chr3-10149885-C-G
Variant summary
Our verdict is Uncertain significance. Variant got -4 ACMG points: 4P and 8B. PS3_SupportingPM1PP3BS2BS1
This summary comes from the ClinGen Evidence Repository: The variant NM_000551.4(VHL):c.562C>G (p.Leu188Val) is a missense variant predicted to cause substitution of Valine for Leucine at position 188. The GroupMax Filtering Allele Frequency (95% CI) in gnomAD v4.1.0 is 0.00002474 (39/1180038 from European, Non-Finnish Population). This is higher than the ClinGen VHL VCEP threshold of >=0.0000156 (0.00156%) threshold expected for VHL disease (BS1). From pooled laboratory data: 105 probands carried this variant, and none met Danish criteria for VHL. 18/105 had a single VHL feature. 27 known carriers were 60+ years old and did not have VHL phenotypes. At least 11 of those 60+ without VHL features had no VHL features reported in the family history (BS2), while 8 had VHL features reported in family history (including a carrier relative who met diagnostic VHL criteria). In most functional studies reviewed, results for this variant were consistent with aberrant extra cellular matrix formation / fibronectin assembly (PMIDs: 19602254, 16452184, 17700531, 15574766, 16585181, 11331612, 18567581). However, for HIF1/2 alpha interaction/regulation and VCB complex formation/stability, most studies showed intact function with some slight effects on complex stability. (PMIDs: 30890701 ,15574766, 12944410, 10878807, 16585181, 19030229, 11331612, 11331613, 19228690, 16452184, 23772956, 19602254.) (PS3_Supporting). The L188V variant is located within the alpha domain (156-192), a key functional domain of VHL (PM1). The computational predictor REVEL gives a score of 0.796, which is above the threshold of >=0.664, evidence that correlates with impact to VHL function (PP3). In summary, this variant meets the criteria to be classified as Uncertain for autosomal-dominant von Hippel Lindau syndrome (VHL syndrome) based on the ACMG/AMP criteria applied, as specified by the ClinGen VHL VCEP Version 1.0 (Specifications approval date: 02/26/2024. Variant Approval Date 06/25/2024). Note: This variant has been reported as a putative low penetrance VHL type 2C variant; however at this time, the VHL VCEP does not have low-penetrance specific classification recommendations (see ClinGen Low Penetrance / Risk Allele Working Group). LINK:https://erepo.genome.network/evrepo/ui/classification/CA020488/MONDO:0008667/078
Frequency
Consequence
NM_000551.4 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Uncertain_significance. Variant got -4 ACMG points.
Transcripts
RefSeq
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | MANE | Protein | UniProt |
---|---|---|---|---|---|---|---|---|
VHL | NM_000551.4 | c.562C>G | p.Leu188Val | missense_variant | 3/3 | ENST00000256474.3 | NP_000542.1 | |
VHL | NM_198156.3 | c.439C>G | p.Leu147Val | missense_variant | 2/2 | NP_937799.1 | ||
VHL | NM_001354723.2 | c.*116C>G | 3_prime_UTR_variant | 3/3 | NP_001341652.1 | |||
VHL | NR_176335.1 | n.891C>G | non_coding_transcript_exon_variant | 4/4 |
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | TSL | MANE | Protein | Appris | UniProt |
---|---|---|---|---|---|---|---|---|---|---|
VHL | ENST00000256474.3 | c.562C>G | p.Leu188Val | missense_variant | 3/3 | 1 | NM_000551.4 | ENSP00000256474.3 |
Frequencies
GnomAD3 genomes AF: 0.0000394 AC: 6AN: 152188Hom.: 0 Cov.: 32
GnomAD3 exomes AF: 0.0000199 AC: 5AN: 251424Hom.: 0 AF XY: 0.0000147 AC XY: 2AN XY: 135906
GnomAD4 exome AF: 0.0000226 AC: 33AN: 1461884Hom.: 0 Cov.: 30 AF XY: 0.0000151 AC XY: 11AN XY: 727244
GnomAD4 genome AF: 0.0000394 AC: 6AN: 152188Hom.: 0 Cov.: 32 AF XY: 0.0000538 AC XY: 4AN XY: 74324
ClinVar
Submissions by phenotype
Von Hippel-Lindau syndrome Pathogenic:8Uncertain:1
