chr3-37004469-A-G

Variant summary

Our verdict is Benign. Variant got -17 ACMG points: 0P and 17B. BP4_StrongBP6_Very_StrongBP7BS1

The NM_000249.4(MLH1):​c.375A>G​(p.Ala125=) variant causes a synonymous change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.000528 in 1,613,700 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Likely benign (★★★). Synonymous variant affecting the same amino acid position (i.e. A125A) has been classified as Likely benign.

Frequency

Genomes: 𝑓 0.00065 ( 0 hom., cov: 33)
Exomes 𝑓: 0.00052 ( 0 hom. )

Consequence

MLH1
NM_000249.4 synonymous

Scores

2

Clinical Significance

Likely benign reviewed by expert panel B:20

Conservation

PhyloP100: -1.40
Variant links:
Genes affected
MLH1 (HGNC:7127): (mutL homolog 1) The protein encoded by this gene can heterodimerize with mismatch repair endonuclease PMS2 to form MutL alpha, part of the DNA mismatch repair system. When MutL alpha is bound by MutS beta and some accessory proteins, the PMS2 subunit of MutL alpha introduces a single-strand break near DNA mismatches, providing an entry point for exonuclease degradation. The encoded protein is also involved in DNA damage signaling and can heterodimerize with DNA mismatch repair protein MLH3 to form MutL gamma, which is involved in meiosis. This gene was identified as a locus frequently mutated in hereditary nonpolyposis colon cancer (HNPCC). [provided by RefSeq, Aug 2017]

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ACMG classification

Classification made for transcript

Verdict is Benign. Variant got -17 ACMG points.

BP4
Computational evidence support a benign effect (BayesDel_noAF=-0.69).
BP6
Variant 3-37004469-A-G is Benign according to our data. Variant chr3-37004469-A-G is described in ClinVar as [Likely_benign]. Clinvar id is 90183.Status of the report is reviewed_by_expert_panel, 3 stars. Variant chr3-37004469-A-G is described in Lovd as [Likely_benign]. Variant chr3-37004469-A-G is described in Lovd as [Benign].
BP7
Synonymous conserved (PhyloP=-1.4 with no splicing effect.
BS1
Variant frequency is greater than expected in population amr. gnomad4 allele frequency = 0.00065 (99/152364) while in subpopulation AMR AF= 0.00301 (46/15304). AF 95% confidence interval is 0.00231. There are 0 homozygotes in gnomad4. There are 59 alleles in male gnomad4 subpopulation. Median coverage is 33. This position pass quality control queck.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE UniProt
MLH1NM_000249.4 linkuse as main transcriptc.375A>G p.Ala125= synonymous_variant 4/19 ENST00000231790.8

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Appris UniProt
MLH1ENST00000231790.8 linkuse as main transcriptc.375A>G p.Ala125= synonymous_variant 4/191 NM_000249.4 P1P40692-1

Frequencies

GnomAD3 genomes
AF:
0.000650
AC:
99
AN:
152246
Hom.:
0
Cov.:
33
show subpopulations
Gnomad AFR
AF:
0.000169
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00301
Gnomad ASJ
AF:
0.000288
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.000632
Gnomad OTH
AF:
0.000957
GnomAD3 exomes
AF:
0.000609
AC:
153
AN:
251398
Hom.:
0
AF XY:
0.000567
AC XY:
77
AN XY:
135862
show subpopulations
Gnomad AFR exome
AF:
0.000185
Gnomad AMR exome
AF:
0.00223
Gnomad ASJ exome
AF:
0.0000992
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.000581
Gnomad OTH exome
AF:
0.000978
GnomAD4 exome
AF:
0.000515
AC:
753
AN:
1461336
Hom.:
0
Cov.:
30
AF XY:
0.000502
AC XY:
365
AN XY:
727014
show subpopulations
Gnomad4 AFR exome
AF:
0.0000598
Gnomad4 AMR exome
AF:
0.00230
Gnomad4 ASJ exome
AF:
0.0000765
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.00
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.000556
Gnomad4 OTH exome
AF:
0.000464
GnomAD4 genome
AF:
0.000650
AC:
99
AN:
152364
Hom.:
0
Cov.:
33
AF XY:
0.000792
AC XY:
59
AN XY:
74506
show subpopulations
Gnomad4 AFR
AF:
0.000168
Gnomad4 AMR
AF:
0.00301
Gnomad4 ASJ
AF:
0.000288
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.000632
Gnomad4 OTH
AF:
0.000947
Alfa
AF:
0.000336
Hom.:
0
Bravo
AF:
0.000846
EpiCase
AF:
0.000382
EpiControl
AF:
0.000296

