rs121909398

Variant summary

Our verdict is Pathogenic. Variant got 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong

The NM_201548.5(CERKL):​c.769C>T​(p.Arg257*) variant causes a stop gained change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.000593 in 1,613,656 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 (★★). Variant results in nonsense mediated mRNA decay.

Frequency

Genomes: 𝑓 0.00037 ( 0 hom., cov: 32)
Exomes 𝑓: 0.00062 ( 0 hom. )

Consequence

CERKL
NM_201548.5 stop_gained

Scores

1
1
5

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:36

Conservation

PhyloP100: -0.0780
Variant links:
Genes affected
CERKL (HGNC:21699): (ceramide kinase like) This gene was initially identified as a locus (RP26) associated with an autosomal recessive form of retinitis pigmentosa (arRP) disease. This gene encodes a protein with ceramide kinase-like domains, however, the protein does not phosphorylate ceramide and its target substrate is currently unknown. This protein may be a negative regulator of apoptosis in photoreceptor cells. Mutations in this gene cause a form of retinitis pigmentosa characterized by autosomal recessive cone and rod dystrophy (arCRD). Alternative splicing of this gene results in multiple transcript variants encoding different isoforms and non-coding transcripts.[provided by RefSeq, May 2010]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 18 ACMG points.

PVS1
Loss of function variant, product undergoes nonsense mediated mRNA decay. LoF is a known mechanism of disease.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 2-181558617-G-A is Pathogenic according to our data. Variant chr2-181558617-G-A is described in ClinVar as [Likely_pathogenic]. Clinvar id is 2364.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-181558617-G-A is described in Lovd as [Pathogenic]. Variant chr2-181558617-G-A is described in Lovd as [Likely_pathogenic]. Variant chr2-181558617-G-A is described in Lovd as [Pathogenic]. Variant chr2-181558617-G-A is described in Lovd as [Likely_pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
CERKLNM_201548.5 linkc.769C>T p.Arg257* stop_gained Exon 5 of 13 ENST00000410087.8 NP_963842.1 Q49MI3-2

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
CERKLENST00000410087.8 linkc.769C>T p.Arg257* stop_gained Exon 5 of 13 1 NM_201548.5 ENSP00000386725.3 Q49MI3-2

Frequencies

GnomAD3 genomes
AF:
0.000375
AC:
57
AN:
152026
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.0000725
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.000525
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:
0.000647
Gnomad OTH
AF:
0.000956
GnomAD3 exomes
AF:
0.000346
AC:
86
AN:
248832
Hom.:
0
AF XY:
0.000407
AC XY:
55
AN XY:
134974
show subpopulations
Gnomad AFR exome
AF:
0.000129
Gnomad AMR exome
AF:
0.000174
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.000523
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.000550
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.000616
AC:
900
AN:
1461512
Hom.:
0
Cov.:
32
AF XY:
0.000631
AC XY:
459
AN XY:
727056
show subpopulations
Gnomad4 AFR exome
AF:
0.0000598
Gnomad4 AMR exome
AF:
0.000313
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.0000252
Gnomad4 SAS exome
AF:
0.000603
Gnomad4 FIN exome
AF:
0.0000374
Gnomad4 NFE exome
AF:
0.000708
Gnomad4 OTH exome
AF:
0.000662
GnomAD4 genome
AF:
0.000375
AC:
57
AN:
152144
Hom.:
0
Cov.:
32
AF XY:
0.000296
AC XY:
22
AN XY:
74388
show subpopulations
Gnomad4 AFR
AF:
0.0000723
Gnomad4 AMR
AF:
0.000524
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.000647
Gnomad4 OTH
AF:
0.000946
Alfa
AF:
0.000390
Hom.:
0
Bravo
AF:
0.000317
TwinsUK
AF:
0.00135
AC:
5
ALSPAC
AF:
0.00
AC:
0
ESP6500AA
AF:
0.000247
AC:
1
ESP6500EA
AF:
0.000599
AC:
5
ExAC
AF:
0.000397
AC:
48
EpiCase
AF:
0.000327
EpiControl
AF:
0.000474

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:36
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Retinitis pigmentosa 26 Pathogenic:10
Oct 01, 2013
OMIM
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: literature only

- -

Apr 08, 2021
Ocular Genomics Institute, Massachusetts Eye and Ear
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: research

The CERKL c.847C>T variant was identified in an individual with retinitis pigmentosa with a presumed recessive inheritance pattern. Through a review of available evidence we were able to apply the following criteria: PVS1, PS3, PM2, PM3, PP1, PP5. Based on this evidence we have classified this variant as Pathogenic. -

May 04, 2022
Broad Center for Mendelian Genomics, Broad Institute of MIT and Harvard
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: curation

