chr2-47798724-AC-A

Variant summary

Our verdict is Pathogenic. The variant received 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong

The NM_000179.3(MSH6):​c.742delC​(p.Arg248GlufsTer31) variant causes a frameshift change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.00000186 in 1,614,098 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Pathogenic (★★). Synonymous variant affecting the same amino acid position (i.e. R248R) has been classified as Likely benign. Variant results in nonsense mediated mRNA decay.

Frequency

Genomes: 𝑓 0.000013 ( 0 hom., cov: 32)
Exomes 𝑓: 6.8e-7 ( 0 hom. )

Consequence

MSH6
NM_000179.3 frameshift

Scores

Not classified

Clinical Significance

Pathogenic criteria provided, multiple submitters, no conflicts P:9

Conservation

PhyloP100: 0.846

Publications

3 publications found
Variant links:
Genes affected
MSH6 (HGNC:7329): (mutS homolog 6) This gene encodes a member of the DNA mismatch repair MutS family. In E. coli, the MutS protein helps in the recognition of mismatched nucleotides prior to their repair. A highly conserved region of approximately 150 aa, called the Walker-A adenine nucleotide binding motif, exists in MutS homologs. The encoded protein heterodimerizes with MSH2 to form a mismatch recognition complex that functions as a bidirectional molecular switch that exchanges ADP and ATP as DNA mismatches are bound and dissociated. Mutations in this gene may be associated with hereditary nonpolyposis colon cancer, colorectal cancer, and endometrial cancer. Transcripts variants encoding different isoforms have been described. [provided by RefSeq, Jul 2013]
FBXO11 (HGNC:13590): (F-box protein 11) This gene encodes a member of the F-box protein family which is characterized by an approximately 40 amino acid motif, the F-box. The F-box proteins constitute one of the four subunits of ubiquitin protein ligase complex called SCFs (SKP1-cullin-F-box), which function in phosphorylation-dependent ubiquitination. The F-box proteins are divided into 3 classes: Fbws containing WD-40 domains, Fbls containing leucine-rich repeats, and Fbxs containing either different protein-protein interaction modules or no recognizable motifs. The protein encoded by this gene belongs to the Fbxs class. It can function as an arginine methyltransferase that symmetrically dimethylates arginine residues, and it acts as an adaptor protein to mediate the neddylation of p53, which leads to the suppression of p53 function. This gene is known to be down-regulated in melanocytes from patients with vitiligo, a skin disorder that results in depigmentation. Polymorphisms in this gene are associated with chronic otitis media with effusion and recurrent otitis media (COME/ROM), a hearing loss disorder, and the knockout of the homologous mouse gene results in the deaf mouse mutant Jeff (Jf), a single gene model of otitis media. Alternatively spliced transcript variants encoding distinct isoforms have been identified for this gene. [provided by RefSeq, Jun 2010]
FBXO11 Gene-Disease associations (from GenCC):
  • intellectual developmental disorder with dysmorphic facies and behavioral abnormalities
    Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: Labcorp Genetics (formerly Invitae), Ambry Genetics, G2P

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Pathogenic. The variant received 18 ACMG points.

PVS1
Loss of function variant, product undergoes nonsense mediated mRNA decay. LoF is a known mechanism of disease.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 2-47798724-AC-A is Pathogenic according to our data. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-47798724-AC-A is described in CliVar as Pathogenic. Clinvar id is 141365.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
MSH6NM_000179.3 linkc.742delC p.Arg248GlufsTer31 frameshift_variant Exon 4 of 10 ENST00000234420.11 NP_000170.1 P52701-1Q3SWU9

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
MSH6ENST00000234420.11 linkc.742delC p.Arg248GlufsTer31 frameshift_variant Exon 4 of 10 1 NM_000179.3 ENSP00000234420.5 P52701-1

Frequencies

GnomAD3 genomes
AF:
0.0000131
AC:
2
AN:
152222
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.0000241
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.0000655
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:
0.00
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.00000398
AC:
1
AN:
251158
AF XY:
0.00000737
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 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:
1461876
Hom.:
0
Cov.:
34
AF XY:
0.00
AC XY:
0
AN XY:
727240
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
33480
American (AMR)
AF:
0.00
AC:
0
AN:
44724
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26136
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39700
South Asian (SAS)
AF:
0.00
AC:
0
AN:
86258
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
53406
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5768
European-Non Finnish (NFE)
AF:
8.99e-7
AC:
1
AN:
1112008
Other (OTH)
AF:
0.00
AC:
0
AN:
60396
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.425
Heterozygous variant carriers
0
0
1
1
2
2
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Variant carriers
0
2
4
6
8
10
<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:
0.0000131
AC:
2
AN:
152222
Hom.:
0
Cov.:
32
AF XY:
0.00
AC XY:
0
AN XY:
74384
show subpopulations
African (AFR)
AF:
0.0000241
AC:
1
AN:
41456
American (AMR)
AF:
0.0000655
AC:
1
AN:
15272
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3472
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5204
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4836
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10624
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
68040
Other (OTH)
AF:
0.00
AC:
0
AN:
2090
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.550
Heterozygous variant carriers
0
0
1
1
2
2
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance
Alfa
AF:
0.00
Hom.:
0

