chr22-50626202-C-T

Variant summary

Our verdict is Pathogenic. The variant received 12 ACMG points: 12P and 0B. PM1PM2PM5PP2PP3_StrongPP5

The NM_000487.6(ARSA):​c.931G>A​(p.Gly311Ser) variant causes a missense change. The variant allele was found at a frequency of 0.0000124 in 1,611,886 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. G311C) has been classified as Likely pathogenic.

Frequency

Genomes: 𝑓 0.0000066 ( 0 hom., cov: 34)
Exomes 𝑓: 0.000013 ( 0 hom. )

Consequence

ARSA
NM_000487.6 missense

Scores

12
4
1

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications P:12U:2

Conservation

PhyloP100: 6.01

Publications

10 publications found
Variant links:
Genes affected
ARSA (HGNC:713): (arylsulfatase A) The protein encoded by this gene hydrolyzes cerebroside sulfate to cerebroside and sulfate. Defects in this gene lead to metachromatic leucodystrophy (MLD), a progressive demyelination disease which results in a variety of neurological symptoms and ultimately death. Alternatively spliced transcript variants have been described for this gene. [provided by RefSeq, Dec 2010]
ARSA Gene-Disease associations (from GenCC):
  • metachromatic leukodystrophy
    Inheritance: AR Classification: DEFINITIVE Submitted by: Myriad Women’s Health, ClinGen
  • metachromatic leukodystrophy, juvenile form
    Inheritance: AR Classification: DEFINITIVE, STRONG Submitted by: Ambry Genetics, Labcorp Genetics (formerly Invitae), G2P, Genomics England PanelApp

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Pathogenic. The variant received 12 ACMG points.

PM1
In a hotspot region, there are 17 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 0 benign, 11 uncertain in NM_000487.6
PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chr22-50626202-C-A is described in CliVar as Likely_pathogenic. Clinvar id is 2727052.Status of the report is criteria_provided_single_submitter, 1 stars.
PP2
Missense variant in the gene, where a lot of missense mutations are associated with disease in ClinVar. The gene has 159 curated pathogenic missense variants (we use a threshold of 10). The gene has 11 curated benign missense variants. Gene score misZ: 0.38013 (below the threshold of 3.09). Trascript score misZ: -0.56919 (below the threshold of 3.09). GenCC associations: The gene is linked to metachromatic leukodystrophy, juvenile form, metachromatic leukodystrophy.
PP3
MetaRNN computational evidence supports a deleterious effect, 0.975
PP5
Variant 22-50626202-C-T is Pathogenic according to our data. Variant chr22-50626202-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 3060. Variant chr22-50626202-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 3060. Variant chr22-50626202-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 3060. Variant chr22-50626202-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 3060. Variant chr22-50626202-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 3060. Variant chr22-50626202-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 3060. Variant chr22-50626202-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 3060. Variant chr22-50626202-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 3060. Variant chr22-50626202-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 3060. Variant chr22-50626202-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 3060. Variant chr22-50626202-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 3060. Variant chr22-50626202-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 3060. Variant chr22-50626202-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 3060. Variant chr22-50626202-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 3060. Variant chr22-50626202-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 3060. Variant chr22-50626202-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 3060. Variant chr22-50626202-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 3060. Variant chr22-50626202-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 3060. Variant chr22-50626202-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 3060. Variant chr22-50626202-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 3060.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
ARSANM_000487.6 linkc.931G>A p.Gly311Ser missense_variant Exon 5 of 8 ENST00000216124.10 NP_000478.3 P15289A0A0C4DFZ2B4DVI5

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
ARSAENST00000216124.10 linkc.931G>A p.Gly311Ser missense_variant Exon 5 of 8 1 NM_000487.6 ENSP00000216124.5 A0A0C4DFZ2

Frequencies

GnomAD3 genomes
AF:
0.00000657
AC:
1
AN:
152232
Hom.:
0
Cov.:
34
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.000207
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.00
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.0000287
AC:
7
AN:
244148
AF XY:
0.0000453
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.0000294
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000273
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000130
AC:
19
AN:
1459654
Hom.:
0
Cov.:
35
AF XY:
0.0000207
AC XY:
15
AN XY:
725954
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
33466
American (AMR)
AF:
0.0000225
AC:
1
AN:
44404
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26034
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39598
South Asian (SAS)
AF:
0.000105
AC:
9
AN:
85782
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
52932
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5768
European-Non Finnish (NFE)
AF:
0.00000720
AC:
8
AN:
1111380
Other (OTH)
AF:
0.0000166
AC:
1
AN:
60290
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.467
Heterozygous variant carriers
0
2
4
5
7
9
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:
0.00000657
AC:
1
AN:
152232
Hom.:
0
Cov.:
34
AF XY:
0.0000134
AC XY:
1
AN XY:
74378
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
41460
American (AMR)
AF:
0.00
AC:
0
AN:
15288
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3472
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5196
South Asian (SAS)
AF:
0.000207
AC:
1
AN:
4838
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10630
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
68028
Other (OTH)
AF:
0.00
AC:
0
AN:
2092
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

