rs1026613471
Positions:
Variant summary
Our verdict is Pathogenic. Variant got 16 ACMG points: 16P and 0B. PM1PM2PP3_StrongPP5_Very_Strong
The NM_000092.5(COL4A4):c.1223G>A(p.Gly408Glu) variant causes a missense change. The variant allele was found at a frequency of 0.0000109 in 1,461,464 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Likely pathogenic (★★).
Frequency
Genomes: not found (cov: 33)
Exomes 𝑓: 0.000011 ( 0 hom. )
Consequence
COL4A4
NM_000092.5 missense
NM_000092.5 missense
Scores
11
7
1
Clinical Significance
Conservation
PhyloP100: 4.98
Genes affected
COL4A4 (HGNC:2206): (collagen type IV alpha 4 chain) This gene encodes one of the six subunits of type IV collagen, the major structural component of basement membranes. This particular collagen IV subunit, however, is only found in a subset of basement membranes. Like the other members of the type IV collagen gene family, this gene is organized in a head-to-head conformation with another type IV collagen gene so that each gene pair shares a common promoter. Mutations in this gene are associated with type II autosomal recessive Alport syndrome (hereditary glomerulonephropathy) and with familial benign hematuria (thin basement membrane disease). Two transcripts, differing only in their transcription start sites, have been identified for this gene and, as is common for collagen genes, multiple polyadenylation sites are found in the 3' UTR. [provided by RefSeq, Jul 2008]
Genome browser will be placed here
ACMG classification
Classification made for transcript
Verdict is Pathogenic. Variant got 16 ACMG points.
PM1
?
In a region_of_interest Disordered (size 46) in uniprot entity CO4A4_HUMAN there are 8 pathogenic changes around while only 2 benign (80%) in NM_000092.5
PM2
?
Very rare variant in population databases, with high coverage;
PP3
?
MetaRNN computational evidence supports a deleterious effect, 0.99
PP5
?
Variant 2-227094271-C-T is Pathogenic according to our data. Variant chr2-227094271-C-T is described in ClinVar as [Likely_pathogenic]. Clinvar id is 562349.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
Transcripts
RefSeq
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | MANE | UniProt |
---|---|---|---|---|---|---|---|
COL4A4 | NM_000092.5 | c.1223G>A | p.Gly408Glu | missense_variant | 20/48 | ENST00000396625.5 |
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | TSL | MANE | Appris | UniProt |
---|---|---|---|---|---|---|---|---|---|
COL4A4 | ENST00000396625.5 | c.1223G>A | p.Gly408Glu | missense_variant | 20/48 | 5 | NM_000092.5 | P1 |
Frequencies
GnomAD3 genomes ? Cov.: 33
GnomAD3 genomes
?
Cov.:
33
GnomAD3 exomes AF: 0.0000241 AC: 6AN: 248574Hom.: 0 AF XY: 0.0000296 AC XY: 4AN XY: 134952
GnomAD3 exomes
AF:
AC:
6
AN:
248574
Hom.:
AF XY:
AC XY:
4
AN XY:
134952
Gnomad AFR exome
AF:
Gnomad AMR exome
AF:
Gnomad ASJ exome
AF:
Gnomad EAS exome
AF:
Gnomad SAS exome
AF:
Gnomad FIN exome
AF:
Gnomad NFE exome
AF:
Gnomad OTH exome
AF:
GnomAD4 exome AF: 0.0000109 AC: 16AN: 1461464Hom.: 0 Cov.: 31 AF XY: 0.0000124 AC XY: 9AN XY: 727018
GnomAD4 exome
AF:
AC:
16
AN:
1461464
Hom.:
Cov.:
31
AF XY:
AC XY:
9
AN XY:
727018
Gnomad4 AFR exome
AF:
Gnomad4 AMR exome
AF:
Gnomad4 ASJ exome
AF:
Gnomad4 EAS exome
AF:
Gnomad4 SAS exome
AF:
Gnomad4 FIN exome
AF:
Gnomad4 NFE exome
AF:
Gnomad4 OTH exome
AF:
GnomAD4 genome ? Cov.: 33
GnomAD4 genome
?