Pathogenic, criteria provided, single submitter | clinical testing | All of Us Research Program, National Institutes of Health | Jan 22, 2024 | The c.562C>G (p.Leu188Val) variant in the VHL gene has been reported in patients with Von Hippel-Lindau syndrome [PMID 12414898, 12000816]. The variant was originally detected in two families diagnosed with mutiple endocrine neoplasia type IIA but without a RET pathogenic variant [PMID 7563486]. This variant was further detected and characterized as a pathogenic variant in patients with VHL type IIC, a disorder characterized with a risk for pheochromocytoma only [PMID 12414898, 12000816]. This variant was detected in 1/271 patients presenting with non syndromic pheochromocytoma [PMID 12000816]. It was also detected and showed to co- segregate with pheochromocytoma in a family with 6 affected individuals [PMID 12414898]. The variant was found in cis configuration with a p.Pro81Ser variant; however the p.Pro81Ser variant is now classified as likely benign and thus not thought to affect the phenotype of these reported patients. This p.Leu188Val was also reported in two siblings with congenital polycythaemia [PMID 23772956]. In vitro assays showed that this variant affects the extra cellular matrix assembly, which correlated with tumor angiogenesis [PMID 16452184]. The amino acid position 188 of the VHL protein is a hot spot for pathogenic variants causing Von Hippel-Lindau syndrome: additional variants affecting the same amino acid at position 188 (p.Leu188Arg, p.Leu188Gln and p.Leu188Pro) have been reported. This variant was observed in two European (Non Finnish) at the heterozygous state in the ExAC database (http://exac.broadinstitute.org/variant/3-10191569-C-G). Leucine at amino acid position 188 of the VHL protein is highly conserved in mammals and while not clinically validated, computer-based algorithms predict this p.Leu188Val change to be deleterious. This variant is thus classified as pathogenic. - |
Pathogenic, no assertion criteria provided | literature only | OMIM | Feb 15, 2003 | - - |
Pathogenic, criteria provided, single submitter | research | Department of Pediatrics, Memorial Sloan Kettering Cancer Center | Dec 15, 2020 | - - |
Pathogenic, criteria provided, single submitter | clinical testing | Women's Health and Genetics/Laboratory Corporation of America, LabCorp | Apr 01, 2021 | Variant summary: VHL c.562C>G (p.Leu188Val) results in a conservative amino acid change located in the alpha domain (IPR024048) of the encoded protein sequence. Four of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 2e-05 in 251424 control chromosomes (gnomAD). c.562C>G has been reported in the literature in multiple individuals affected with Von Hippel-Lindau Syndrome (example: Neumann_1995, Glavac_1996). Individuals from two of these families also had C-cell tumor and extra adrenal pheochromocytoma. The variant also reported to segregate in a family where most of the affected individuals had only pheochromocytoma (Ritter_1996). In functional studies, the variant was able to direct polyubiquitination of transcription factor HIF (hypoxia-inducible factor) but was partially defective to promoting extracellular fibronectin matrix formation (Hoffman_2001). Kurban et al report that in matrigel assays, the renal carcinoma cells expressing the variant were shown to be highly invasive and in nude mouse xenograft assays they were capable of generating highly vascularized tumors (Kurban_2006). These data indicate that the variant is very likely to be associated with disease. Seven ClinVar submitters (evaluation after 2014) cite the variant as pathogenic/likely pathogenic (n=6) or uncertain significance (n=1). Based on the evidence outlined above, the variant was classified as pathogenic. - |
Uncertain significance, reviewed by expert panel | curation | ClinGen VHL Variant Curation Expert Panel, ClinGen | Jun 25, 2024 | The variant NM_000551.4(VHL):c.562C>G (p.Leu188Val) is a missense variant predicted to cause substitution of Valine for Leucine at position 188. The GroupMax Filtering Allele Frequency (95% CI) in gnomAD v4.1.0 is 0.00002474 (39/1180038 from European, Non-Finnish Population). This is higher than the ClinGen VHL VCEP threshold of >=0.0000156 (0.00156%) threshold expected for VHL disease (BS1). From pooled laboratory data: 105 probands carried this variant, and none met Danish criteria for VHL. 18/105 had a single VHL feature. 