rs11669576

Variant summary

Our verdict is Benign. Variant got -14 ACMG points: 0P and 14B. BS2BA1BP4BP2

This summary comes from the ClinGen Evidence Repository: The NM_000527.5(LDLR):c.1171G>A (p.Ala391Thr) variant is classified as Benign for Familial Hypercholesterolemia by applying evidence codes BA1, BS2, BP2 and BP4 as defined by the ClinGen Familial Hypercholesterolemia Expert Panel LDLR-specific variant curation guidelines (https://doi.org/10.1101/2021.03.17.21252755). The supporting evidence is as follows: BA1 - FAF = 0.1752 (17.52%) in African exomes (gnomAD v2.1.1); frequency meets BA1 >0.5%BS2 - Case-level data in VCI indicates this variant is identified in heterozygosity in 1894 normolipidemic individuals, as well as in homozygosity in 58 normolipidemic individuals.BP2 - Case-level data present in VCI indicates this variant has been identified to co-occur with Pathogenic LDLR variants in at least 3 index cases with heterozygous FH phenotype.BP4 - REVEL = 0.309; score is below BP4 threshold of <0.50. splicing evaluation is required. Functional data on splicing not available. A) not on limits B) does not create GT C) no nearby GT. LINK:https://erepo.genome.network/evrepo/ui/classification/CA023426/MONDO:0007750/013

Frequency

Genomes: 𝑓 0.080 ( 764 hom., cov: 31)
Exomes 𝑓: 0.048 ( 2184 hom. )

Consequence

LDLR
NM_000527.5 missense

Scores

2
16

Clinical Significance

Benign reviewed by expert panel B:25O:1

Conservation

PhyloP100: -0.270
Variant links:
Genes affected
LDLR (HGNC:6547): (low density lipoprotein receptor) The low density lipoprotein receptor (LDLR) gene family consists of cell surface proteins involved in receptor-mediated endocytosis of specific ligands. The encoded protein is normally bound at the cell membrane, where it binds low density lipoprotein/cholesterol and is taken into the cell. Lysosomes release the cholesterol, which is made available for repression of microsomal enzyme 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase, the rate-limiting step in cholesterol synthesis. At the same time, a reciprocal stimulation of cholesterol ester synthesis takes place. Mutations in this gene cause the autosomal dominant disorder, familial hypercholesterolemia. Alternate splicing results in multiple transcript variants.[provided by RefSeq, May 2022]

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ACMG classification

Classification made for transcript

Verdict is Benign. Variant got -14 ACMG points.

BP2
For more information check the summary or visit ClinGen Evidence Repository.
BP4
For more information check the summary or visit ClinGen Evidence Repository.
BS2
For more information check the summary or visit ClinGen Evidence Repository.
BA1
For more information check the summary or visit ClinGen Evidence Repository.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
LDLRNM_000527.5 linkc.1171G>A p.Ala391Thr missense_variant Exon 8 of 18 ENST00000558518.6 NP_000518.1 P01130-1A0A024R7D5

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
LDLRENST00000558518.6 linkc.1171G>A p.Ala391Thr missense_variant Exon 8 of 18 1 NM_000527.5 ENSP00000454071.1 P01130-1