ClinVar

Significance: Likely benign
Submissions summary: Benign:20
Revision: reviewed by expert panel
LINK: link

Submissions by phenotype

not provided Benign:5
Benign, criteria provided, single submitterclinical testingARUP Laboratories, Molecular Genetics and Genomics, ARUP LaboratoriesSep 07, 2023- -
Benign, criteria provided, single submitterclinical testingQuest Diagnostics Nichols Institute San Juan CapistranoOct 06, 2022- -
Benign, no assertion criteria providedclinical testingMayo Clinic Laboratories, Mayo ClinicNov 30, 2017- -
Likely benign, criteria provided, single submitternot providedBreakthrough Genomics, Breakthrough Genomics-- -
Likely benign, criteria provided, single submitterclinical testingCeGaT Center for Human Genetics TuebingenNov 01, 2023MLH1: BP4, BP7 -
Colorectal cancer, hereditary nonpolyposis, type 2 Benign:4
Likely benign, criteria provided, single submitterclinical testingCounsylNov 18, 2015- -
Likely benign, criteria provided, single submitterclinical testingMendelicsMay 28, 2019- -
Benign, criteria provided, single submitterclinical testingMyriad Genetics, Inc.Mar 15, 2023This variant is considered benign. This variant is a silent/synonymous amino acid change and it is not expected to impact splicing. -
Likely benign, criteria provided, single submitterclinical testingIllumina Laboratory Services, IlluminaOct 17, 2017This variant was observed as part of a predisposition screen in an ostensibly healthy population. A literature search was performed for the gene, cDNA change, and amino acid change (where applicable). Publications were found based on this search. The evidence from the literature, in combination with allele frequency data from public databases where available, was sufficient to determine this variant is unlikely to cause disease. Therefore, this variant is classified as likely benign. -
not specified Benign:3
Benign, criteria provided, single submitterclinical testingGeneDxNov 05, 2013This 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. -
Likely benign, criteria provided, single submitterclinical testingGenetic Services Laboratory, University of ChicagoJan 08, 2021DNA sequence analysis of the MUTYH gene demonstrated a sequence change, c.925C>T, in exon 10 that results in an amino acid change, p.Arg309Cys. This sequence change has been described in the gnomAD database with a frequency of 0.09% in the European population (dbSNP rs138089183). The p.Arg309Cys change affects a poorly conserved amino acid residue located in a domain of the MUTYH protein that is known to be functional. In-silico pathogenicity prediction tools (SIFT, PolyPhen2, Align GVGD, REVEL) provide contradictory results for the p.Arg309Cys substitution. The c.925C>T sequence change has been identified in individuals with colorectal polyps and/or colorectal cancer (PMIDs: 19732775; 19527492, 27829682). Out et al., 2012, identified the p.Arg309Cys change in individuals with a personal and/or family history of breast cancer and in controls, without a statistically significant difference in the rates of detection between the two populations (PMID: 22297469). In vitro analyses of the p.Arg309Cys change have shown contradictory results. Goto et al., 2010, demonstrated that the variant retains normal glycosylase activity in vitro (PMID: 20848659). However, Brinkmeyer et al., 2015, and Komine et al., 2015, performed in vitro assays that demonstrated significant decreases in enzyme activity, binding activity to damaged DNA, and defective base excision repair activity (PMIDs: 26377631, 25820570). Due to these contrasting evidences, the clinical significance of the p.Arg309Cys change remains unknown at this time. -
Likely benign, criteria provided, single submitterclinical testingCenter for Genomic Medicine, Rigshospitalet, Copenhagen University HospitalAug 15, 2023- -
