rs104893621

Variant summary

Our verdict is Pathogenic. Variant got 18 ACMG points: 18P and 0B. PM1PM2PM5PP3_StrongPP5_Very_Strong

The NM_001298.3(CNGA3):​c.1306C>T​(p.Arg436Trp) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000694 in 1,613,912 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 Pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R436Q) has been classified as Likely pathogenic.

Frequency

Genomes: 𝑓 0.000066 ( 0 hom., cov: 32)
Exomes 𝑓: 0.000070 ( 0 hom. )

Consequence

CNGA3
NM_001298.3 missense

Scores

12
4
3

Clinical Significance

Pathogenic criteria provided, multiple submitters, no conflicts P:17

Conservation

PhyloP100: 1.57
Variant links:
Genes affected
CNGA3 (HGNC:2150): (cyclic nucleotide gated channel subunit alpha 3) This gene encodes a member of the cyclic nucleotide-gated cation channel protein family which is required for normal vision and olfactory signal transduction. Mutations in this gene are associated with achromatopsia (rod monochromacy) and color blindness. Two alternatively spliced transcripts encoding different isoforms have been described. [provided by RefSeq, Jul 2008]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 18 ACMG points.

PM1
In a helix (size 15) in uniprot entity CNGA3_HUMAN there are 15 pathogenic changes around while only 0 benign (100%) in NM_001298.3
PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chrnull-null-null-null is described in UniProt as null.
PP3
MetaRNN computational evidence supports a deleterious effect, 0.948
PP5
Variant 2-98396476-C-T is Pathogenic according to our data. Variant chr2-98396476-C-T is described in ClinVar as [Pathogenic]. Clinvar id is 9482.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-98396476-C-T is described in Lovd as [Likely_pathogenic]. Variant chr2-98396476-C-T is described in Lovd as [Pathogenic]. Variant chr2-98396476-C-T is described in Lovd as [Pathogenic]. Variant chr2-98396476-C-T is described in Lovd as [Likely_pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
CNGA3NM_001298.3 linkc.1306C>T p.Arg436Trp missense_variant Exon 8 of 8 ENST00000272602.7 NP_001289.1 Q16281-1

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
CNGA3ENST00000272602.7 linkc.1306C>T p.Arg436Trp missense_variant Exon 8 of 8 1 NM_001298.3 ENSP00000272602.2 Q16281-1
CNGA3ENST00000436404.6 linkc.1252C>T p.Arg418Trp missense_variant Exon 7 of 7 1 ENSP00000410070.2 Q16281-2
CNGA3ENST00000409937.1 linkn.1459C>T non_coding_transcript_exon_variant Exon 8 of 8 2

Frequencies

GnomAD3 genomes
AF:
0.0000658
AC:
10
AN:
152026
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
Gnomad ASJ
AF:
0.000576
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00125
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0000294
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000957
AC:
24
AN:
250684
Hom.:
0
AF XY:
0.000111
AC XY:
15
AN XY:
135586
show subpopulations
Gnomad AFR exome
AF:
0.000124
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.000399
Gnomad EAS exome
AF:
0.000109
Gnomad SAS exome
AF:
0.000360
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000442
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000698
AC:
102
AN:
1461768
Hom.:
0
Cov.:
31
AF XY:
0.0000756
AC XY:
55
AN XY:
727164
show subpopulations
Gnomad4 AFR exome
AF:
0.0000896
Gnomad4 AMR exome
AF:
0.00
Gnomad4 ASJ exome
AF:
0.000344
Gnomad4 EAS exome
AF:
0.000101
Gnomad4 SAS exome
AF:
0.000313
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.0000513
Gnomad4 OTH exome
AF:
0.0000331
GnomAD4 genome
AF:
0.0000657
AC:
10
AN:
152144
Hom.:
0
Cov.:
32
AF XY:
0.000108
AC XY:
8
AN XY:
74378
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.000576
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00125
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.0000294
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.000130
Hom.:
0
Bravo
AF:
0.0000378
ESP6500AA
AF:
0.000227
AC:
1
ESP6500EA
AF:
0.000116
AC:
1
ExAC
AF:
0.0000906
AC:
11
Asia WGS
AF:
0.000289
AC:
1
AN:
3478
EpiCase
AF:
0.000109
EpiControl
AF:
0.0000593

ClinVar

Significance: Pathogenic
Submissions summary: Pathogenic:17
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Achromatopsia 2 Pathogenic:7
-
Institute for Medical Genetics and Human Genetics, Charité - Universitätsmedizin Berlin
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: not provided

- -

Aug 26, 2022
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Variant summary: CNGA3 c.1306C>T (p.Arg436Trp) results in a non-conservative amino acid change in the encoded protein sequence. 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 9.6e-05 in 250684 control chromosomes. c.1306C>T has been reported in the literature in multiple individuals affected with Achromatopsia and has been shown to segregate in families (eg. Saqib_2015, Wissinger_2001, etc). These data indicate that the variant is very likely to be associated with disease. Experimental studies have shown the variant to have absent cGMP-activated current upon patch-clamp recordings, suggesting that this mutation causes a loss of function of the channels (Muraki-Oda_2007). Additionally, a mouse model demonstrated the variant to result in a loss of activity and impaired cellular trafficking, as a result of changes to the secondary structure (Matveev_2010). Seven clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 without evidence for independent evaluation. All laboratories classified the variant as pathogenic/likely pathogenic. Based on the evidence outlined above, the variant was classified as pathogenic. -