Genome 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
Alfa
AF:
0.00000956
Hom.:
0
ExAC
AF:
0.0000165
AC:
2

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Pathogenic:12Uncertain:2
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

Metachromatic leukodystrophy Pathogenic:8Uncertain:1
Apr 04, 2017
Counsyl
Significance:Likely pathogenic
Review Status:no assertion criteria provided
Collection Method:clinical testing

This submission and the accompanying classification are no longer maintained by the submitter. For more information on current observations and classification, please contact variantquestions@myriad.com. -

-
Kasturba Medical College, Manipal, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Oct 15, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence change replaces glycine, which is neutral and non-polar, with serine, which is neutral and polar, at codon 311 of the ARSA protein (p.Gly311Ser). This variant is present in population databases (rs74315459, gnomAD 0.01%). This missense change has been observed in individual(s) with metachromatic leukodystrophy (PMID: 8101038, 26462614, 28670130). In at least one individual the data is consistent with being in trans (on the opposite chromosome) from a pathogenic variant. This variant is also known as Gly309Ser. ClinVar contains an entry for this variant (Variation ID: 3060). Invitae Evidence Modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) indicates that this missense variant is expected to disrupt ARSA protein function with a positive predictive value of 95%. Experimental studies have shown that this missense change affects ARSA function (PMID: 8101038). For these reasons, this variant has been classified as Pathogenic. -

Mar 13, 2024
Fulgent Genetics, Fulgent Genetics
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Jul 03, 2020
Natera, Inc.
Significance:Pathogenic
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

May 13, 2019
Institute of Human Genetics, University of Leipzig Medical Center
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was identified as homozygous -

Sep 26, 2024
Institute of Medical Genetics and Applied Genomics, University Hospital Tübingen
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

-
Myelin Disorders Clinic-Children's Medical Center/Medical Genetics Lab-Tarbiat Modares University, Children's Medical Center, Pediatrics Center of Excellence,
Significance:Uncertain significance
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Feb 12, 2024
Genomic Research Center, Shahid Beheshti University of Medical Sciences
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

not provided Pathogenic:2
Jul 01, 2024
CeGaT Center for Human Genetics Tuebingen
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

ARSA: PM3:Strong, PM1, PM2, PM5, PS3:Supporting -

Sep 30, 2022
GeneDx
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Published functional studies demonstrate G309S results in a significant reduction in enzyme activity (Kreysing et al., 1993; Bhringer et al., 2017); Not observed at significant frequency in large population cohorts (gnomAD); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; Also known as p.G309S; This variant is associated with the following publications: (PMID: 8101038, 15326627, 33385934, 27289174, 28762252, 33547378, 33855715, 34426522, 33726816, 27535533) -

Metachromatic leukodystrophy, late infantile form Pathogenic:1
Aug 01, 1993
OMIM
Significance:Pathogenic
Review Status:no assertion criteria provided
Collection Method:literature only

- -

Abnormality of the nervous system Pathogenic:1
Jul 10, 2021
Kariminejad - Najmabadi Pathology & Genetics Center
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

PSEUDOARYLSULFATASE A DEFICIENCY Uncertain:1
Aug 07, 2018
Genomic Research Center, Shahid Beheshti University of Medical Sciences
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
BayesDel_addAF
Pathogenic
0.39
D
BayesDel_noAF
Pathogenic
0.52
CADD
Pathogenic
29
DANN
Uncertain
1.0
DEOGEN2
Uncertain
0.48
T;T;T;.;T
Eigen
Pathogenic
0.84
Eigen_PC
Pathogenic
0.77
FATHMM_MKL
Pathogenic
0.99
D
LIST_S2
Uncertain
0.96
.;.;.;D;D
M_CAP
Pathogenic
0.76
D
MetaRNN
Pathogenic
0.98
D;D;D;D;D
MetaSVM
Pathogenic
1.1
D
PhyloP100
6.0
PrimateAI
Uncertain
0.60
T
PROVEAN
Pathogenic
-5.9
D;D;D;D;D
REVEL
Pathogenic
0.97
Sift
Pathogenic
0.0
D;D;D;D;D
Sift4G
Pathogenic
0.0
D;D;D;D;D
Vest4
0.98
MVP
0.99
ClinPred
0.95
D
GERP RS
5.4
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.7
gMVP
0.98
Mutation Taster
=2/98
disease causing (ClinVar)

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.060
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: rs74315459; hg19: chr22-51064630; API