27 known carriers were 60+ years old and did not have VHL phenotypes. At least 11 of those 60+ without VHL features had no VHL features reported in the family history (BS2), while 8 had VHL features reported in family history (including a carrier relative who met diagnostic VHL criteria). In most functional studies reviewed, results for this variant were consistent with aberrant extra cellular matrix formation / fibronectin assembly (PMIDs: 19602254, 16452184, 17700531, 15574766, 16585181, 11331612, 18567581). However, for HIF1/2 alpha interaction/regulation and VCB complex formation/stability, most studies showed intact function with some slight effects on complex stability. (PMIDs: 30890701 ,15574766, 12944410, 10878807, 16585181, 19030229, 11331612, 11331613, 19228690, 16452184, 23772956, 19602254.) (PS3_Supporting). The L188V variant is located within the alpha domain (156-192), a key functional domain of VHL (PM1). The computational predictor REVEL gives a score of 0.796, which is above the threshold of >=0.664, evidence that correlates with impact to VHL function (PP3). In summary, this variant meets the criteria to be classified as Uncertain for autosomal-dominant von Hippel Lindau syndrome (VHL syndrome) based on the ACMG/AMP criteria applied, as specified by the ClinGen VHL VCEP Version 1.0 (Specifications approval date: 02/26/2024. Variant Approval Date 06/25/2024). Note: This variant has been reported as a putative low penetrance VHL type 2C variant; however at this time, the VHL VCEP does not have low-penetrance specific classification recommendations (see ClinGen Low Penetrance / Risk Allele Working Group). - |
Pathogenic, no assertion criteria provided | clinical testing | Genomic Diagnostic Laboratory, Division of Genomic Diagnostics, Children's Hospital of Philadelphia | Feb 26, 2016 | - - |
Likely pathogenic, criteria provided, single submitter | clinical testing | Myriad Genetics, Inc. | Feb 22, 2024 | This variant is considered likely pathogenic. This variant has been reported in multiple individuals with clinical features of gene-specific disease [PMID: 7563486, 8772572, 19906784, 34628056]. - |
Pathogenic, criteria provided, single submitter | clinical testing | Human Genome Sequencing Center Clinical Lab, Baylor College of Medicine | May 24, 2017 | The c.562C>G (p.Leu188Val) variant has been reported in patients with Von Hippel-Lindau syndrome [PMID 12414898, 12000816]. The variant was originally detected in two families diagnosed with mutiple endocrine neoplasia type IIA but without a RET pathogenic variant [PMID 7563486]. This variant was further detected and characterized as a pathogenic variant in patients with VHL type IIC, a disorder characterized with a risk for pheochromocytoma only [PMID 12414898, 12000816]. This variant was detected in 1/271 patients presenting with non syndromic pheochromocytoma [PMID 12000816]. It was also detected and showed to co- segregate with pheochromocytoma in a family with 6 affected individuals [PMID 12414898]. The variant was found in cis configuration with a p.Pro81Ser variant; however the p.Pro81Ser variant is now classified as likely benign and thus not thought to affect the phenotype of these reported patients. This p.Leu188Val was also reported in two siblings with congenital polycythaemia [PMID 23772956]. In vitro assays showed that this variant affects the extra cellular matrix assembly, which correlated with tumor angiogenesis [PMID 16452184]. The amino acid position 188 of the VHL protein is a hot spot for pathogenic variants causing Von Hippel-Lindau syndrome: additional variants affecting the same amino acid at position 188 (p.Leu188Arg, p.Leu188Gln and p.Leu188Pro) have been reported. This variant was observed in two European (Non Finnish) at the heterozygous state in the ExAC database (http://exac.broadinstitute.org/variant/3-10191569-C-G). Leucine at amino acid position 188 of the VHL protein is highly conserved in mammals and while not clinically validated, computer-based algorithms predict this p.Leu188Val change to be deleterious. This variant is thus classified as pathogenic. - |
Likely pathogenic, criteria provided, single submitter | clinical testing | Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine | Feb 07, 2024 | The p.Leu188Val variant in VHL (also described as p.Leu259Val in the literature) has been reported in the heterozygous state in 6 individuals with von Hippel-Lindau syndrome type 2C and segregated with disease in at least 12 affected relatives from 2 families (Neumann 1995 PMID: 7563486, Ritter 1996 PMID: 8772572, Zbar 1996 PMID: 8956040, Neumann 2002 PMID: 12000816, Weirich 2002 PMID: 12414898). This variant has also been reported in the compound heterozygous state in 3 individuals with congenital polycythemia (Pastore 2003 PMID: 12844285, Bento 2005 PMID: 15642680). However, it has also been identified in 0.003% (39/1180038) of European chromosomes by gnomAD (http://gnomad.broadinstitute.org, v4.0.0). Furthermore, it has been identified in