chr7-143339295-G-A

Variant summary

Our verdict is Pathogenic. Variant got 16 ACMG points: 16P and 0B. PM1PM5PP3_StrongPP5_Very_Strong

The NM_000083.3(CLCN1):​c.1444G>A​(p.Gly482Arg) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.000013 in 1,613,006 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. 13/21 in silico tools predict a damaging outcome for this variant. Variant has been reported in ClinVar as Likely pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. G482?) has been classified as Pathogenic.

Frequency

Genomes: 𝑓 0.0000066 ( 0 hom., cov: 32)
Exomes 𝑓: 0.000014 ( 0 hom. )

Consequence

CLCN1
NM_000083.3 missense

Scores

17
1
1

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:7

Conservation

PhyloP100: 9.99
Variant links:
Genes affected
CLCN1 (HGNC:2019): (chloride voltage-gated channel 1) The CLCN family of voltage-dependent chloride channel genes comprises nine members (CLCN1-7, Ka and Kb) which demonstrate quite diverse functional characteristics while sharing significant sequence homology. The protein encoded by this gene regulates the electric excitability of the skeletal muscle membrane. Mutations in this gene cause two forms of inherited human muscle disorders: recessive generalized myotonia congenita (Becker) and dominant myotonia (Thomsen). Alternative splicing results in multiple transcript variants. [provided by RefSeq, Mar 2012]

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ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 16 ACMG points.

PM1
In a transmembrane_region Helical (size 19) in uniprot entity CLCN1_HUMAN there are 15 pathogenic changes around while only 0 benign (100%) in NM_000083.3
PM5
Other missense variant is known to change same aminoacid residue: Variant chr7-143339295-G-M is described in Lovd as [Pathogenic].
PP3
MetaRNN computational evidence supports a deleterious effect, 0.995
PP5
Variant 7-143339295-G-A is Pathogenic according to our data. Variant chr7-143339295-G-A is described in ClinVar as [Likely_pathogenic]. Clinvar id is 546108.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-143339295-G-A is described in Lovd as [Pathogenic]. Variant chr7-143339295-G-A is described in Lovd as [Pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
CLCN1NM_000083.3 linkuse as main transcriptc.1444G>A p.Gly482Arg missense_variant 13/23 ENST00000343257.7 NP_000074.3
CLCN1NR_046453.2 linkuse as main transcriptn.1399G>A non_coding_transcript_exon_variant 12/22

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
CLCN1ENST00000343257.7 linkuse as main transcriptc.1444G>A p.Gly482Arg missense_variant 13/231 NM_000083.3 ENSP00000339867 P4
CLCN1ENST00000432192.6 linkuse as main transcriptc.*729G>A 3_prime_UTR_variant, NMD_transcript_variant 13/231 ENSP00000395949
CLCN1ENST00000650516.2 linkuse as main transcriptc.1444G>A p.Gly482Arg missense_variant 13/23 ENSP00000498052 A2

Frequencies

GnomAD3 genomes
AF:
0.00000657
AC:
1
AN:
152186
Hom.:
0
Cov.:
32
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:
0.000192
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
GnomAD3 exomes
AF:
0.0000119
AC:
3
AN:
251486
Hom.:
0
AF XY:
0.00000736
AC XY:
1
AN XY:
135918
show subpopulations
Gnomad AFR exome
AF:
0.000123
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00000879
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000137
AC:
20
AN:
1460820
Hom.:
0
Cov.:
31
AF XY:
0.00000963
AC XY:
7
AN XY:
726750
show subpopulations
Gnomad4 AFR exome
AF:
0.000120
Gnomad4 AMR exome
AF:
0.00
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.0000252
Gnomad4 SAS exome
AF:
0.00
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.0000117
Gnomad4 OTH exome
AF:
0.0000166
GnomAD4 genome
AF:
0.00000657
AC:
1
AN:
152186
Hom.:
0
Cov.:
32
AF XY:
0.00
AC XY:
0
AN XY:
74346
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.000192
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.00
Gnomad4 OTH
AF:
0.00
Bravo
AF:
0.0000302
ExAC
AF:
0.0000165
AC:
2
Asia WGS
AF:
0.000577
AC:
2
AN:
3478

