chr7-155803211-G-C

Variant summary

Our verdict is Uncertain significance. The variant received 3 ACMG points: 3P and 0B. PM1PP2

The NM_000193.4(SHH):​c.1078C>G​(p.Leu360Val) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000125 in 1,357,246 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Uncertain significance (★). Synonymous variant affecting the same amino acid position (i.e. L360L) has been classified as Likely benign.

Frequency

Genomes: not found (cov: 32)
Exomes 𝑓: 0.000013 ( 0 hom. )

Consequence

SHH
NM_000193.4 missense

Scores

4
4
11

Clinical Significance

Uncertain significance criteria provided, single submitter U:1

Conservation

PhyloP100: 1.22

Publications

0 publications found
Variant links:
Genes affected
SHH (HGNC:10848): (sonic hedgehog signaling molecule) This gene encodes a protein that is instrumental in patterning the early embryo. It has been implicated as the key inductive signal in patterning of the ventral neural tube, the anterior-posterior limb axis, and the ventral somites. Of three human proteins showing sequence and functional similarity to the sonic hedgehog protein of Drosophila, this protein is the most similar. The protein is made as a precursor that is autocatalytically cleaved; the N-terminal portion is soluble and contains the signalling activity while the C-terminal portion is involved in precursor processing. More importantly, the C-terminal product covalently attaches a cholesterol moiety to the N-terminal product, restricting the N-terminal product to the cell surface and preventing it from freely diffusing throughout the developing embryo. Defects in this protein or in its signalling pathway are a cause of holoprosencephaly (HPE), a disorder in which the developing forebrain fails to correctly separate into right and left hemispheres. HPE is manifested by facial deformities. It is also thought that mutations in this gene or in its signalling pathway may be responsible for VACTERL syndrome, which is characterized by vertebral defects, anal atresia, tracheoesophageal fistula with esophageal atresia, radial and renal dysplasia, cardiac anomalies, and limb abnormalities. Additionally, mutations in a long range enhancer located approximately 1 megabase upstream of this gene disrupt limb patterning and can result in preaxial polydactyly. [provided by RefSeq, Jul 2008]
SHH Gene-Disease associations (from GenCC):
  • holoprosencephaly 3
    Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: G2P, Ambry Genetics, Labcorp Genetics (formerly Invitae)
  • microphthalmia, isolated, with coloboma 5
    Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: G2P, PanelApp Australia
  • polydactyly of a triphalangeal thumb
    Inheritance: AD Classification: DEFINITIVE, SUPPORTIVE Submitted by: G2P, Orphanet
  • solitary median maxillary central incisor syndrome
    Inheritance: AD Classification: DEFINITIVE, MODERATE Submitted by: G2P, Ambry Genetics
  • skeletal system disorder
    Inheritance: AD Classification: MODERATE Submitted by: Ambry Genetics
  • autosomal dominant preaxial polydactyly-upperback hypertrichosis syndrome
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • hypoplastic tibiae-postaxial polydactyly syndrome
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • microphthalmia, isolated, with coloboma
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • syndactyly type 4
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • triphalangeal thumb-polysyndactyly syndrome
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • holoprosencephaly
    Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Uncertain_significance. The variant received 3 ACMG points.

PM1
In a hotspot region, there are 5 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 0 benign, 9 uncertain in NM_000193.4
PP2
Missense variant in the gene, where a lot of missense mutations are associated with disease in ClinVar. The gene has 26 curated pathogenic missense variants (we use a threshold of 10). The gene has 8 curated benign missense variants. Gene score misZ: 2.9479 (below the threshold of 3.09). Trascript score misZ: 0.49525 (below the threshold of 3.09). GenCC associations: The gene is linked to polydactyly of a triphalangeal thumb, microphthalmia, isolated, with coloboma 5, solitary median maxillary central incisor syndrome, holoprosencephaly 3, skeletal system disorder, hypoplastic tibiae-postaxial polydactyly syndrome, holoprosencephaly, syndactyly type 4, microphthalmia, isolated, with coloboma, autosomal dominant preaxial polydactyly-upperback hypertrichosis syndrome, triphalangeal thumb-polysyndactyly syndrome.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
SHHNM_000193.4 linkc.1078C>G p.Leu360Val missense_variant Exon 3 of 3 ENST00000297261.7 NP_000184.1 Q15465

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
SHHENST00000297261.7 linkc.1078C>G p.Leu360Val missense_variant Exon 3 of 3 1 NM_000193.4 ENSP00000297261.2 Q15465
SHHENST00000430104.5 linkc.302-2966C>G intron_variant Intron 3 of 3 1 ENSP00000396621.1 C9JC48
SHHENST00000435425.1 linkn.302-2614C>G intron_variant Intron 3 of 4 1 ENSP00000413871.1 F8WEH4
SHHENST00000441114.5 linkn.302-2544C>G intron_variant Intron 3 of 4 1 ENSP00000410546.1 F8WB84

Frequencies

GnomAD3 genomes
Cov.:
32
GnomAD4 exome
AF:
0.0000125
AC:
17
AN:
1357246
Hom.:
0
Cov.:
35
AF XY:
0.00000596
AC XY:
4
AN XY:
671476
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
28290
American (AMR)
AF:
0.00
AC:
0
AN:
32268
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
23860
East Asian (EAS)
AF:
0.00
AC:
0
AN:
30922
South Asian (SAS)
AF:
0.00
AC:
0
AN:
75440
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
38152
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5486
European-Non Finnish (NFE)
AF:
0.0000159
AC:
17
AN:
1066580
Other (OTH)
AF:
0.00
AC:
0
AN:
56248
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.460
Heterozygous variant carriers
0
1
2
4
5
6
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
Cov.:
32

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:1
Revision: criteria provided, single submitter
LINK: link

Submissions by phenotype

Holoprosencephaly 3 Uncertain:1
Nov 19, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence change replaces leucine, which is neutral and non-polar, with valine, which is neutral and non-polar, at codon 360 of the SHH protein (p.Leu360Val). This variant is not present in population databases (gnomAD no frequency). This variant has not been reported in the literature in individuals affected with SHH-related conditions. 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 not expected to disrupt SHH protein function with a negative predictive value of 80%. 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
0.28
BayesDel_addAF
Uncertain
0.072
D
BayesDel_noAF
Benign
-0.13
CADD
Benign
21
DANN
Benign
0.90
DEOGEN2
Pathogenic
0.86
D
Eigen
Benign
-0.18
Eigen_PC
Benign
-0.13
FATHMM_MKL
Uncertain
0.86
D
LIST_S2
Benign
0.85
T
M_CAP
Pathogenic
0.97
D
MetaRNN
Uncertain
0.69
D
MetaSVM
Pathogenic
0.80
D
MutationAssessor
Benign
1.4
L
PhyloP100
1.2
PrimateAI
Pathogenic
0.90
D
PROVEAN
Benign
-1.0
N
REVEL
Uncertain
0.47
Sift
Benign
0.64
T
Sift4G
Benign
0.93
T
Polyphen
0.56
P
Vest4
0.17
MutPred
0.85
Gain of sheet (P = 0.0827);
MVP
0.83
ClinPred
0.70
D
GERP RS
2.7
Varity_R
0.20
gMVP
0.69
Mutation Taster
=60/40
polymorphism

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

Other links and lift over

dbSNP: rs191903572; hg19: chr7-155595905; API