multiple adults with no known VHL-related tumors, suggesting that it may be associated with reduced penetrance (Savatt 2022 PMID: 35668420, Ambry Genetics personal communication). This variant has been reported in ClinVar (Variation ID 2225). In vitro functional studies provide some evidence that the p.Leu188Val variant may impact protein function (Hoffman 2001 PMID: 11331612, Kurban 2006 PMID: 16452184, Knauth 2009 PMID: 19228690). Computational prediction tools and conservation analyses are consistent with pathogenicity. In summary, although additional studies are required to fully establish its clinical significance, this variant meets criteria to be classified as likely pathogenic for autosomal dominant von Hippel-Lindau syndrome type 2C, however its penetrance may be reduced. ACMG/AMP codes applied: PS4_Moderate, PP1_Strong, PS3_Supporting, PP3. - |
not provided Pathogenic:4
Pathogenic, criteria provided, single submitter | clinical testing | CeGaT Center for Human Genetics Tuebingen | Apr 01, 2022 | VHL: PP1:Strong, PS4, PM1, PS3:Supporting - |
Likely pathogenic, criteria provided, single submitter | clinical testing | Mayo Clinic Laboratories, Mayo Clinic | Jul 27, 2023 | PP1, PP5, PS3 - |
Pathogenic, criteria provided, single submitter | clinical testing | Revvity Omics, Revvity | Apr 04, 2019 | - - |
Likely pathogenic, criteria provided, single submitter | clinical testing | GeneDx | Nov 11, 2024 | Observed in the heterozygous state in multiple adult individuals without VHL-related tumors tested at GeneDx and in the literature, suggesting this variant may be associated with reduced penetrance (PMID: 29625052, 30113886, 31447099, 34720947, 35668420); Co-observed with a second VHL variant in individuals with recessively-inherited congenital polycythemia; however, additional evidence is needed to establish whether there is a relationship between this variant and autosomal recessive disease (PMID: 12844285, 15642680, 23772956, 35142155); Published functional studies demonstrate retained ability to ubiquitinate and degrade hypoxia-inducible factor (HIF)-1 as well as downregulate HIF-1 target genes, normal to reduced protein stability, and retained or reduced protein binding, but also show defective fibronectin extracellular matrix assembly as well as impaired interaction with mitochondrial proteins (PMID: 10878807, 11331613, 11331612, 12944410, 15574766, 16585181, 16452184, 19030229, 17700531, 19602254, 19228690, 26846855, 30890701, 35760869); In silico analysis indicates that this missense variant does not alter protein structure/function; Not observed at significant frequency in large population cohorts (gnomAD); Also known as Leu259Val; This variant is associated with the following publications: (PMID: 12097293, 11331613, 23772956, 7987306, 8772572, 11331612, 19030229, 16585181, 8634692, 15177666, 12000816, 19228690, 7563486, 22393103, 11409863, 27517496, 30105105, 30113886, 19602254, 16452184, 18567581, 15642680, 18836774, 19906784, 25371412, 28620007, 27114602, 24969085, 12844285, 28235946, 28945216, 28503092, 8707293, 10878807, 8956040, 29478617, 12944410, 26846855, 15574766, 17898043, 29790589, 29625052, 30890701, 9829911, 31447099, 31980715, 32869749, 34308366, 34720947, 35205407, 34628056, 29748190, 17700531, 35760869, 35668420, 33720516, 35142155, 12414898, 36744932, 36451132) - |
Chuvash polycythemia Pathogenic:2
Pathogenic, no assertion criteria provided | literature only | OMIM | Feb 15, 2003 | - - |
Pathogenic, criteria provided, single submitter | clinical testing | Baylor Genetics | Nov 20, 2023 | - - |
Hereditary cancer-predisposing syndrome Pathogenic:2
Pathogenic, criteria provided, single submitter | clinical testing | University of Washington Department of Laboratory Medicine, University of Washington | Nov 20, 2015 | - - |
