chr2-178725602-C-T

Variant names:

Variant summary

Our verdict is Benign. The variant received -20 ACMG points: 0P and 20B. BP4_StrongBP6_Very_StrongBS1BS2

The NM_001267550.2(TTN):c.20602G>A(p.Gly6868Arg) variant causes a missense change. The variant allele was found at a frequency of 0.0158 in 1,608,306 control chromosomes in the GnomAD database, including 239 homozygotes. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Likely benign (★★).

Frequency

Genomes: 𝑓 0.012 ( 21 hom., cov: 33)

Exomes 𝑓: 0.016 ( 218 hom. )

Consequence

TTN
NM_001267550.2 missense

Scores

Clinical Significance

Benign/Likely benign criteria provided, multiple submitters, no conflicts B:26

Conservation

PhyloP100: 5.85

Publications

14 publications found

Variant links:

Genes affected

TTN (HGNC:12403): (titin) This gene encodes a large abundant protein of striated muscle. The product of this gene is divided into two regions, a N-terminal I-band and a C-terminal A-band. The I-band, which is the elastic part of the molecule, contains two regions of tandem immunoglobulin domains on either side of a PEVK region that is rich in proline, glutamate, valine and lysine. The A-band, which is thought to act as a protein-ruler, contains a mixture of immunoglobulin and fibronectin repeats, and possesses kinase activity. An N-terminal Z-disc region and a C-terminal M-line region bind to the Z-line and M-line of the sarcomere, respectively, so that a single titin molecule spans half the length of a sarcomere. Titin also contains binding sites for muscle associated proteins so it serves as an adhesion template for the assembly of contractile machinery in muscle cells. It has also been identified as a structural protein for chromosomes. Alternative splicing of this gene results in multiple transcript variants. Considerable variability exists in the I-band, the M-line and the Z-disc regions of titin. Variability in the I-band region contributes to the differences in elasticity of different titin isoforms and, therefore, to the differences in elasticity of different muscle types. Mutations in this gene are associated with familial hypertrophic cardiomyopathy 9, and autoantibodies to titin are produced in patients with the autoimmune disease scleroderma. [provided by RefSeq, Feb 2012]

TTN links:

ENSG00000267784 (HGNC:):

ENSG00000267784 links:

TTN-AS1 (HGNC:44124): (TTN antisense RNA 1) This gene encodes a non-coding RNA transcribed from the opposite strand to the titin gene. [provided by RefSeq, Aug 2016]

TTN-AS1 links:

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Benign. The variant received -20 ACMG points.

BP4

Computational evidence support a benign effect (MetaRNN=0.007750064).

BP6

Variant 2-178725602-C-T is Benign according to our data. Variant chr2-178725602-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46672.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178725602-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46672.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178725602-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46672.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178725602-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46672.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178725602-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46672.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178725602-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46672.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178725602-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46672.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178725602-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46672.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178725602-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46672.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178725602-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46672.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178725602-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46672.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178725602-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46672.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178725602-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46672.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178725602-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46672.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178725602-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46672.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178725602-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46672.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178725602-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46672.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178725602-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46672.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178725602-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46672.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178725602-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46672.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

BS1

Variant frequency is greater than expected in population nfe. GnomAd4 allele frequency = 0.0116 (1767/152168) while in subpopulation NFE AF = 0.0177 (1204/67990). AF 95% confidence interval is 0.0169. There are 21 homozygotes in GnomAd4. There are 805 alleles in the male GnomAd4 subpopulation. Median coverage is 33. This position passed quality control check.

