic:1
Likely pathogenic, criteria provided, single submitterclinical testingAmbry GeneticsSep 24, 2018The c.708+6_708+9delTGAG intronic variant, located in intron 6 of the GRN gene, results from a deletion of 4 nucleotides within intron 6 of the GRN gene. This variant was detected in two individuals with frontotemporal lobular degeneration (FTLD) with ubiquitin positive inclusions; analysis in one individual demonstrated a reduction in mRNA levels (83% of wild type) and aberrant splicing (Skoglund L et al. Alzheimer Dis Assoc Disord;25:173-8). In a second study, mRNA levels were 56% and 73%, respectively, in two individuals with FTLD with TAR DNAbinding protein 43-positive inclusions (Bit-Ivan EN et al. J. Neuropathol. Exp. Neurol., 2014 May;73:467-73). In one family, this variant segregated with dementia in 3 affected individuals (Galimberti D et al. Mov. Disord., 2017 03;32:476-478). These nucleotide positions are well conserved in available vertebrate species. Using the BDGP and ESEfinder splice site prediction tools, this alteration is predicted to weaken the efficiency of the native splice donor site; however, direct evidence is unavailable. Based on the majority of available evidence to date, this variant is likely to be pathogenic. -
GRN-related frontotemporal lobar degeneration with Tdp43 inclusions;C3539123:Neuronal ceroid lipofuscinosis 11 Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpDec 18, 2023This sequence change falls in intron 7 of the GRN gene. It does not directly change the encoded amino acid sequence of the GRN protein. RNA analysis indicates that this variant induces altered splicing and may result in an absent or disrupted protein product. This variant is present in population databases (rs778599933, gnomAD 0.002%). This variant has been observed in individuals with autosomal dominant frontotemporal lobar degeneration (PMID: 20975516, 24709683, 27632209, 27859661). This variant is also known as IVS6+5_8delGTGA (g.101707_101710delGTGA) and g.1642_1645delTGAG (IVS7 + 1delTGAG). ClinVar contains an entry for this variant (Variation ID: 586221). Variants that disrupt the consensus splice site are a relatively common cause of aberrant splicing (PMID: 17576681, 9536098). Studies have shown that this variant results in skipping of exon 7 and introduces a premature termination codon (PMID: 20975516). The resulting mRNA is expected to undergo nonsense-mediated decay. For these reasons, this variant has been classified as Pathogenic. -
GRN-related frontotemporal lobar degeneration with Tdp43 inclusions Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingMolecular Genetics, Royal Melbourne HospitalMar 01, 2024This sequence change in GRN is an intronic variant located in intron 7. The highest population minor allele frequency in the population database gnomAD v4.0 is 0.004% (40/1,104,774 alleles) in the European (non-Finnish) population. The prevalence of the variant in individuals with frontotemporal dementia (FTD) is significantly increased compared with the prevalence in controls (PMID: 20975516, 24709683, 27632209, 27859661, 30475763, 31914217, 36264717, 33141172; gnomAD v4.0). The variant has been reported to segregate with FTD in multiple families (PMID: 27859661, 24709683, 30475763). The results from an in silico splicing predictor (SpliceAI) indicate that this variant may impact splicing by disrupting the donor splice site of intron 7 of GRN. This prediction is confirmed by RNA studies in patient cells (PMID: 20975516). Furthermore, progranulin levels in the serum/brain were significantly reduced in individuals with the variant (PMID: 20975516, 24709683, 27859661, 30475763). Based on the classification scheme RMH Modified ACMG/AMP Guidelines v1.6.1, this variant is classified as PATHOGENIC. Following criteria are met: PP1_Strong, PS4, PVS1. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.40
Details are displayed if max score is > 0.2
DS_DG_spliceai
0.28
Position offset: -44
DS_DL_spliceai
0.40
Position offset: 0

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: rs778599933; hg19: chr17-42428168; API