rs1004405095
Variant summary
Our verdict is Uncertain significance. Variant got 4 ACMG points: 4P and 0B. PM1PM5
The NM_002667.5(PLN):c.74G>A(p.Arg25His) variant causes a missense change. The variant allele was found at a frequency of 0.0000112 in 1,610,616 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Uncertain significance (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R25C) has been classified as Pathogenic.
Frequency
Consequence
NM_002667.5 missense
Scores
Clinical Significance
Conservation
Genome browser will be placed here
ACMG classification
Verdict is Uncertain_significance. Variant got 4 ACMG points.
Transcripts
RefSeq
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
---|---|---|---|---|---|---|---|---|---|---|
PLN | ENST00000357525.6 | c.74G>A | p.Arg25His | missense_variant | Exon 2 of 2 | 1 | NM_002667.5 | ENSP00000350132.5 | ||
CEP85L | ENST00000368491.8 | c.1020+6534C>T | intron_variant | Intron 3 of 12 | 1 | NM_001042475.3 | ENSP00000357477.3 |
Frequencies
GnomAD3 genomes AF: 0.0000131 AC: 2AN: 152158Hom.: 0 Cov.: 32
GnomAD3 exomes AF: 0.00000796 AC: 2AN: 251160Hom.: 0 AF XY: 0.00000737 AC XY: 1AN XY: 135720
GnomAD4 exome AF: 0.0000110 AC: 16AN: 1458458Hom.: 0 Cov.: 28 AF XY: 0.0000152 AC XY: 11AN XY: 725830
GnomAD4 genome AF: 0.0000131 AC: 2AN: 152158Hom.: 0 Cov.: 32 AF XY: 0.0000135 AC XY: 1AN XY: 74336
ClinVar
Submissions by phenotype
not provided Uncertain:2
Identified in patients with HCM referred for genetic testing at GeneDx and in published literature (Walsh et al., 2017); Not observed at significant frequency in large population cohorts (gnomAD); 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: 28082330) -
PLN p.Arg25His Given the lack of case data we consider this variant to be of unknown significance and we do not feel it is suitable for assessing risk in healthy relatives ("predictive genetic testing"). We have seen this variant in a patient with a clinical diagnosis of HCM and was diagnosed with Fabry disease by a very likely disease-causing variant on the HCM panel. Testing was done by Invitae. The PLN variant has not been reported in the literature (as of 6/13/2016). Another variant affecting codon 25 has been reported by Dr. Hershberger's group. Liu et al., 2015 identified the R25C variant in a family with DCM and prominent arrhythmias. The PLN R25C variant came from the maternal side of the pedigree and a LMNA variant (c.607 G>A, p.Glu203Lys) came from the paternal side (previously reported in Parks et al., 2009). These variants showed incomplete segregation. The PLN variant segregated with cardiac disease in four of seven family members and the LMNA variant segregated with cardiac disease in four of seven family members. One person had both variants and presented at 47 with sudden cardiac arrest, then was diagnosed with DCM. His mother (palpitatations at 47, PVCs at 57, DCM at 71) and two of his sisters (one with LV dilation since 51, NSVT and ICD and the other with DCM at 45, NSVT and ICD) had the PLN variant. His father (AFib at 65, EF 45% at 82), uncle (DCM at 62, conduction disease, SCD), and another sister (DCM at 39, VT and ICD) had the LMNA variant. Functional studies were consistent with impaired calcium handling, suggesting pathogenicity. The Invitae report notes that the "sequence change replaces arginine with histidine at codon 25 of the PLN protein (p.Arg25His). The arginine residue is highly conserved and there is a small physicochemical difference between arginine and histidine...Algorithms developed to predict the effect of missense changes on protein structure and function (SIFT, PolyPhen-2, Align-GVGD) all suggest that this variant is likely to be disruptive, but these predictions have not been confirmed by published functional studies." There is no variation at codon 25 listed in the Exome Aggregation Consortium dataset (http://exac.broadinstitute.org/), which currently includes variant calls on ~64,000 individuals of European, African, Latino and Asian descent (as of 6/13/2016). The mean and median coverages at that site in ExAC are greater than 80x. Approximately 95% of individuals have 50x coverage. -
Dilated cardiomyopathy 1P Uncertain:1
This sequence change replaces arginine, which is basic and polar, with histidine, which is basic and polar, at codon 25 of the PLN protein (p.Arg25His). This variant is present in population databases (no rsID available, gnomAD 0.002%). This missense change has been observed in individual(s) with clinical features of PLN-related conditions (Invitae). ClinVar contains an entry for this variant (Variation ID: 410616). An algorithm developed to predict the effect of missense changes on protein structure and function (PolyPhen-2) suggests that this variant is likely to be disruptive. This variant disrupts the p.Arg25 amino acid residue in PLN. Other variant(s) that disrupt this residue have been determined to be pathogenic (PMID: 25852082, 30847666; Invitae). This suggests that this residue is clinically significant, and that variants that disrupt this residue are likely to be disease-causing. 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. -
Cardiovascular phenotype Uncertain:1
The p.R25H variant (also known as c.74G>A), located in coding exon 1 of the PLN gene, results from a G to A substitution at nucleotide position 74. The arginine at codon 25 is replaced by histidine, an amino acid with highly similar properties. This alteration has been reported in hypertrophic cardiomyopathy (HCM) cohorts; however, clinical details were limited (Lopes LR et al. Heart, 2015 Feb;101:294-301; (Harper AR et al. Nat Genet, 2021 02;53:135-142).). An alternate amino acid substitution at this codon, p.R25C, has been associated with a variety of cardiac phenotypes, including HCM, Brugada syndrome, and dilated cardiomyopathy (Lopes LR et al. Heart, 2015 Feb;101:294-301; Behr ER et al. Cardiovasc. Res., 2015 Jun;106:520-9; Liu GS et al. Cardiovasc. Res., 2015 Jul;107:164-74). This amino acid position is highly conserved in available vertebrate species. In addition, the in silico prediction for this alteration is inconclusive. 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