The heterozygous p.Arg283Ter variant in CERKL (also referred to as p.Arg257Ter) was identified by our study, along with a likely pathogenic variant, in 1 individual with retinitis pigmentosa 26. The variant has been reported in at least 9 individuals of Danish, Spanish, and unknown ethnicity with retinitis pigmentosa 26 (PMID: 14681825, 25097241), segregated with disease in 6 affected relatives from 2 families (PMID: 14681825), and has been identified in 0.05% (62/112768) of European non-Finnish chromosomes by the Genome Aggregation Database (gnomAD, http://gnomad.broadinstitute.org; dbSNP ID: rs121909398). Although this variant has been seen in the general population, its frequency is not high enough to rule out a pathogenic role. This variant has also been reported in ClinVar (Variation ID: 2364) as pathogenic by multiple submitters and as likely pathogenic by Medical Genetics Laboratory, Kennedy Center, Juliane Marie Center, Rigshospitalet. This nonsense variant leads to a premature termination codon at position 283, which is predicted to lead to a truncated or absent protein. Loss of function of the CERKL gene is a moderately established disease mechanism in autosomal recessive retinitis pigmentosa 26. The presence of this variant in at least 8 affected homozygotes, in combination with at least 1 reported pathogenic variant, and in at least 9 individuals with retinitis pigmentosa 26 increases the likelihood that the p.Arg283Ter variant is pathogenic (Variation ID: 91393; PMID: 14681825, 25097241). In summary, this variant meets criteria to be classified as pathogenic for retinitis pigmentosa 26 in an autosomal recessive manner based on the predicted impact of the variant, segregation in multiple families, and multiple homozygous occurrences and occurrences with pathogenic CERKL variants in affected individuals. ACMG/AMP Criteria applied: PVS1_strong, PP1_strong, PM3_strong (Richards 2015). -

Jun 22, 2023
Revvity Omics, Revvity
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

-
Genomics England Pilot Project, Genomics England
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Mar 28, 2024
Baylor Genetics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

May 28, 2019
Mendelics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Nov 08, 2018
Centre for Mendelian Genomics, University Medical Centre Ljubljana
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This variant was classified as: Pathogenic. The following ACMG criteria were applied in classifying this variant: PVS1,PM2. -

Sep 16, 2020
Natera, Inc.
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

Mar 07, 2024
Fulgent Genetics, Fulgent Genetics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

not provided Pathogenic:8
Oct 23, 2020
Institute of Medical Genetics and Applied Genomics, University Hospital Tübingen
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Feb 09, 2022
GeneDx
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Nonsense variant predicted to result in protein truncation or nonsense mediated decay in a gene for which loss-of-function is a known mechanism of disease; This variant is associated with the following publications: (PMID: 21151602, 29555955, 29068140, 30337596, 28157192, 15708351, 24123366, 25097241, 25525159, 14681825, 28041643, 25999674, 22164218, 24043777, 18515597, 30718709, 28559085, 31082679, 34426522, 32411380, 32036094, 32865075, 31456290, 32581362, 31589614, 33576794, 33322828, 31054281, 32037395) -

Mar 01, 2024
CeGaT Center for Human Genetics Tuebingen
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

CERKL: PM3:Very Strong, PVS1, PM2 -

Jan 07, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This sequence change creates a premature translational stop signal (p.Arg283*) in the CERKL gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in CERKL are known to be pathogenic (PMID: 14681825, 23591405, 24043777). This variant is present in population databases (rs121909398, gnomAD 0.05%). This premature translational stop signal has been observed in individual(s) with CERKL-related conditions (PMID: 14681825, 21151602, 24625443, 25097241, 28041643, 221642182). ClinVar contains an entry for this variant (Variation ID: 2364). Algorithms developed to predict the effect of sequence changes on RNA splicing suggest that this variant may disrupt the consensus splice site. For these reasons, this variant has been classified as Pathogenic. -

Dec 16, 2016
Eurofins Ntd Llc (ga)
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

-
Clinical Genetics, Academic 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: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

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

- -

Retinitis pigmentosa Pathogenic:6
Apr 27, 2017
Illumina Laboratory Services, Illumina
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The CERKL c.769C>T (p.Arg257Ter) variant, also referred to as c.847C>T (p.Arg283Ter), is a stop-gained variant and is predicted to result in a premature termination of the protein. The p.Arg257Ter variant has been reported in at least five studies in which it is found in at least 24 individuals with retinitis pigmentosa including 21 in a homozygous state from 13 families, and three affected siblings from an additional family in a compound heterozygous state (Tuson et al. 2004; Avila-Fernandez et al. 2010; Gonzalez-del Pozo et al. 2011; Nishiguchi et al. 2013; van Huet et al. 2015). The variant was absent from 360 control individuals and is reported at a frequency of 0.00067 in the South Asian population of the Exome Aggregation Consortium. The variant is located in the conserved catalytic domain of the protein (Tuson et al. 2004) and is reported to segregate with disease in several families (Avila-Fernandez et al. 2010; Gonzalez-del Pozo et al. 2011). Due to the potential impact of stop-gained variants and the supporting evidence, the p.Arg257Ter variant is classified as pathogenic for recessive retinitis pigmentosa. This variant was observed by ICSL as part of a predisposition screen in an ostensibly healthy population. -

