chr19-49861765-ACGCTACCTGG-A
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Variant summary
Our verdict is Pathogenic. Variant got 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong
The NM_007254.4(PNKP):c.1295_1298+6del variant causes a splice donor, splice donor 5th base, coding sequence, intron change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.000046 in 1,566,646 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Likely pathogenic (★★).
Frequency
Genomes: 𝑓 0.000033 ( 0 hom., cov: 32)
Exomes 𝑓: 0.000047 ( 0 hom. )
Consequence
PNKP
NM_007254.4 splice_donor, splice_donor_5th_base, coding_sequence, intron
NM_007254.4 splice_donor, splice_donor_5th_base, coding_sequence, intron
Scores
Not classified
Clinical Significance
Conservation
PhyloP100: 3.56
Genes affected
PNKP (HGNC:9154): (polynucleotide kinase 3'-phosphatase) This locus represents a gene involved in DNA repair. In response to ionizing radiation or oxidative damage, the protein encoded by this locus catalyzes 5' phosphorylation and 3' dephosphorylation of nucleic acids. Mutations at this locus have been associated with microcephaly, seizures, and developmental delay.[provided by RefSeq, Sep 2010]
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ACMG classification
Classification made for transcript
Verdict is Pathogenic. Variant got 18 ACMG points.
PVS1
Splicing +-2 bp (donor or acceptor) variant, LoF is a know mechanism of disease, Cryptic splice site detected, with MaxEntScore 5, offset of 19, new splice context is: gccGTaggt. Cryptic site results in frameshift change. If cryptic site found is not functional and variant results in exon loss, it results in frameshift change.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 19-49861765-ACGCTACCTGG-A is Pathogenic according to our data. Variant chr19-49861765-ACGCTACCTGG-A is described in ClinVar as [Likely_pathogenic]. Clinvar id is 159788.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
Transcripts
RefSeq
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | MANE | Protein | UniProt |
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PNKP | NM_007254.4 | c.1295_1298+6del | splice_donor_variant, splice_donor_5th_base_variant, coding_sequence_variant, intron_variant | 14/17 | ENST00000322344.8 | NP_009185.2 |
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | TSL | MANE | Protein | Appris | UniProt |
---|---|---|---|---|---|---|---|---|---|---|
PNKP | ENST00000322344.8 | c.1295_1298+6del | splice_donor_variant, splice_donor_5th_base_variant, coding_sequence_variant, intron_variant | 14/17 | 1 | NM_007254.4 | ENSP00000323511 | P1 |
Frequencies
GnomAD3 genomes AF: 0.0000329 AC: 5AN: 152120Hom.: 0 Cov.: 32
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GnomAD3 exomes AF: 0.0000683 AC: 12AN: 175710Hom.: 0 AF XY: 0.0000848 AC XY: 8AN XY: 94316
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GnomAD4 exome AF: 0.0000474 AC: 67AN: 1414526Hom.: 0 AF XY: 0.0000586 AC XY: 41AN XY: 699848
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GnomAD4 genome AF: 0.0000329 AC: 5AN: 152120Hom.: 0 Cov.: 32 AF XY: 0.0000269 AC XY: 2AN XY: 74298
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ClinVar
Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:7
Revision: criteria provided, multiple submitters, no conflicts
LINK: link
Submissions by phenotype
not provided Pathogenic:3
Pathogenic, criteria provided, single submitter | clinical testing | Revvity Omics, Revvity | Apr 06, 2021 | - - |
Pathogenic, criteria provided, single submitter | clinical testing | GeneDx | Sep 19, 2013 | The c.1295_1298+6delCCAGGTAGCG mutation in the PNKP gene results in the deletion of ten nucleotides at the exon 14/intron 14 boundary, thereby destroying the canonical splice donor site in intron 14. It is predicted to cause abnormal gene splicing, either leading to an abnormal message that is subject to nonsense-mediated mRNA decay or to an abnormal protein product if the message is used for protein translation. Although this mutation has not been previously reported to our knowledge, it is considered a disease-causing mutation.The variant is found in CHILD-EPI,EPILEPSY panel(s). - |
Likely pathogenic, criteria provided, single submitter | clinical testing | Eurofins Ntd Llc (ga) | Jun 28, 2016 | - - |
Ataxia, early-onset, with oculomotor apraxia and hypoalbuminemia Pathogenic:1
