rs121907993
Variant summary
Our verdict is Pathogenic. Variant got 13 ACMG points: 13P and 0B. PM1PM2PP3PP5_Very_Strong
The NM_000053.4(ATP7B):c.2755C>T(p.Arg919Trp) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000322 in 1,613,962 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
Consequence
NM_000053.4 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Pathogenic. Variant got 13 ACMG points.
Transcripts
RefSeq
Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt |
---|---|---|---|---|---|---|---|---|
ATP7B | NM_000053.4 | c.2755C>T | p.Arg919Trp | missense_variant | Exon 12 of 21 | ENST00000242839.10 | NP_000044.2 |
Ensembl
Frequencies
GnomAD3 genomes AF: 0.0000526 AC: 8AN: 152094Hom.: 0 Cov.: 32
GnomAD3 exomes AF: 0.0000603 AC: 15AN: 248730Hom.: 0 AF XY: 0.0000444 AC XY: 6AN XY: 135060
GnomAD4 exome AF: 0.0000301 AC: 44AN: 1461750Hom.: 0 Cov.: 36 AF XY: 0.0000371 AC XY: 27AN XY: 727168
GnomAD4 genome AF: 0.0000526 AC: 8AN: 152212Hom.: 0 Cov.: 32 AF XY: 0.0000403 AC XY: 3AN XY: 74418
ClinVar
Submissions by phenotype
Wilson disease Pathogenic:11
The p.Arg919Trp variant in ATP7B has been reported in at least 10 individuals with Wilson disease, including at least 1 homozygote and 5 compound heterozygotes, and segregated in at least 1 affected sibling (Coffey 2013, Ferenci 2019, Lepori 2007, Loudianos 1998, Loudianos 2013, Merle 2010, Poon 2016, Simsek Papur 2013, Wei 2014, Weiss 2010). This variant has also been identified in 3/15386 African chromosomes by gnomAD (http://gnomad.broadinstitute.org). It has also been reported in ClinVar (Variation ID: 312386). Another missense variant at the same position (c.2755C>G, p.Arg919Gly) has been reported in ClinVar and classified by several clinical laboratories as pathogenic (Variation ID 3857). Computational prediction tools and conservation analyses do not provide strong support for or against an impact to the protein. In summary, although additional studies are required to fully establish its clinical significance, this variant meets criteria to be classified as likely pathogenic for autosomal recessive Wilson disease. ACMG/AMP criteria applied: PM3_Strong, PM5_Supporting, PM2_Supporting, PP1, PP4. -
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This sequence change replaces arginine, which is basic and polar, with tryptophan, which is neutral and slightly polar, at codon 919 of the ATP7B protein (p.Arg919Trp). This variant is present in population databases (rs121907993, gnomAD 0.02%). This missense change has been observed in individual(s) with Wilson disease (PMID: 23219664, 25089800). It has also been observed to segregate with disease in related individuals. ClinVar contains an entry for this variant (Variation ID: 312386). 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 expected to disrupt ATP7B protein function with a positive predictive value of 80%. This variant disrupts the p.Arg919 amino acid residue in ATP7B. Other variant(s) that disrupt this residue have been determined to be pathogenic (PMID: 11405812, 12376745, 17680703, 21796144, 23219664, 25089800, 26032686). This suggests that this residue is clinically significant, and that variants that disrupt this residue are likely to be disease-causing. For these reasons, this variant has been classified as Pathogenic. -
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Variant summary: ATP7B c.2755C>T (p.Arg919Trp) results in a non-conservative amino acid change in the encoded protein sequence. Three of three in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 6.4e-05 in 251064 control chromosomes (gnomAD and publication data). This frequency is not significantly higher than estimated for a pathogenic variant in ATP7B causing Wilson Disease (6.4e-05 vs 0.0054), allowing no conclusion about variant significance. c.2755C>T has been reported in the literature in individuals affected with Wilson Disease (Loudianos_2013, Maleki_2013, Wei_2014, Collins_2021). These data indicate that the variant is very likely to be associated with disease. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. The following publications have been ascertained in the context of this evaluation (PMID: 17949296, 9671269, 20517649, 22692182, 23518715, 23235335, 23333878, 24253677, 23219664, 20082719, 25089800, 23159873, 23333878, 31980526, 33640437). Seven submitters have cited clinical-significance assessments for this variant to ClinVar after 2014 and classified this variant as uncertain significance (n=1), likely pathogenic (n=5) and pathogenic (n=1). Based on the evidence outlined above, the variant was classified as pathogenic. -