Apr 01, 2018
Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet
Significance: Likely pathogenic
Review Status: no assertion criteria provided
Collection Method: research

- -

Apr 01, 2021
Broad Center for Mendelian Genomics, Broad Institute of MIT and Harvard
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: curation

The p.Arg283Ter variant in CERKL was identified in an individual with Retinitis pigmentosa, via a collaborative study between the Broad Institute's Center for Mendelian Genomics and the Pierce lab (https://oculargenomics.meei.harvard.edu/labs/pierce-lab/lab-members/). Through a review of available evidence we were able to apply the following criteria: PVS1, PS3, PM2, PM3, PP1, PP5. Based on this evidence we have classified this variant as Pathogenic. If you have any questions about the classification please reach out to the Pierce Lab. -

Jan 01, 2015
NIHR Bioresource Rare Diseases, University of Cambridge
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: research

- -

Aug 25, 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: CERKL c.847C>T (p.Arg283X) results in a premature termination codon, predicted to cause a truncation of the encoded protein or absence of the protein due to nonsense mediated decay, which are commonly known mechanisms for disease. Truncations downstream of this position have been associated with Retinitis pigmentosa in HGMD and been classified as pathogenic in Clinvar. The variant allele was found at a frequency of 0.00035 in 248832 control chromosomes. This frequency is not significantly higher than expected for a pathogenic variant in CERKL causing Retinitis Pigmentosa (0.00035 vs 0.0013), allowing no conclusion about variant significance. c.847C>T has been reported in the literature in multiple families affected with Retinitis Pigmentosa, with strong segregation of the variant with disease (eg. Tuson_2004, Aleman_2009, Khan_2013, etc). These data indicate that the variant is very likely to be associated with disease. 22 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. -

Jul 24, 2023
Ophthalmic Genetics Group, Institute of Molecular and Clinical Ophthalmology Basel
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: research

Clinical significance based on ACMG v2.0 -

Cone-rod dystrophy Pathogenic:4
Sep 01, 2016
Joint Genome Diagnostic Labs from Nijmegen and Maastricht, Radboudumc and MUMC+
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

Apr 01, 2018
Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: research

- -

Jul 24, 2023
Ophthalmic Genetics Group, Institute of Molecular and Clinical Ophthalmology Basel
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: research

Clinical significance based on ACMG v2.0 -

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

- -

Retinal dystrophy Pathogenic:4
Aug 02, 2019
Blueprint Genetics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

May 27, 2024
Ophthalmic Genetics Group, Institute of Molecular and Clinical Ophthalmology Basel
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: research

- -

Jan 01, 2023
Institute of Human Genetics, Univ. Regensburg, Univ. Regensburg
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Jan 01, 2015
NIHR Bioresource Rare Diseases, University of Cambridge
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: research

- -

Cone dystrophy;C1840457:Retinal pigment epithelial atrophy Pathogenic:1
Jan 01, 2017
Centre for Mendelian Genomics, University Medical Centre Ljubljana
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

CERKL-related retinopathy Pathogenic:1
May 29, 2023
Department of Pathology and Laboratory Medicine, Sinai Health System
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: research

- -

See cases Pathogenic:1
Aug 25, 2020
Laboratorio de Genetica e Diagnostico Molecular, Hospital Israelita Albert Einstein
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

ACMG classification criteria: PVS1, PM3 -

CERKL-related disorder Pathogenic:1
Sep 27, 2024
PreventionGenetics, part of Exact Sciences
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

The CERKL c.847C>T variant is predicted to result in premature protein termination (p.Arg283*). This variant can also be denoted as c.769C>T (p.Arg257*) in transcript NM_201548.4. This variant has been reported many times to be causative for autosomal recessive retinitis pigmentosa (Tuson et al. 2004. PubMed ID: 14681825; Littink et al. 2010. PubMed ID: 20554613; Stone et al. 2017. PubMed ID: 28559085). This variant is reported in 0.054% of alleles in individuals of European (Non-Finnish) descent in gnomAD. Nonsense variants in CERKL are expected to be pathogenic, and this variant has been classified as pathogenic by multiple independent submitters to the ClinVar database (https://www.ncbi.nlm.nih.gov/clinvar/variation/2364/). Given the evidence, we interpret this variant as pathogenic. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
BayesDel_addAF
Pathogenic
0.33
D
BayesDel_noAF
Uncertain
0.050
CADD
Pathogenic
28
DANN
Benign
0.89
Eigen
Benign
-0.40
Eigen_PC
Benign
-0.83
FATHMM_MKL
Benign
0.021
N
Vest4
0.87
GERP RS
-11

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: rs121909398; hg19: chr2-182423344; COSMIC: COSV59205418; COSMIC: COSV59205418; API