-
Neuberg Centre For Genomic Medicine, NCGM
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The missense variant p.R436W in CNGA3 (NM_001298.3) has been previously reported in multiple affected individuals (Li S et al,Huang L et al). Functional studies suggest a damaging effect (Muraki-Oda S et al). In silico tools are damaging and the residue is poorly conserved across species. For these reasons, this variant has been classified as Pathogenic. -

-
Laboratory of Genetics in Ophthalmology, Institut Imagine
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: research

- -

-
Genetics laboratory, Department of Obstetrics & Gynae, Institute of Kidney Diseases & Research Centre Dr. H.L. Trivedi Institute Of Transplantation Sciences
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

Oct 01, 2001
OMIM
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: literature only

- -

-
Centogene AG - the Rare Disease Company
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

not provided Pathogenic:5
Aug 12, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This sequence change replaces arginine, which is basic and polar, with tryptophan, which is neutral and slightly polar, at codon 436 of the CNGA3 protein (p.Arg436Trp). This variant is present in population databases (rs104893621, gnomAD 0.04%). This missense change has been observed in individuals with retinal dystrophy (PMID: 11536077, 25943428, 26992781). It has also been observed to segregate with disease in related individuals. ClinVar contains an entry for this variant (Variation ID: 9482). 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 CNGA3 protein function with a positive predictive value of 95%. Experimental studies have shown that this missense change affects CNGA3 function (PMID: 17693388). For these reasons, this variant has been classified as Pathogenic. -

May 01, 2023
CeGaT Center for Human Genetics Tuebingen
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

CNGA3: PM3:Very Strong, PM1, PM2, PS3:Supporting -

Oct 23, 2022
GeneDx
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Published functional studies demonstrate a damaging effect with loss of activity and impaired cellular trafficking, as a result of changes to the secondary structure (Muraki-Oda et al., 2007; Matveev et al., 2010); This variant is associated with the following publications: (PMID: 16961972, 32531858, 26992781, 20088482, 11536077, 25943428, 25616768, 21778272, 15712225, 14757870, 17693388, 30804581, 30609409, 30682209, 24903488, 30418171, 31456290, 33083013, 34426522) -

-
Clinical Genetics DNA and cytogenetics Diagnostics Lab, Erasmus MC, Erasmus Medical Center
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

-
Joint Genome Diagnostic Labs from Nijmegen and Maastricht, Radboudumc and MUMC+
Significance: Likely pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

Achromatopsia Pathogenic:3
Mar 20, 2018
Molecular Genetics Laboratory, Institute for Ophthalmic Research
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: research

- -

Mar 28, 2017
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The p.Arg436Trp (NM001298.2 c.1306C>T) variant in CNGA3 has been reported in at least 2 homozygous and 10 compound heterozygous individuals with clinical diagno sis of achromatopsia or cone-rod dystrophy (Li 2014, Wissinger 2001, Johnson 200 4, Goto-Omoto 2006, Saqib 2015, Huang 2016, Nishiguchi 2005, Zelinger 2015, and Genead 2011), and segregated in 3 affected homozygous family members in one fami ly (Saqib 2015). This variant has also been identified in 0.036% (6/16,458) of S outh Asian chromosomes by the Exome Aggregation Consortium (ExAC, http://exac.br oadinstitute.org; dbSNP rs104893621). Although this variant has been seen in the general population, its frequency is low enough to be consistent with a recessi ve carrier frequency. In summary, this variant meets criteria to be classified a s pathogenic for CNGA3-related achromatopsia/ cone-rod dystrophy in an autosomal recessive manner based upon its biallelic occurrence in affected individuals an d low frequency in control populations. -

Jun 23, 2019
Sharon lab, Hadassah-Hebrew University Medical Center
Significance: Likely pathogenic
Review Status: no assertion criteria provided
Collection Method: research

- -

Retinal dystrophy Pathogenic:2
Jan 01, 2017
Institute of Human Genetics, Univ. Regensburg, Univ. Regensburg
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

May 13, 2018
Blueprint Genetics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Uncertain
0.56
BayesDel_addAF
Pathogenic
0.29
D
BayesDel_noAF
Pathogenic
0.49
CADD
Pathogenic
30
DANN
Uncertain
1.0
DEOGEN2
Pathogenic
0.85
D;.;D;.
Eigen
Uncertain
0.32
Eigen_PC
Benign
0.14
FATHMM_MKL
Benign
0.59
D
LIST_S2
Pathogenic
0.99
D;D;.;D
M_CAP
Pathogenic
0.44
D
MetaRNN
Pathogenic
0.95
D;D;D;D
MetaSVM
Pathogenic
1.1
D
MutationAssessor
Pathogenic
3.8
H;.;H;.
PrimateAI
Uncertain
0.68
T
PROVEAN
Pathogenic
-7.5
D;D;D;D
REVEL
Pathogenic
0.86
Sift
Pathogenic
0.0
D;D;D;D
Sift4G
Pathogenic
0.0
D;D;D;D
Polyphen
1.0
D;.;D;.
Vest4
0.86
MVP
1.0
MPC
0.52
ClinPred
0.99
D
GERP RS
4.0
Varity_R
0.75
gMVP
0.87

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

LitVar

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs104893621; hg19: chr2-99012939; COSMIC: COSV55625945; API