Pathogenic, criteria provided, single submitter | clinical testing | Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine | Dec 19, 2023 | The c.1295_1298+6del (NM_007254.3 c.1295_1298+6delCCAGGTAGCG) variant in PNKP has been reported in the compound heterozygous state in 1 individual with microcephaly with early onset seizures (MCSZ), in 1 individual with motor neuropathy, and in 2 individuals with ataxia with oculomotor apraxia and segregated with disease in 2 affected relatives from 1 family (Previtali 2019 PMID: 31167812, Kalasova 2019 PMID: 31041400, da Costa 2022 PMID: 35426160). This variant has also been reported by other clinical laboratories in ClinVar (Variation ID 159788) and has been identified in 0.06% (3/4832) of South Asian and 0.0029% (2/68006) of European chromosomes by gnomAD (http://gnomad.broadinstitute.org, v.3.1.2). This variant is a deletion of ten nucleotides at the exon 14/intron 14 boundary, thereby destroying the canonical splice donor site in intron 14. It is predicted to cause altered splicing, leading to an abnormal or absent protein. Biallelic loss of function of the PNKP gene has been associated with ataxia with oculomotor apraxia. Functional studies in patient fibroblasts provide some evidence that this variant reduced protein expression and activity and were more susceptible to single strand breaks due to reduced repair activity (Kalasova 2019 PMID: 31041400, Kalasova 2020 PMID: 32504494). In summary, the c.1295_1298+6delCCAGGTAGCG variant in PNKP meets criteria to be classified as pathogenic for PNKP-related disorders, such as autosomal recessive ataxia with oculomotor apraxia, and autosomal recessive microcephaly, seizures and developmental delay. ACMG/AMP Criteria applied: PVS1, PM3_Strong, PP1, PS3_Supporting. - |
Microcephaly, seizures, and developmental delay Pathogenic:1
Pathogenic, criteria provided, single submitter | clinical testing | Genetic Services Laboratory, University of Chicago | Jun 05, 2014 | - - |
PNKP-related disorder Pathogenic:1
Pathogenic, criteria provided, single submitter | clinical testing | Women's Health and Genetics/Laboratory Corporation of America, LabCorp | Jun 06, 2024 | Variant summary: PNKP c.1295_1298+6del10 is located in a canonical splice-site and is predicted to affect mRNA splicing resulting in a significantly altered protein due to either exon skipping, shortening, or inclusion of intronic material. Several computational tools predict a significant impact on normal splicing: Three predict the variant abolishes a 5' splicing donor site. The variant allele was found at a frequency of 6.8e-05 in 175710 control chromosomes (gnomAD). This frequency is not significantly higher than estimated for a pathogenic variant in PNKP causing PNKP-Related Disorders, allowing no conclusion about variant significance. The variant, c.1295_1298+6del10, has been reported in the literature in multiple individuals affected with PNKP-Related Disorders ranging from microcephaly with early onset seizures to oculomotor apraxia and Charcot-Marie-Tooth type 2 (CMT2) disease (e.g. Previtali_2019, Kalasova_2020, daCosta_2022). These data indicate that the variant is very likely to be associated with disease. At least one publication reports experimental evidence evaluating an impact on protein function, and demonstrated strongly reduced protein level and reduced function in patient derived cells (Kalasova_2020). The following publications have been ascertained in the context of this evaluation (PMID: 31167812, 32504494, 35426160). ClinVar contains an entry for this variant (Variation ID: 159788). Based on the evidence outlined above, the variant was classified as pathogenic. - |
Developmental and epileptic encephalopathy, 12 Pathogenic:1
Pathogenic, criteria provided, single submitter | clinical testing | Labcorp Genetics (formerly Invitae), Labcorp | Dec 04, 2023 | This variant results in the deletion of part of exon 14 (c.1295_1298+6del) of the PNKP gene. It is expected to disrupt RNA splicing. Variants that disrupt the donor or acceptor splice site typically lead to a loss of protein function (PMID: 16199547), and loss-of-function variants in PNKP are known to be pathogenic (PMID: 20118933, 25728773). This variant is present in population databases (rs587784366, gnomAD 0.03%). This variant has been observed in individual(s) with PNKP-related conditions (PMID: 31167812). It has also been observed to segregate with disease in related individuals. ClinVar contains an entry for this variant (Variation ID: 159788). Algorithms developed to predict the effect of variants on protein structure and function are not available or were not evaluated for this variant. Experimental studies have shown that this variant affects PNKP function (PMID: 32504494). For these reasons, this variant has been classified as Pathogenic. - |
Computational scores
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Find out detailed SpliceAI scores and Pangolin per-transcript scores at