chrX-101401654-G-C
Variant summary
Our verdict is Benign. Variant got -9 ACMG points: 0P and 9B. BP6BS1BS2
The NM_000169.3(GLA):āc.525C>Gā(p.Asp175Glu) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000984 in 1,208,879 control chromosomes in the GnomAD database, with no homozygous occurrence. There are 40 hemizygotes in GnomAD. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).
Frequency
Consequence
NM_000169.3 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Benign. Variant got -9 ACMG points.
Transcripts
RefSeq
Ensembl
Frequencies
GnomAD3 genomes AF: 0.00000895 AC: 1AN: 111743Hom.: 0 Cov.: 23 AF XY: 0.0000295 AC XY: 1AN XY: 33921
GnomAD3 exomes AF: 0.0000327 AC: 6AN: 183473Hom.: 0 AF XY: 0.0000736 AC XY: 5AN XY: 67909
GnomAD4 exome AF: 0.000108 AC: 118AN: 1097136Hom.: 0 Cov.: 29 AF XY: 0.000108 AC XY: 39AN XY: 362502
GnomAD4 genome AF: 0.00000895 AC: 1AN: 111743Hom.: 0 Cov.: 23 AF XY: 0.0000295 AC XY: 1AN XY: 33921
ClinVar
Submissions by phenotype
Fabry disease Uncertain:3Benign:1
This missense variant replaces aspartic acid with glutamic acid at codon 175 of the GLA protein. Computational prediction suggests that this variant may not impact protein structure and function (internally defined REVEL score threshold <= 0.5, PMID: 27666373). Functional studies have shown that this variant causes partial reduction of GLA enzyme activity (PMID: 23935525, 31036492). However, clinical relevance of this observation is not known. This variant has been reported in two unrelated individuals affected with hypertrophic cardiomyopathy (PMID: 27532257, 32531501). This variant has also been identified in 6/183473 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -
This sequence change replaces aspartic acid, which is acidic and polar, with glutamic acid, which is acidic and polar, at codon 175 of the GLA protein (p.Asp175Glu). This variant is present in population databases (rs782722844, gnomAD 0.006%). This missense change has been observed in individual(s) with Fabry disease and/or hypertrophic cardiomyopathy (PMID: 27532257, 32531501; internal data). ClinVar contains an entry for this variant (Variation ID: 573833). 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 GLA protein function with a negative predictive value of 80%. Experimental studies have shown that this missense change affects GLA function (PMID: 31036492). 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. -
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not provided Uncertain:1Benign:1
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This variant is associated with the following publications: (PMID: 27657681, 27532257, 23935525) -
GLA-related disorder Uncertain:1
The GLA c.525C>G variant is predicted to result in the amino acid substitution p.Asp175Glu. This variant was reported in a patients with Fabry disease and related cardiac phenotypes (Lukas et al. 2013. PubMed ID: 23935525; Patient 5 in Patel et al. 2015. PubMed ID: 25655062; Azevedo et al. 2020. PubMed ID: 32531501). In one case, a patient was noted to also have variants in other HCM gene (Azevedo et al. 2020. PubMed ID: 32531501; Patient 101 in Supplementary Table 2, Mademont-Soler et al. 2017. PubMed ID: 28771489). Functional analysis of this variant showed that enzymatic activity was mildly impacted and ~90% compared to wildtype (Lukas et al. 2013. PubMed ID: 23935525). This variant is reported in 0.0061% of alleles in individuals of European, including five hemizygous individuals (Non-Finnish) descent in gnomAD (http://gnomad.broadinstitute.org/variant/X-100656642-G-C) which is likely too frequent to be associated with high penetrance. In ClinVar, this variant has conflicting interpretations regarding its pathogenicity ranging from likely benign to uncertain (https://preview.ncbi.nlm.nih.gov/clinvar/variation/573833/). Although we suspect that this variant may be benign, at this time, the clinical significance of this variant is uncertain due to the absence of conclusive functional and genetic evidence. -
Cardiovascular phenotype Uncertain:1
The p.D175E variant (also known as c.525C>G), located in coding exon 3 of the GLA gene, results from a C to G substitution at nucleotide position 525. The aspartic acid at codon 175 is replaced by glutamic acid, an amino acid with highly similar properties. This variant has been detected in multiple individuals with hypertrophic cardiomyopathy (HCM), some of whom have variants in other cardiac genes (Mademont-Soler I et al. PLoS ONE, 2017 Aug;12:e0181465; Walsh R et al. Genet. Med., 2017 02;19:192-203; Azevedo O et al. Am. Heart J., 2020 08;226:114-126). This variant was also identified in a male individual with Anderson-Fabry disease who had sudden cardiac death (Patel V et al. Heart, 2015 Jun). Based on data from gnomAD, the G allele has an overall frequency of 0.003% (6/183473) total alleles studied, with 5 hemizygotes observed. The highest observed frequency was 0.02208% (1/4530) of Other alleles. This amino acid position is well conserved in available vertebrate species. In addition, this alteration is predicted to be tolerated by in silico analysis. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear. -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at