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:7
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Pathogenic:3
Likely pathogenic, criteria provided, single submitterclinical testingGeneDxMay 03, 2021Observed in the heterozygous state, without a second pathogenic variant, in multiple individuals with Thomson disease (domiant form), although some individuals were reported to have clinical features consistent with the more severe Becker disease (recessive form) (Meyer-Kleine et al., 1995; Jou et al., 2004; Lo Monaco et al., 2004); Observed in the heterozygous state in a patient with myotonia congenita and was found to be inherited from an unaffected father (Jou et al., 2004); Observed in patients with myotonia congenita who harbored a second CLCN1 variant in the literature and referred for genetic testing at GeneDx (Lo Monaco et al., 2015); Published functional studies with electrophysiological analysis of Xenopus oocytes demonstrate G482R results in loss of CLCN1 channel function (Lin et al., 2006); Not observed at a significant frequency in large population cohorts (Lek et al., 2016); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; This variant is associated with the following publications: (PMID: 23739125, 17097617, 10644771, 15311340, 24349310, 25065301, 28427807, 15786415, 12210360, 8533761, 31567646, 31544778, 22346025) -
Pathogenic, criteria provided, single submitterclinical testingRevvity Omics, RevvityFeb 29, 2020- -
Pathogenic, criteria provided, single submitterclinical testingCeGaT Center for Human Genetics TuebingenNov 01, 2022CLCN1: PS3, PS4, PM2, PM5, PP3, PS2:Supporting -
Congenital myotonia, autosomal recessive form Pathogenic:2
Pathogenic, criteria provided, single submitterclinical testingMolecular Genetics, Royal Melbourne HospitalNov 05, 2023This sequence change in CLCN1 is predicted to replace glycine with arginine at codon 482, p.(Gly482Arg). The glycine residue is highly conserved (100 vertebrates, UCSC), and is a critical glycine residue in the helical transmembrane M-N Linker domain of the chloride ion channel (PMID: 24349310). There is a large physicochemical difference between glycine and arginine. The highest population minor allele frequency in the population database gnomAD v2.1 is 0.01% (2/16,256 alleles) in the African/African American population, which is consistent with a recessive disease. This variant has been detected in at least three individuals with autosomal recessive/Becker myotonia congenita (MC). Of those individuals, one individual was homozygous and two were compound heterozygous for the variant and a pathogenic variant, confirmed in trans (PMID: 22346025, 37066920; LOVD). The variant is reported to segregate with disease in the homozygous state in a single family (PMID: 22346025). There are limited reports of the variant in autosomal dominant/Thomsen MC (PMID: 15311340, 31567646). In vitro patch-clamp assays with limited validation in HEK293 cells and Xenopus oocytes demonstrate the variant leads to a loss of chloride channel function (PMID: 10644771, 17097617, 18035046). Computational evidence [predicts a deleterious effect/ predicts a benign effect/ is uninformative] for the missense substitution (REVEL = 0.997). Based on the classification scheme RMH Modified ACMG/AMP Guidelines v1.6.1, this variant is classified as PATHOGENIC. Following criteria are met: PM3_Strong, PM1, PP3_Moderate, PM2_Supporting, PS3_Supporting, PP1. -
Pathogenic, no assertion criteria providedliterature onlyOMIMOct 07, 2013- -
Congenital myotonia, autosomal recessive form;C2936781:Congenital myotonia, autosomal dominant form Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpJan 31, 2024This sequence change replaces glycine, which is neutral and non-polar, with arginine, which is basic and polar, at codon 482 of the CLCN1 protein (p.Gly482Arg). This variant is present in population databases (rs746125212, gnomAD 0.01%). This missense change has been observed in individuals with autosomal recessive myotonia congenita (PMID: 22346025, 25065301; Invitae). It has also been observed to segregate with disease in related individuals. This variant has been reported in individual(s) with autosomal dominant myotonia congenita (PMID: 8533761, 15311340, 15786415, 31567646); however, the role of the variant in this condition is currently unclear. ClinVar contains an entry for this variant (Variation ID: 546108). 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 CLCN1 protein function with a positive predictive value of 95%. Experimental studies have shown that this missense change affects CLCN1 function (PMID: 10644771, 17097617, 18035046). For these reasons, this variant has been classified as Pathogenic. -
Congenital myotonia, autosomal dominant form Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingCenter for Genomic Medicine, King Faisal Specialist Hospital and Research CenterMar 25, 2024- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
1.0
BayesDel_addAF
Pathogenic
0.40
D
BayesDel_noAF
Pathogenic
0.57
CADD
Pathogenic
33
DANN
Pathogenic
1.0
DEOGEN2
Pathogenic
0.96
D
Eigen
Pathogenic
1.1
Eigen_PC
Pathogenic
1.0
FATHMM_MKL
Pathogenic
0.99
D
LIST_S2
Uncertain
0.96
D
M_CAP
Pathogenic
0.82
D
MetaRNN
Pathogenic
0.99
D
MetaSVM
Pathogenic
0.94
D
MutationAssessor
Pathogenic
4.5
H
MutationTaster
Benign
1.0
D
PrimateAI
Pathogenic
0.82
D
PROVEAN
Pathogenic
-7.7
D
REVEL
Pathogenic
1.0
Sift
Pathogenic
0.0
D
Sift4G
Pathogenic
0.0
D
Polyphen
1.0
D
Vest4
0.99
MutPred
0.98
Gain of methylation at G482 (P = 0.0278);
MVP
0.99
MPC
0.81
ClinPred
1.0
D
GERP RS
5.6
Varity_R
0.99
gMVP
0.99

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.13
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: rs746125212; hg19: chr7-143036388; COSMIC: COSV58367156; API