ClinVar

Significance: Pathogenic
Submissions summary: Pathogenic:9
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Pathogenic:2
Mar 17, 2023
GeneDx
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Frameshift variant predicted to result in protein truncation or nonsense mediated decay in a gene for which loss of function is a known mechanism of disease; Not observed at significant frequency in large population cohorts (gnomAD); Truncating variants in this gene are considered pathogenic by a well-established clinical consortium and/or database; Identified in patients with colorectal or breast cancer (AlDubayan et al., 2018; Huang et al., 2018; Lu et al., 2019); This variant is associated with the following publications: (PMID: 28152038, 30787465, 20301390, 24362816, 18269114, 29703791, 30279230, 29478780, 29625052, 29922827, 35070997, 28514183, 30128536) -

Jan 08, 2020
Quest Diagnostics Nichols Institute San Juan Capistrano
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The variant results in a shift of the reading frame, and is therefore predicted to result in the loss of a functional protein. Found in at least one patient with expected phenotype for this gene, and not found in general population data. -

Hereditary cancer-predisposing syndrome Pathogenic:2
Feb 17, 2022
Sema4, Sema4
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:curation

- -

Nov 07, 2024
Ambry Genetics
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The c.742delC pathogenic mutation, located in coding exon 4 of the MSH6 gene, results from a deletion of one nucleotide at nucleotide position 742, causing a translational frameshift with a predicted alternate stop codon (p.R248Efs*31). This alteration was observed in a colorectal cancer cohort (AlDubayan SH et al. Am. J. Hum. Genet. 2018 Mar;102(3):401-414) and in an individual diagnosed with breast cancer (Lu HM et al. JAMA Oncol, 2019 01;5:51-57). In addition to the clinical data presented in the literature, this alteration is expected to result in loss of function by premature protein truncation or nonsense-mediated mRNA decay. As such, this alteration is interpreted as a disease-causing mutation. -

Lynch syndrome 5 Pathogenic:1
Aug 10, 2023
Myriad Genetics, Inc.
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant is considered pathogenic. This variant creates a frameshift predicted to result in premature protein truncation. -

Hereditary nonpolyposis colon cancer Pathogenic:1
Jan 29, 2022
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Variant summary: MSH6 c.742delC (p.Arg248GlufsX31) results in a premature termination codon, predicted to cause a truncation of the encoded protein or absence of the protein due to nonsense mediated decay, which are commonly known mechanisms for disease. Truncations downstream of this position have been classified as pathogenic by our laboratory. The variant allele was found at a frequency of 4e-06 in 251158 control chromosomes. c.742delC has been reported in the literature in individuals affected with Hereditary cancers/colorectal cancers (example, Espenschied_2017, LaDuca_2017, AlDubayan_2018). These data indicate that the variant is likely to be associated with disease. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. Four clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 without evidence for independent evaluation. All laboratories classified the variant as pathogenic. Based on the evidence outlined above, the variant was classified as pathogenic. -

Lynch syndrome Pathogenic:1
Oct 23, 2023
All of Us Research Program, National Institutes of Health
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant deletes 1 nucleotide in exon 4 of the MSH6 gene, creating a premature translation stop signal. This variant is expected to result in an absent or non-functional protein product. This variant has been observed in individuals affected with breast, colorectal, and unspecified cancers (PMID: 29478780, 29625052, 30128536, 35070997). This variant has been identified in 2/282566 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Loss of MSH6 function is a known mechanism of disease (clinicalgenome.org). Based on the available evidence, this variant is classified as Pathogenic. -

Hereditary nonpolyposis colorectal neoplasms Pathogenic:1
Jan 20, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence change creates a premature translational stop signal (p.Arg248Glufs*31) in the MSH6 gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in MSH6 are known to be pathogenic (PMID: 18269114, 24362816). This variant is present in population databases (rs587781691, gnomAD 0.004%). This premature translational stop signal has been observed in individual(s) with Lynch syndrome (PMID: 28514183). Invitae Evidence Modeling of clinical and family history, age, sex, and reported ancestry of multiple individuals with this MSH6 variant has been performed. This variant is expected to be pathogenic with a positive predictive value of at least 99%. This is a validated machine learning model that incorporates the clinical features of 1,370,736 individuals referred to our laboratory for MSH6 testing. ClinVar contains an entry for this variant (Variation ID: 141365). For these reasons, this variant has been classified as Pathogenic. -

Endometrial carcinoma Pathogenic:1
Mar 20, 2023
Baylor Genetics
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
PhyloP100
0.85
Mutation Taster
=0/200
disease causing (ClinVar)

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

Other links and lift over

dbSNP: rs587781691; hg19: chr2-48025863; API