Frequencies

GnomAD3 genomes
AF:
0.0801
AC:
12192
AN:
152174
Hom.:
765
Cov.:
31
show subpopulations
Gnomad AFR
AF:
0.179
Gnomad AMI
AF:
0.0253
Gnomad AMR
AF:
0.0437
Gnomad ASJ
AF:
0.0251
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00393
Gnomad FIN
AF:
0.0449
Gnomad MID
AF:
0.0222
Gnomad NFE
AF:
0.0496
Gnomad OTH
AF:
0.0583
GnomAD3 exomes
AF:
0.0434
AC:
10892
AN:
250704
Hom.:
450
AF XY:
0.0408
AC XY:
5527
AN XY:
135630
show subpopulations
Gnomad AFR exome
AF:
0.181
Gnomad AMR exome
AF:
0.0255
Gnomad ASJ exome
AF:
0.0222
Gnomad EAS exome
AF:
0.0000545
Gnomad SAS exome
AF:
0.00493
Gnomad FIN exome
AF:
0.0444
Gnomad NFE exome
AF:
0.0487
Gnomad OTH exome
AF:
0.0382
GnomAD4 exome
AF:
0.0475
AC:
69434
AN:
1461152
Hom.:
2184
Cov.:
32
AF XY:
0.0460
AC XY:
33454
AN XY:
726870
show subpopulations
Gnomad4 AFR exome
AF:
0.188
Gnomad4 AMR exome
AF:
0.0287
Gnomad4 ASJ exome
AF:
0.0229
Gnomad4 EAS exome
AF:
0.0000504
Gnomad4 SAS exome
AF:
0.00527
Gnomad4 FIN exome
AF:
0.0451
Gnomad4 NFE exome
AF:
0.0496
Gnomad4 OTH exome
AF:
0.0512
GnomAD4 genome
AF:
0.0801
AC:
12198
AN:
152292
Hom.:
764
Cov.:
31
AF XY:
0.0761
AC XY:
5669
AN XY:
74454
show subpopulations
Gnomad4 AFR
AF:
0.179
Gnomad4 AMR
AF:
0.0437
Gnomad4 ASJ
AF:
0.0251
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00393
Gnomad4 FIN
AF:
0.0449
Gnomad4 NFE
AF:
0.0495
Gnomad4 OTH
AF:
0.0577
Alfa
AF:
0.0504
Hom.:
480
Bravo
AF:
0.0855
TwinsUK
AF:
0.0475
AC:
176
ALSPAC
AF:
0.0462
AC:
178
ESP6500AA
AF:
0.173
AC:
762
ESP6500EA
AF:
0.0484
AC:
416
ExAC
AF:
0.0464
AC:
5631
Asia WGS
AF:
0.0130
AC:
45
AN:
3478
EpiCase
AF:
0.0492
EpiControl
AF:
0.0499

ClinVar

Significance: Benign
Submissions summary: Benign:25Other:1
Revision: reviewed by expert panel
LINK: link

Submissions by phenotype

Hypercholesterolemia, familial, 1 Benign:13
Mar 01, 2016
Laboratory of Genetics and Molecular Cardiology, University of São Paulo
Significance: Benign
Review Status: criteria provided, single submitter
Collection Method: research

- -

Mar 01, 2016
Cardiovascular Research Group, Instituto Nacional de Saude Doutor Ricardo Jorge
Significance: Benign
Review Status: criteria provided, single submitter
Collection Method: research

MAF = 0.10 in normolipidemic controls; MAF = 8,7% in 86 Spanish healthy individuals; 0/200 Brazilian (european ancestry) normolipidemic individuals; 0/100 healthy control individuals; 0/77 healthy control individuals -

Jul 23, 2018
Department of Human Genetics, Laborarztpraxis Dres. Walther, Weindel und Kollegen
Significance: Likely benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Due to the increased occurrence of the mutation (>= 5%), this variant is classified as likely benign. -

Oct 02, 2024
All of Us Research Program, National Institutes of Health
Significance: Benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Jun 22, 2017
Color Diagnostics, LLC DBA Color Health
Significance: Benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Aug 22, 2019
Robarts Research Institute, Western University
Significance: Likely benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Aug 31, 2016
Cardiovascular Biomarker Research Laboratory, Mayo Clinic
Significance: Likely benign
Review Status: criteria provided, single submitter
Collection Method: research

DLCN criteria >=3. -

Jun 23, 2021
ClinGen Familial Hypercholesterolemia Variant Curation Expert Panel
Significance: Benign
Review Status: reviewed by expert panel
Collection Method: curation

The NM_000527.5(LDLR):c.1171G>A (p.Ala391Thr) variant is classified as Benign for Familial Hypercholesterolemia by applying evidence codes BA1, BS2, BP2 and BP4 as defined by the ClinGen Familial Hypercholesterolemia Expert Panel LDLR-specific variant curation guidelines (https://doi.org/10.1101/2021.03.17.21252755). The supporting evidence is as follows: BA1 - FAF = 0.1752 (17.52%) in African exomes (gnomAD v2.1.1); frequency meets BA1 >0.5% BS2 - Case-level data in VCI indicates this variant is identified in heterozygosity in 1894 normolipidemic individuals, as well as in homozygosity in 58 normolipidemic individuals. BP2 - Case-level data present in VCI indicates this variant has been identified to co-occur with Pathogenic LDLR variants in at least 3 index cases with heterozygous FH phenotype. BP4 - REVEL = 0.309; score is below BP4 threshold of <0.50. splicing evaluation is required. Functional data on splicing not available. A) not on limits B) does not create GT C) no nearby GT. -