Cov.:
33
Alfa
AF:
Hom.:
Bravo
AF:
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
Pathogenic, criteria provided, single submitter | clinical testing | Invitae | Oct 24, 2023 | This sequence change replaces glycine, which is neutral and non-polar, with glutamic acid, which is acidic and polar, at codon 408 of the COL4A4 protein (p.Gly408Glu). This variant is present in population databases (no rsID available, gnomAD 0.05%). This missense change has been observed in individuals with clinical features of Alport syndrome (Invitae). ClinVar contains an entry for this variant (Variation ID: 562349). 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 COL4A4 protein function with a positive predictive value of 95%. For these reasons, this variant has been classified as Pathogenic. - |
Likely pathogenic, no assertion criteria provided | research | Gharavi Laboratory, Columbia University | Sep 16, 2018 | - - |
Likely pathogenic, criteria provided, single submitter | clinical testing | Athena Diagnostics | May 02, 2019 | The variant disrupts a glycine residue in the canonical Gly-X-Y repeats of the triple helix domain, which are required for stability and structure of this protein. Therefore it is expected to severely affect the function of the protein. The best available variant frequency is uninformative because it is below the disease allele frequency. - |
Autosomal recessive Alport syndrome Pathogenic:2
Likely pathogenic, criteria provided, single submitter | clinical testing | Division Of Personalized Genomic Medicine, Columbia University Irving Medical Center | Nov 11, 2019 | The c.1223G>A variant in the COL4A4 gene is a missense variant, which results in the substitution of the highly conserved glycine residue at the 408 position to glutamic acid (p.Gly408Glu). This variant localizes to coding exon 20 of the COL4A4 gene (48 exons total; NP_000083.3) and is within the triple helical domain of the protein. To the best of our knowledge, this specific variant has not been described to be associated with disease. However, glycine substitutions within the triple helical domain of this protein are a known mechanism of disease. In silico analysis predicts this change to be deleterious and damaging to the structure and/or function of the protein (probably damaging by PolyPhen2 and damaging by SIFT). This variant has been observed in the Genome Aggregation Database (gnomAD) at a very low frequency (6/248,574), indicating it is not a common benign variant in the populations represented in this database. Of note, allele frequency is higher among individuals of Ashkenazi Jewish descent (5/10,026). Based on the evidence presented, this variant is classified as likely pathogenic. - |
Likely pathogenic, criteria provided, single submitter | clinical testing | Women's Health and Genetics/Laboratory Corporation of America, LabCorp | Mar 01, 2024 | Variant summary: COL4A4 c.1223G>A (p.Gly408Glu) results in a non-conservative amino acid change located in the Collagen triple helix repeat (IPR008160) of the encoded protein sequence. This missense variant disrupts a critical glycine residue at position 1 of a Gly-X-Y repeat in the collagenous domain of the collagen IV alpha 4 chain, and variants affecting these glycine residues are significantly enriched in individuals with Alport syndrome (PMID: 33854215). Five of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 2.4e-05 in 248574 control chromosomes. c.1223G>A has been reported at a heterozygous state in the literature in at-least one individual affected with Glomerulopathy (Groopman_2019). These data do not allow any conclusion about variant significance. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. The following publication have been ascertained in the context of this evaluation (PMID: 30586318). ClinVar contains an entry for this variant (Variation ID: 562349). Based on the evidence outlined above, the variant was classified as likely pathogenic. - |
Benign familial hematuria;C4746745:Autosomal recessive Alport syndrome Pathogenic:1
Pathogenic, criteria provided, single submitter | clinical testing | Fulgent Genetics, Fulgent Genetics | Apr 05, 2022 | - - |
COL4A4-related disorder Pathogenic:1
Likely pathogenic, criteria provided, single submitter | clinical testing | PreventionGenetics, part of Exact Sciences | Apr 05, 2023 | The COL4A4 c.1223G>A variant is predicted to result in the amino acid substitution p.Gly408Glu. This variant was reported in the heterozygous state in an individual with glomerulopathy and family history of kidney disease (Table S7. Groopman et al 2019. PubMed ID: 30586318). At PreventionGenetics, we have observed the c.1223G>A variant in the heterozygous state in a patient with microhematuria and proteinuria and in another patient with Alport syndrome who also carried a COL4A4 nonsense variant (internal data). The Gly408Glu variant affects a Gly residue of the conserved triple helical domain (residues 65 – 1459) of the COL4A4 protein (uniprot.org). The majority of pathogenic variants in COL4A4 substitute a glycine residue to a bulkier amino acid in the triple-helical domain (Hudson et al. 1993. PubMed ID: 8253711; https://www.ncbi.nlm.nih.gov/books/NBK1207/). This variant is reported in 0.050% of alleles in individuals of Ashkenazi Jewish descent in gnomAD (http://gnomad.broadinstitute.org/variant/2-227958987-C-T). This variant is interpreted as likely pathogenic. - |
Computational scores
Source:
Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
BayesDel_addAF
Pathogenic
D
BayesDel_noAF
Uncertain
CADD
Uncertain
DANN
Uncertain
DEOGEN2
Uncertain
D
Eigen
Pathogenic
Eigen_PC
Pathogenic
FATHMM_MKL
Uncertain
D
LIST_S2
Uncertain
D
M_CAP
Pathogenic
D
MetaRNN
Pathogenic
D
MetaSVM
Pathogenic
D
MutationAssessor
Pathogenic
M
MutationTaster
Benign
D;D
PrimateAI
Uncertain
T
PROVEAN
Pathogenic
D
REVEL
Pathogenic
Sift
Uncertain
D
Sift4G
Pathogenic
D
Polyphen
D
Vest4
MutPred
Loss of glycosylation at P407 (P = 0.1988);
MVP
MPC
ClinPred
D
GERP RS
Varity_R
gMVP
Splicing
Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
Details are displayed if max score is > 0.2
Find out detailed SpliceAI scores and Pangolin per-transcript scores at