Likely pathogenic, criteria provided, single submitter | clinical testing | Ambry Genetics | Dec 26, 2023 | The p.L188V variant (also known as c.562C>G), located in coding exon 3 of the VHL gene, results from a C to G substitution at nucleotide position 562. The leucine at codon 188 is replaced by valine, an amino acid with highly similar properties. This variant has been reported in several individuals and families with VHL or VHL related tumors (Ritter MM et al. J. Clin. Endocrinol. Metab. 1996 Mar;81(3):1035-7; Neumann HP et al. JAMA. 1995 Oct;274(14):1149-51; Crossey PA et al. Hum. Mol. Genet. 1994 Aug;3(8):1303-8; Weirich G et al. J Clin Endocrinol Metab, 2002 Nov;87:5241-6) and in conjunction with a VHL mutation in multiple individuals affected with autosomal recessive polycythemia (Bento MC et al. Haematologica. 2005 Jan;90(1):128-9; Lorenzo FR et al. Br. J. Haematol. 2013 Sep;162(6):851-3; Pastore Y et al. Am J Hum Genet, 2003 Aug;73:412-9). Functional studies demonstrate that this variant is characteristic of VHL type 2C alterations in that it maintains the ability to ubiquitinate and downregulate key targets such as HIF2a (Hoffman MA et al. Hum. Mol. Genet., 2001 May;10:1019-27; Hacker KE et al. PLoS ONE, 2008 Nov;3:e3801), and is deficient at extracellular matrix formation (Kurban G et al. Cancer Res., 2006 Feb;66:1313-9). Further studies which injected human RCC cells containing this variant into nude mice showed the formation of highly vascularized, invasive tumors in contrast to those containing wild type VHL that formed no tumors (Kurban G et al. Cancer Res., 2006 Feb;66:1313-9). This alteration has been identified in numerous individuals that do not have a diagnosis of VHL, or any VHL associated tumors (Ambry internal data) suggesting this variant may be associated with significantly reduced penetrance. This amino acid position is highly conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. Based on the majority of available evidence to date, p.L188V is likely to be a low penetrance pathogenic variant and may not be associated with classic von Hippel Lindau disease or associated tumors. Clinical correlation is advised. - |
VHL-related disorder Pathogenic:1
Likely pathogenic, no assertion criteria provided | clinical testing | PreventionGenetics, part of Exact Sciences | May 20, 2024 | The VHL c.562C>G variant is predicted to result in the amino acid substitution p.Leu188Val. This variant has been reported in several individuals with Von Hippel-Lindau syndrome or pheochromocytoma, and shown to co-segregate with the disease in multiple families (Neumann et al. 1995. PubMed ID: 7563486; Lorenzo et al. 2013. PubMed ID: 23772956; Neumann et al. 2002. PubMed ID: 12000816; Weirich et al. 2002. PubMed ID: 12414898). It has also been identified in adult individuals with no known VHL-related tumors, suggesting that it may be associated with reduced penetrance (Savatt et al. 2022. PMID: 35668420). Functional studies have produced variable results, but on whole suggest a reduction in protein function (see for example, Hoffman et al. 2001. PubMed ID: 11331612; Knauth et al. 2009. PubMed ID: 19228690; Lorenzo et al. 2013. PubMed ID: 23772956; Bangiyeva et al. 2009. PubMed ID: 19602254). This variant is reported in 0.0039% of alleles in individuals of European (Non-Finnish) descent in gnomAD and is reported from uncertain to pathogenic in ClinVar (https://www.ncbi.nlm.nih.gov/clinvar/variation/2225). This variant is interpreted as likely pathogenic. - |
Au-Kline syndrome Pathogenic:1
Likely pathogenic, criteria provided, single submitter | not provided | Institute for Medical Genetics and Human Genetics, Charité - Universitätsmedizin Berlin | - | - - |
Pheochromocytoma Pathogenic:1
Pathogenic, no assertion criteria provided | literature only | OMIM | Feb 15, 2003 | - - |
Von Hippel-Lindau syndrome;C1837915:Chuvash polycythemia Pathogenic:1
Pathogenic, criteria provided, single submitter | clinical testing | Labcorp Genetics (formerly Invitae), Labcorp | Jan 31, 2024 | This sequence change replaces leucine, which is neutral and non-polar, with valine, which is neutral and non-polar, at codon 188 of the VHL protein (p.Leu188Val). This variant is present in population databases (rs5030824, gnomAD 0.006%). This missense change has been observed in individuals with von Hippel-Lindau syndrome (PMID: 7563486, 7987306, 8772572, 12844285, 15642680, 23772956). It has also been observed to segregate with disease in related individuals. This variant is also known as Leu259Val, Leu229Val, and C775G. ClinVar contains an entry for this variant (Variation ID: 2225). 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 expected to disrupt VHL protein function with a positive predictive value of 95%. Experimental studies have shown that this missense change affects VHL function (PMID: 11331612, 16452184, 18567581, 19228690, 23772956). For these reasons, this variant has been classified as Pathogenic. - |
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at