Hereditary cancer-predisposing syndrome Benign:3
Benign, criteria provided, single submitterclinical testingColor Diagnostics, LLC DBA Color HealthApr 01, 2015- -
Benign, criteria provided, single submittercurationSema4, Sema4Apr 14, 2021- -
Likely benign, criteria provided, single submitterclinical testingAmbry GeneticsAug 05, 2014This alteration is classified as likely benign based on a combination of the following: seen in unaffected individuals, 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. -
Breast and/or ovarian cancer Benign:1
Likely benign, criteria provided, single submitterclinical testingCHEO Genetics Diagnostic Laboratory, Children's Hospital of Eastern OntarioJun 12, 2023- -
Lynch syndrome Benign:1
Likely benign, reviewed by expert panelresearchInternational Society for Gastrointestinal Hereditary Tumours (InSiGHT)Sep 05, 2013Synonymous substitution with no effect on splicing, tested with NMD inhibitor -
MLH1-related disorder Benign:1
Likely benign, no assertion criteria providedclinical testingPreventionGenetics, part of Exact SciencesMay 01, 2024This variant is classified as likely benign based on ACMG/AMP sequence variant interpretation guidelines (Richards et al. 2015 PMID: 25741868, with internal and published modifications). -
Hereditary nonpolyposis colorectal neoplasms Benign:1
Benign, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpFeb 01, 2024- -
Malignant tumor of breast Benign:1
Likely benign, no assertion criteria providedclinical testingDepartment of Pathology and Laboratory Medicine, Sinai Health System-The MLH1 p.Ala125= variant was identified in dbSNP (ID: rs1800144 as With Likely benign allele), ClinVar (likely benign as reviewed by expert panel; 8x as benign or likely benign), Cosmic (1x), UMD-LSDB (9x, classified as neutral, co-occurred with pathogenic variants in MLH1 or MSH2 3x), Insight Colon Cancer Gene Variant Database (6x, as likely not pathogenic), and Mismatch Repair Genes Variant Database. The variant was also identified in control databases in 150 of 277158 chromosomes at a frequency of 0.0005, increasing the likelihood this could be a low frequency benign variant (Genome Aggregation Database Feb 27, 2017). It was identified in the following populations: African in 4 of 24038 chromosomes (freq: 0.0002), Other in 3 of 6464 chromosomes (freq: 0.0005), Latino in 77 of 34418 chromosomes (freq: 0.002237), European Non-Finnish in 65 of 126642 chromosomes (freq: 0.0005), and Ashkenazi Jewish in 1 of 10150 chromosomes (freq: 0.0001); it was not observed in the East Asian, Finnish, or South Asian populations. The variant was not identified in MutDB or the Zhejiang Colon Cancer Database. The p.Ala125= variant is not expected to have clinical significance because it does not result in a change of amino acid and is not located in a known consensus splice site. In silico or computational prediction software programs (SpliceSiteFinder, MaxEntScan, NNSPLICE, GeneSplicer, HumanSpliceFinder) do not predict a difference in splicing. In addition, one study using RT-PCR from patient RNA followed by sequencing did not detect aberrant splicing (Auclair 2006). In summary, the clinical significance of this variant cannot be determined with certainty at this time although the available information is suggestive of a benign role. This variant is classified as likely benign. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
BayesDel_noAF
Benign
-0.69
CADD
Benign
2.0
DANN
Benign
0.61
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.7

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.11
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: rs1800144; hg19: chr3-37045960; COSMIC: COSV51622308; COSMIC: COSV51622308; API