Mar 25, 2016
LDLR-LOVD, British Heart Foundation
Significance: Benign
Review Status: criteria provided, single submitter
Collection Method: literature only

- -

Dec 16, 2016
Centre de Génétique Moléculaire et Chromosomique, Unité de génétique de l'Obésité et des Dyslipidémies, APHP, GH Hôpitaux Universitaires Pitié-Salpêtrière / Charles-Foix
Significance: Benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

subjects mutated among 2600 FH index cases screened = 201 6 being homozygotes / Software predictions: Benign -

Mar 22, 2017
Molecular Genetics Laboratory, Centre for Cardiovascular Surgery and Transplantation
Significance: Benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

-
Laboratorium voor Moleculaire Diagnostiek Experimentele Vasculaire Geneeskunde, Academisch Medisch Centrum
Significance: Benign
Review Status: no assertion criteria provided
Collection Method: research

- -

Mar 06, 2018
Illumina Laboratory Services, Illumina
Significance: Benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as benign is not then subjected to further curation. The score for this variant resulted in a classification of benign for this disease. -

not specified Benign:5
-
PreventionGenetics, part of Exact Sciences
Significance: Benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

-
Clinical Genetics, Academic Medical Center
Significance: Benign
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

-
Diagnostic Laboratory, Department of Genetics, University Medical Center Groningen
Significance: Benign
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

Jan 05, 2017
GeneDx
Significance: Benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This variant is considered likely benign or benign based on one or more of the following criteria: it is a conservative change, it occurs at a poorly conserved position in the protein, it is predicted to be benign by multiple in silico algorithms, and/or has population frequency not consistent with disease. -

Mar 21, 2017
Athena Diagnostics
Significance: Likely benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Familial hypercholesterolemia Benign:4
Feb 09, 2023
Cohesion Phenomics
Significance: Benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Oct 30, 2019
Natera, Inc.
Significance: Benign
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

Feb 04, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Jul 18, 2022
GENinCode PLC
Significance: Benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

not provided Benign:2Other:1
-
Dept. of Genetics and Pharmacogenomics, Merck Research Labs
Significance: not provided
Review Status: no classification provided
Collection Method: in vitro

- -

Nov 21, 2024
ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories
Significance: Benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

-
Breakthrough Genomics, Breakthrough Genomics
Significance: Benign
Review Status: criteria provided, single submitter
Collection Method: not provided

- -

Cardiovascular phenotype Benign:1
Mar 23, 2016
Ambry Genetics
Significance: Benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This alteration is classified as benign based on a combination of the following: seen in unaffected individuals, population frequency, intact protein function, lack of segregation with disease, co-occurrence, RNA analysis, in silico models, amino acid conservation, lack of disease association in case-control studies, and/or the mechanism of disease or impacted region is inconsistent with a known cause of pathogenicity. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.067
BayesDel_addAF
Benign
-0.44
T
BayesDel_noAF
Benign
-0.26
CADD
Benign
5.0
DANN
Benign
0.22
DEOGEN2
Uncertain
0.45
T;.;.;.;.;.
Eigen
Benign
-1.5
Eigen_PC
Benign
-1.3
FATHMM_MKL
Benign
0.44
N
LIST_S2
Benign
0.83
T;T;T;T;T;T
MetaRNN
Benign
0.0035
T;T;T;T;T;T
MetaSVM
Benign
-0.90
T
MutationAssessor
Benign
-2.1
N;.;.;.;.;N
PrimateAI
Benign
0.28
T
PROVEAN
Benign
0.68
N;N;N;N;N;N
REVEL
Uncertain
0.31
Sift
Benign
0.57
T;T;T;T;T;T
Sift4G
Benign
1.0
T;T;T;T;T;T
Polyphen
0.0050
B;.;.;.;.;.
Vest4
0.019
MPC
0.24
ClinPred
0.0040
T
GERP RS
-0.82
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.7
Varity_R
0.14
gMVP
0.82

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.020
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: rs11669576; hg19: chr19-11222300; COSMIC: COSV52943212; COSMIC: COSV52943212; API