BS2

High Homozygotes in GnomAd4 at 21 AD,AR gene

Transcripts

RefSeq

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	MANE	Protein	UniProt
TTN	NM_001267550.2 link	c.20602G>A	p.Gly6868Arg	missense_variant	Exon 71 of 363	ENST00000589042.5	NP_001254479.2	A0A0A0MTS7

Ensembl

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	TSL	MANE	Protein	Appris	UniProt
TTN	ENST00000589042.5 link	c.20602G>A	p.Gly6868Arg	missense_variant	Exon 71 of 363	5	NM_001267550.2	ENSP00000467141.1		A0A0A0MTS7

Frequencies

GnomAD3 genomes

AF:

0.0116

AC:

1769

AN:

152050

Hom.:

Cov.:

show subpopulations

Gnomad AFR

AF:

0.00326

Gnomad AMI

AF:

0.0396

Gnomad AMR

AF:

0.0109

Gnomad ASJ

AF:

0.0115

Gnomad EAS

AF:

0.00

Gnomad SAS

AF:

0.00810

Gnomad FIN

AF:

0.0105

Gnomad MID

AF:

0.00

Gnomad NFE

AF:

0.0177

Gnomad OTH

AF:

0.0172

GnomAD2 exomes

AF:

0.0118

AC:

2870

AN:

243616

AF XY:

0.0121

show subpopulations

Gnomad AFR exome

AF:

0.00273

Gnomad AMR exome

AF:

0.00522

Gnomad ASJ exome

AF:

0.00890

Gnomad EAS exome

AF:

0.00

Gnomad FIN exome

AF:

0.0129

Gnomad NFE exome

AF:

0.0179

Gnomad OTH exome

AF:

0.0158

GnomAD4 exome

AF:

0.0162

AC:

23591

AN:

1456138

Hom.:

218

Cov.:

AF XY:

0.0160

AC XY:

11547

AN XY:

723872

show subpopulations

African (AFR)

AF:

0.00256

AC:

AN:

33262

American (AMR)

AF:

0.00668

AC:

296

AN:

44292

Ashkenazi Jewish (ASJ)

AF:

0.00943

AC:

243

AN:

25764

East Asian (EAS)

AF:

0.0000505

AC:

AN:

39608

South Asian (SAS)

AF:

0.00787

AC:

670

AN:

85118

European-Finnish (FIN)

AF:

0.0133

AC:

705

AN:

53172

Middle Eastern (MID)

AF:

0.0124

AC:

AN:

5726

European-Non Finnish (NFE)

AF:

0.0185

AC:

20571

AN:

1109102

Other (OTH)

AF:

0.0158

AC:

948

AN:

60094

Allele Balance Distribution

Red line indicates average allele balance

Average allele balance: 0.484

Heterozygous variant carriers

1353

2705

4058

5410

6763

0.00

0.20

0.40

0.60

0.80

0.95

Allele balance

Age Distribution

Exome Het

Exome Hom

Variant carriers

776

1552

2328

3104

3880

<30

30-35

35-40

40-45

45-50

50-55

55-60

60-65

65-70

70-75

75-80

>80

Age

GnomAD4 genome

AF:

0.0116

AC:

1767

AN:

152168

Hom.:

Cov.:

AF XY:

0.0108

AC XY:

805

AN XY:

74392

show subpopulations

African (AFR)

AF:

0.00325

AC:

135

AN:

41552

American (AMR)

AF:

0.0109

AC:

167

AN:

15272

Ashkenazi Jewish (ASJ)

AF:

0.0115

AC:

AN:

3468

East Asian (EAS)

AF:

0.00

AC:

AN:

5168

South Asian (SAS)

AF:

0.00790

AC:

AN:

4810

European-Finnish (FIN)

AF:

0.0105

AC:

111

AN:

10594

Middle Eastern (MID)

AF:

0.00

AC:

AN:

294

European-Non Finnish (NFE)

AF:

0.0177

AC:

1204

AN:

67990

Other (OTH)

AF:

0.0171

AC:

AN:

2110

Allele Balance Distribution

Red line indicates average allele balance

Average allele balance: 0.501

Heterozygous variant carriers

176

263

351

439

0.00

0.20

0.40

0.60

0.80

0.95

Allele balance

Age Distribution

Genome Het

Genome Hom

Variant carriers

100

<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:

0.0154

Hom.:

Bravo

AF:

0.0118

TwinsUK

AF:

0.0210

AC:

ALSPAC

AF:

