rs121908128

Variant summary

Our verdict is Pathogenic. The variant received 12 ACMG points: 12P and 0B. PM2PP3_ModeratePP5_Very_Strong

The NM_004937.3(CTNS):​c.969C>G​(p.Asn323Lys) variant causes a missense, splice region change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000031 in 1,611,508 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. 3/3 splice prediction tools predict no significant impact on normal splicing. Variant has been reported in ClinVar as Pathogenic (★★). Synonymous variant affecting the same amino acid position (i.e. N323N) has been classified as Likely benign.

Frequency

Genomes: 𝑓 0.000013 ( 0 hom., cov: 34)
Exomes 𝑓: 0.0000021 ( 0 hom. )

Consequence

CTNS
NM_004937.3 missense, splice_region

Scores

3
9
6
Splicing: ADA: 0.0001416
2

Clinical Significance

Pathogenic criteria provided, multiple submitters, no conflicts P:3

Conservation

PhyloP100: -0.895

Publications

14 publications found
Variant links:
Genes affected
CTNS (HGNC:2518): (cystinosin, lysosomal cystine transporter) This gene encodes a seven-transmembrane domain protein that functions to transport cystine out of lysosomes. Its activity is driven by the H+ electrochemical gradient of the lysosomal membrane. Mutations in this gene cause cystinosis, a lysosomal storage disorder. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Jul 2009]
CTNS Gene-Disease associations (from GenCC):
  • cystinosis
    Inheritance: AR Classification: DEFINITIVE Submitted by: ClinGen, Myriad Women’s Health
  • nephropathic cystinosis
    Inheritance: AR Classification: DEFINITIVE, STRONG Submitted by: G2P, Genomics England PanelApp, Ambry Genetics
  • juvenile nephropathic cystinosis
    Inheritance: AR Classification: STRONG, SUPPORTIVE Submitted by: Genomics England PanelApp, Orphanet, Labcorp Genetics (formerly Invitae)
  • ocular cystinosis
    Inheritance: AR Classification: STRONG, SUPPORTIVE Submitted by: Orphanet, Genomics England PanelApp
  • nephropathic infantile cystinosis
    Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Pathogenic. The variant received 12 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
PP3
MetaRNN computational evidence supports a deleterious effect, 0.921
PP5
Variant 17-3659974-C-G is Pathogenic according to our data. Variant chr17-3659974-C-G is described in ClinVar as Pathogenic. ClinVar VariationId is 4456.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Variant Effect in Transcripts

ACMG analysis was done for transcript: NM_004937.3. You can select a different transcript below to see updated ACMG assignments.

RefSeq Transcripts

Sel.
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
CTNS
NM_004937.3
MANE Select
c.969C>Gp.Asn323Lys
missense splice_region
Exon 11 of 12NP_004928.2O60931-1
CTNS
NM_001031681.3
c.969C>Gp.Asn323Lys
missense splice_region
Exon 11 of 13NP_001026851.2O60931-2
CTNS
NM_001374492.1
c.969C>Gp.Asn323Lys
missense splice_region
Exon 11 of 13NP_001361421.1O60931-2

Ensembl Transcripts

Sel.
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
CTNS
ENST00000046640.9
TSL:1 MANE Select
c.969C>Gp.Asn323Lys
missense splice_region
Exon 11 of 12ENSP00000046640.4O60931-1
CTNS
ENST00000381870.8
TSL:1
c.969C>Gp.Asn323Lys
missense splice_region
Exon 11 of 13ENSP00000371294.3O60931-2
CTNS
ENST00000673965.1
c.969C>Gp.Asn323Lys
missense splice_region
Exon 11 of 12ENSP00000500995.1O60931-1

Frequencies

GnomAD3 genomes
AF:
0.0000131
AC:
2
AN:
152230
Hom.:
0
Cov.:
34
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0000294
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.0000120
AC:
3
AN:
250840
AF XY:
0.0000147
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.000109
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00000883
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.00000206
AC:
3
AN:
1459278
Hom.:
0
Cov.:
31
AF XY:
0.00000275
AC XY:
2
AN XY:
726012
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
33422
American (AMR)
AF:
0.00
AC:
0
AN:
44718
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26126
East Asian (EAS)
AF:
0.0000504
AC:
2
AN:
39694
South Asian (SAS)
AF:
0.00
AC:
0
AN:
86210
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
53000
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5510
European-Non Finnish (NFE)
AF:
9.01e-7
AC:
1
AN:
1110304
Other (OTH)
AF:
0.00
AC:
0
AN:
60294
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.458
Heterozygous variant carriers
0
1
1
2
2
3
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Variant carriers
0
2
4
6
8
10
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
GnomAD4 genome
AF:
0.0000131
AC:
2
AN:
152230
Hom.:
0
Cov.:
34
AF XY:
0.00
AC XY:
0
AN XY:
74362
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
41472
American (AMR)
AF:
0.00
AC:
0
AN:
15292
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3470
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5194
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4836
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10618
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.0000294
AC:
2
AN:
68032
Other (OTH)
AF:
0.00
AC:
0
AN:
2088
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.550
Heterozygous variant carriers
0
0
1
1
2
2
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Genome Het
Variant carriers
0
2
4
6
8
10
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
Alfa
AF:
0.00000438
Hom.:
0
Bravo
AF:
0.0000151
ExAC
AF:
0.0000247
AC:
3

ClinVar

ClinVar submissions
Significance:Pathogenic
Revision:criteria provided, multiple submitters, no conflicts
View on ClinVar
Pathogenic
VUS
Benign
Condition
1
-
-
Juvenile nephropathic cystinosis (1)
1
-
-
Juvenile nephropathic cystinosis;C0950123:Inborn genetic diseases;C2931013:Ocular cystinosis (1)
1
-
-
Nephropathic cystinosis (1)

Computational scores

Source: dbNSFP v4.9

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.78
BayesDel_addAF
Benign
-0.029
T
BayesDel_noAF
Uncertain
-0.050
CADD
Benign
17
DANN
Uncertain
0.99
DEOGEN2
Pathogenic
0.84
D
Eigen
Benign
-0.68
Eigen_PC
Benign
-0.85
FATHMM_MKL
Benign
0.20
N
LIST_S2
Uncertain
0.92
D
M_CAP
Uncertain
0.24
D
MetaRNN
Pathogenic
0.92
D
MetaSVM
Uncertain
0.69
D
MutationAssessor
Uncertain
2.7
M
PhyloP100
-0.90
PrimateAI
Uncertain
0.71
T
PROVEAN
Uncertain
-3.2
D
REVEL
Uncertain
0.61
Sift
Benign
0.32
T
Sift4G
Benign
0.26
T
Polyphen
0.99
D
Vest4
0.93
MutPred
0.79
Gain of ubiquitination at N323 (P = 0.0185)
MVP
0.81
MPC
0.72
ClinPred
0.73
D
GERP RS
-5.3
Varity_R
0.87
gMVP
0.87
Mutation Taster
=0/100
disease causing (ClinVar)

Splicing

Name
Calibrated prediction
Score
Prediction
dbscSNV1_ADA
Benign
0.00014
dbscSNV1_RF
Benign
0.082
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

Other links and lift over

dbSNP: rs121908128; hg19: chr17-3563268; API