chr21-43066290-G-A

Variant summary

Our verdict is Likely benign. Variant got -2 ACMG points: 0P and 2B. BP4_Moderate

The NM_000071.3(CBS):​c.404C>T​(p.Thr135Met) variant causes a missense change involving the alteration of a non-conserved nucleotide. In-silico tool predicts a benign outcome for this variant. 14/21 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Uncertain significance (★★).

Frequency

Genomes: 𝑓 0.000080 ( 1 hom., cov: 14)
Exomes 𝑓: 0.000030 ( 1 hom. )

Consequence

CBS
NM_000071.3 missense

Scores

5
14

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:5

Conservation

PhyloP100: 1.19
Variant links:
Genes affected
CBS (HGNC:1550): (cystathionine beta-synthase) The protein encoded by this gene acts as a homotetramer to catalyze the conversion of homocysteine to cystathionine, the first step in the transsulfuration pathway. The encoded protein is allosterically activated by adenosyl-methionine and uses pyridoxal phosphate as a cofactor. Defects in this gene can cause cystathionine beta-synthase deficiency (CBSD), which can lead to homocystinuria. This gene is a major contributor to cellular hydrogen sulfide production. Multiple alternatively spliced transcript variants have been found for this gene. [provided by RefSeq, Feb 2016]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Likely_benign. Variant got -2 ACMG points.

BP4
Computational evidence support a benign effect (MetaRNN=0.17937884).

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
CBSNM_000071.3 linkuse as main transcriptc.404C>T p.Thr135Met missense_variant 5/17 ENST00000398165.8 NP_000062.1

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
CBSENST00000398165.8 linkuse as main transcriptc.404C>T p.Thr135Met missense_variant 5/171 NM_000071.3 ENSP00000381231 P1P35520-1

Frequencies

GnomAD3 genomes
AF:
0.0000801
AC:
8
AN:
99908
Hom.:
1
Cov.:
14
show subpopulations
Gnomad AFR
AF:
0.000287
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.0000869
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:
0.0000395
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000439
AC:
11
AN:
250664
Hom.:
0
AF XY:
0.0000369
AC XY:
5
AN XY:
135632
show subpopulations
Gnomad AFR exome
AF:
0.0000616
Gnomad AMR exome
AF:
0.0000578
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.0000327
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000617
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000301
AC:
30
AN:
997794
Hom.:
1
Cov.:
15
AF XY:
0.0000295
AC XY:
15
AN XY:
508924
show subpopulations
Gnomad4 AFR exome
AF:
0.0000607
Gnomad4 AMR exome
AF:
0.0000713
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:
0.0000360
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
AF:
0.0000801
AC:
8
AN:
99908
Hom.:
1
Cov.:
14
AF XY:
0.0000620
AC XY:
3
AN XY:
48364
show subpopulations
Gnomad4 AFR
AF:
0.000287
Gnomad4 AMR
AF:
0.0000869
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.0000395
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.0000706
Hom.:
1
ESP6500AA
AF:
0.000227
AC:
1
ESP6500EA
AF:
0.00
AC:
0
ExAC
AF:
0.0000330
AC:
4
EpiCase
AF:
0.00
EpiControl
AF:
0.0000593

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:5
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Classic homocystinuria Uncertain:2
Uncertain significance, criteria provided, single submitterclinical testingRevvity Omics, RevvityJun 08, 2022- -
Uncertain significance, no assertion criteria providedclinical testingNatera, Inc.Aug 15, 2020- -
Familial thoracic aortic aneurysm and aortic dissection Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingAmbry GeneticsSep 18, 2023The p.T135M variant (also known as c.404C>T), located in coding exon 3 of the CBS gene, results from a C to T substitution at nucleotide position 404. The threonine at codon 135 is replaced by methionine, an amino acid with similar properties. This amino acid position is not well conserved in available vertebrate species. In addition, the in silico prediction for this alteration is inconclusive. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear. -
not provided Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingMayo Clinic Laboratories, Mayo ClinicSep 26, 2022BP4 -
HYPERHOMOCYSTEINEMIA, THROMBOTIC, CBS-RELATED Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpOct 08, 2022This sequence change replaces threonine, which is neutral and polar, with methionine, which is neutral and non-polar, at codon 135 of the CBS protein (p.Thr135Met). This variant is present in population databases (rs144832032, gnomAD 0.007%). This variant has not been reported in the literature in individuals affected with CBS-related conditions. ClinVar contains an entry for this variant (Variation ID: 471364). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is not expected to disrupt CBS protein function. In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.070
BayesDel_addAF
Benign
-0.085
T
BayesDel_noAF
Benign
-0.18
CADD
Benign
14
DANN
Uncertain
0.99
DEOGEN2
Uncertain
0.67
D;D;D;D;.
Eigen
Benign
-1.1
Eigen_PC
Benign
-1.1
FATHMM_MKL
Benign
0.060
N
LIST_S2
Uncertain
0.92
.;.;.;D;D
M_CAP
Uncertain
0.20
D
MetaRNN
Benign
0.18
T;T;T;T;T
MetaSVM
Uncertain
0.70
D
MutationAssessor
Benign
0.88
L;L;L;L;.
MutationTaster
Benign
1.0
N;N;N;N;N;N;N;N;N;N;N;N
PrimateAI
Benign
0.38
T
PROVEAN
Benign
0.54
N;N;N;N;N
REVEL
Benign
0.22
Sift
Benign
0.24
T;T;T;T;T
Sift4G
Benign
0.24
T;T;T;T;T
Polyphen
0.036
B;B;B;B;.
Vest4
0.37
MVP
0.54
MPC
0.38
ClinPred
0.035
T
GERP RS
-0.95
Varity_R
0.063
gMVP
0.45

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

LitVar

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs144832032; hg19: chr21-44486400; COSMIC: COSV61442556; COSMIC: COSV61442556; API