0.0228

AC:

ESP6500AA

AF:

0.00349

AC:

ESP6500EA

AF:

0.0173

AC:

142

ExAC

AF:

0.0112

AC:

1355

Asia WGS

AF:

0.00462

AC:

AN:

3476

ClinVar

Significance: Benign/Likely benign

Submissions summary: Benign:26

Revision: criteria provided, multiple submitters, no conflicts

LINK: link

Submissions by phenotype

not specified

Benign:10

Apr 06, 2017

Eurofins Ntd Llc (ga)

Significance:Benign

Review Status:criteria provided, single submitter

Collection Method:clinical testing

- -

Jul 03, 2013

GeneDx

Significance:Benign

Review Status:criteria provided, single submitter

Collection Method:clinical testing

This variant is considered likely benign or benign based on one or more of the following criteria: it is a conservative change, it occurs at a poorly conserved position in the protein, it is predicted to be benign by multiple in silico algorithms, and/or has population frequency not consistent with disease. -

Jun 24, 2013

Biesecker Lab/Clinical Genomics Section, National Institutes of Health

Significance:Benign

Review Status:criteria provided, single submitter

Collection Method:research

- -

Joint Genome Diagnostic Labs from Nijmegen and Maastricht, Radboudumc and MUMC+

Significance:Benign

Review Status:no assertion criteria provided

Collection Method:clinical testing

- -

PreventionGenetics, part of Exact Sciences

Significance:Benign

Review Status:criteria provided, single submitter

Collection Method:clinical testing

- -

Clinical Genetics, Academic Medical Center

Significance:Benign

Review Status:no assertion criteria provided

Collection Method:clinical testing

- -

Apr 18, 2020

Women's Health and Genetics/Laboratory Corporation of America, LabCorp

Significance:Likely benign

Review Status:criteria provided, single submitter

Collection Method:clinical testing

- -

Apr 09, 2025

Molecular Diagnostic Laboratory for Inherited Cardiovascular Disease, Montreal Heart Institute

Significance:Benign

Review Status:criteria provided, single submitter

Collection Method:clinical testing

- -

Mar 22, 2012

Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine

Significance:Benign

Review Status:criteria provided, single submitter

Collection Method:clinical testing

Gly5624Arg in exon 68 of TTN: This variant is not expected to have clinical sign ificance because it has been identified in 1.7% (112/6604) of European American chromosomes from a broad population by the NHLBI Exome Sequencing Project (http: //evs.gs.washington.edu/EVS; dbSNP rs17355460). -

Clinical Genetics DNA and cytogenetics Diagnostics Lab, Erasmus MC, Erasmus Medical Center

Significance:Benign

Review Status:no assertion criteria provided

Collection Method:clinical testing

- -

not provided

Benign:5

Breakthrough Genomics, Breakthrough Genomics

Significance:Likely benign

Review Status:criteria provided, single submitter

Collection Method:not provided

- -

Diagnostic Laboratory, Department of Genetics, University Medical Center Groningen

Significance:Likely benign

Review Status:no assertion criteria provided

Collection Method:clinical testing

- -

Nov 29, 2023

ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories

Significance:Benign

Review Status:criteria provided, single submitter

Collection Method:clinical testing

- -

Laboratory of Diagnostic Genome Analysis, Leiden University Medical Center (LUMC)

Significance:Likely benign

Review Status:no assertion criteria provided

Collection Method:clinical testing

- -

Jun 01, 2025

CeGaT Center for Human Genetics Tuebingen

Significance:Benign

Review Status:criteria provided, single submitter

Collection Method:clinical testing

TTN: BS1, BS2 -

Autosomal recessive limb-girdle muscular dystrophy type 2J

Benign:2

Sep 10, 2021

Genome-Nilou Lab

Significance:Benign

Review Status:criteria provided, single submitter

Collection Method:clinical testing

- -

Jan 13, 2018

Illumina Laboratory Services, Illumina

Significance:Likely benign

Review Status:criteria provided, single submitter

Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as likely benign is not then subjected to further curation. The score for this variant resulted in a classification of likely benign for this disease. -