PM2_Supporting+PM5+PP3+PM3+PP4+PP1 -
The ATP7B c.2755C>T; p.Arg919Trp variant (rs121907993, ClinVar Variation ID: 312386) is reported in the literature in multiple individuals affected with Wilson disease (Collins 2021, Loudianos 1998, Loudianos 2013, Simsek 2013, Zhao 2019). This variant is found in the non-Finnish European population with an allele frequency of .007% (8/112722 alleles) in the Genome Aggregation Database (v2.1.1). Computational analyses predict that this variant is deleterious (REVEL: 0.75). Additionally, another variant at this codon (c.2755C>G, p.Arg919Gly) has been reported in individuals with Wilson disease and are considered pathogenic (Geng 2013, Takeshita 2002). Based on available information, this variant is considered to be likely pathogenic. References: Collins CJ et al. Direct Measurement of ATP7B Peptides Is Highly Effective in the Diagnosis of Wilson Disease. Gastroenterology. 2021 Jun;160(7):2367-2382.e1. PMID: 33640437 Geng J et al. Identification of one novel and nine recurrent mutations of the ATP7B gene in 11 children with Wilson disease. World J Pediatr. 2013 May;9(2):158-62. PMID: 23275100. Loudianos G et al. Further delineation of the molecular pathology of Wilson disease in the Mediterranean population. Hum Mutat. 1998;12(2):89-94. PMID: 9671269. Loudianos G et al. Wilson's disease in two consecutive generations: the detection of three mutated alleles in the ATP7B gene in two Sardinian families. Dig Liver Dis. 2013 Apr;45(4):342-5. PMID: 23219664. Simsek Papur O et al. Mutation analysis of ATP7B gene in Turkish Wilson disease patients: identification of five novel mutations. Eur J Med Genet. 2013 Apr;56(4):175-9. PMID: 23333878. Takeshita Y et al. Two families with Wilson disease in which siblings showed different phenotypes. J Hum Genet. 2002;47(10):543-7. PMID: 12376745. Zhao S et al. Pilot study of expanded carrier screening for 11 recessive diseases in China: results from 10,476 ethnically diverse couples. Eur J Hum Genet. 2019 Feb;27(2):254-262. PMID: 30275481 -
This missense variant replaces arginine with tryptophan at codon 919 of the ATP7B protein. Computational prediction suggests that this variant may have deleterious impact on protein structure and function (internally defined REVEL score threshold >= 0.7, PMID: 27666373). To our knowledge, functional studies have not been reported for this variant. This variant has been reported in individuals affected with autosomal recessive Wilson disease (PMID: 9671269, 17949296, 20082719, 20517649, 23219664, 23333878, 23518715, 25089800). In two of these individuals, this variant was confirmed to be in the homozygous state (PMID: 25089800) or compound heterozygous state with a second pathogenic variant in the same gene (PMID: 23219664). This variant has been identified in 15/248730 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Based on the available evidence, this variant is classified as Likely Pathogenic. -
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not provided Pathogenic:3
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PP3, PM2, PM3, PM5 -
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: 22692182, 31980526, 34470610, 33260258, 31217899, 27022412, 30275481, 23219664, 23518715, 20082719, 30232804, 23275100, 9671269, 33763395, 28433111, 37229156, 35314707) -
ATP7B-related disorder Pathogenic:1
The ATP7B c.2755C>T variant is predicted to result in the amino acid substitution p.Arg919Trp. This variant has been reported in multiple individuals with Wilson disease (Loudianos et al. 1998. PubMed ID: 9671269; family 1, Loudianos et al. 2012. PubMed ID: 23219664; Wei et al. 2014. PubMed ID: 25089800; Merle et al. 2010. PubMed ID: 20082719; Lepori et al. 2007. PubMed ID: 17949296; Weiss et al. 2010. PubMed ID: 20517649; Simsek Papur et al. 2013. PubMed ID: 23333878). This variant is reported in 0.019% of alleles in individuals of African descent in gnomAD and has been consistently interpreted as pathogenic and likely pathogenic by several other laboratories in the ClinVar database (https://www.ncbi.nlm.nih.gov/clinvar/variation/312386/). A different missense change impacting the same amino acid (c.2755C>G, p.Arg919Gly) has been reported in the homozygous and compound heterozygous state in multiple individuals with Wilson disease (see for example: Yamaguchi. 1998. PubMed ID: 9452121; Wang et al. 2018. PubMed ID: 29637721). This variant is interpreted as likely pathogenic. -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at