Early-onset myopathy with fatal cardiomyopathy

Benign:2

Sep 10, 2021

Genome-Nilou Lab

Significance:Benign

Review Status:criteria provided, single submitter

Collection Method:clinical testing

- -

Jan 13, 2018

Illumina Laboratory Services, Illumina

Significance:Likely benign

Review Status:criteria provided, single submitter

Collection Method:clinical testing

Tibial muscular dystrophy

Benign:2

Jan 13, 2018

Illumina Laboratory Services, Illumina

Significance:Benign

Review Status:criteria provided, single submitter

Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as benign is not then subjected to further curation. The score for this variant resulted in a classification of benign for this disease. -

Sep 10, 2021

Genome-Nilou Lab

Significance:Benign

Review Status:criteria provided, single submitter

Collection Method:clinical testing

- -

Myopathy, myofibrillar, 9, with early respiratory failure

Benign:2

Sep 10, 2021

Genome-Nilou Lab

Significance:Benign

Review Status:criteria provided, single submitter

Collection Method:clinical testing

- -

Jan 13, 2018

Illumina Laboratory Services, Illumina

Significance:Benign

Review Status:criteria provided, single submitter

Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as benign is not then subjected to further curation. The score for this variant resulted in a classification of benign for this disease. -

Autosomal recessive limb-girdle muscular dystrophy type 2J;C1858763:Dilated cardiomyopathy 1G

Benign:1

Feb 04, 2025

Labcorp Genetics (formerly Invitae), Labcorp

Significance:Benign

Review Status:criteria provided, single submitter

Collection Method:clinical testing

- -

Dilated cardiomyopathy 1G

Benign:1

Jan 13, 2018

Illumina Laboratory Services, Illumina

Significance:Likely benign

Review Status:criteria provided, single submitter

Collection Method:clinical testing

Cardiovascular phenotype

Benign:1

Jan 08, 2013

Ambry Genetics

Significance:Benign

Review Status:criteria provided, single submitter

Collection Method:clinical testing

This alteration is classified as benign based on a combination of the following: population frequency, intact protein function, lack of segregation with disease, co-occurrence, RNA analysis, in silico models, amino acid conservation, lack of disease association in case-control studies, and/or the mechanism of disease or impacted region is inconsistent with a known cause of pathogenicity. -

Computational scores

Source: dbNSFP v4.3

Name

Calibrated prediction

Score

Prediction

AlphaMissense

Uncertain

0.41

BayesDel_addAF

Benign

-0.32

BayesDel_noAF

Benign

-0.22

CADD

Uncertain

(source)

DANN

Benign

0.85

Eigen

Pathogenic

0.86

Eigen_PC

Pathogenic

0.76

FATHMM_MKL

Pathogenic

0.98

LIST_S2

Benign

0.85

T;D;.;T

MetaRNN

Benign

0.0078

T;T;T;T

MetaSVM

Uncertain

0.56

PhyloP100

5.9

PrimateAI

Uncertain

0.64

PROVEAN

Pathogenic

-4.6

D;.;.;.

REVEL

Uncertain

0.60

Sift

Benign

0.085

T;.;.;.

Polyphen

1.0

.;.;D;D

Vest4

0.18

MutPred

0.78

.;.;Loss of catalytic residue at A6550 (P = 0.0402);Loss of catalytic residue at A6550 (P = 0.0402);

MPC

0.50

ClinPred

0.038

GERP RS

5.9

Mutation Taster

=29/71

disease causing

(source)

Splicing

Name

Calibrated prediction

Score

Prediction

SpliceAI score (max)

0.040

Details are displayed if max score is > 0.2

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Publications

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Variant summary

Frequency

Consequence

Scores

Clinical Significance

Conservation

Publications

ACMG classification

Transcripts

RefSeq

Ensembl

Frequencies

Age Distribution

Age Distribution

ClinVar

Submissions by phenotype

Computational scores

Splicing

Publications

Other links and lift over