rs121913026

Variant summary

Our verdict is Pathogenic. The variant received 14 ACMG points: 14P and 0B. PM1PM2PP3_ModeratePP5_Very_Strong

The NM_000400.4(ERCC2):​c.2164C>T​(p.Arg722Trp) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000273 in 1,613,898 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. R722L) has been classified as Uncertain significance.

Frequency

Genomes: 𝑓 0.000079 ( 0 hom., cov: 32)
Exomes 𝑓: 0.000022 ( 0 hom. )

Consequence

ERCC2
NM_000400.4 missense

Scores

11
4
4

Clinical Significance

Pathogenic criteria provided, multiple submitters, no conflicts P:16

Conservation

PhyloP100: 0.263

Publications

62 publications found
Variant links:
Genes affected
ERCC2 (HGNC:3434): (ERCC excision repair 2, TFIIH core complex helicase subunit) The nucleotide excision repair pathway is a mechanism to repair damage to DNA. The protein encoded by this gene is involved in transcription-coupled nucleotide excision repair and is an integral member of the basal transcription factor BTF2/TFIIH complex. The gene product has ATP-dependent DNA helicase activity and belongs to the RAD3/XPD subfamily of helicases. Defects in this gene can result in three different disorders, the cancer-prone syndrome xeroderma pigmentosum complementation group D, trichothiodystrophy, and Cockayne syndrome. Alternatively spliced transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Aug 2008]
ERCC2 Gene-Disease associations (from GenCC):
  • cerebrooculofacioskeletal syndrome 2
    Inheritance: AR Classification: DEFINITIVE Submitted by: G2P
  • trichothiodystrophy 1, photosensitive
    Inheritance: AR Classification: DEFINITIVE, STRONG Submitted by: Illumina, Labcorp Genetics (formerly Invitae), G2P, Genomics England PanelApp
  • xeroderma pigmentosum group D
    Inheritance: AR Classification: DEFINITIVE, STRONG Submitted by: Genomics England PanelApp, Laboratory for Molecular Medicine, ClinGen, Labcorp Genetics (formerly Invitae), G2P
  • sarcoma
    Inheritance: AR Classification: MODERATE Submitted by: Genomics England PanelApp
  • COFS syndrome
    Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
  • trichothiodystrophy
    Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
  • xeroderma pigmentosum
    Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
  • xeroderma pigmentosum-Cockayne syndrome complex
    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 14 ACMG points.

PM1
In a hotspot region, there are 4 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 0 benign, 21 uncertain in NM_000400.4
PM2
Very rare variant in population databases, with high coverage;
PP3
MetaRNN computational evidence supports a deleterious effect, 0.892
PP5
Variant 19-45352235-G-A is Pathogenic according to our data. Variant chr19-45352235-G-A is described in ClinVar as Pathogenic. ClinVar VariationId is 16792.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
ERCC2NM_000400.4 linkc.2164C>T p.Arg722Trp missense_variant Exon 22 of 23 ENST00000391945.10 NP_000391.1

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
ERCC2ENST00000391945.10 linkc.2164C>T p.Arg722Trp missense_variant Exon 22 of 23 1 NM_000400.4 ENSP00000375809.4

Frequencies

GnomAD3 genomes
AF:
0.0000789
AC:
12
AN:
152172
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.000193
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:
0.0000588
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.0000239
AC:
6
AN:
251074
AF XY:
0.0000442
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.0000289
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000353
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000219
AC:
32
AN:
1461726
Hom.:
0
Cov.:
33
AF XY:
0.0000275
AC XY:
20
AN XY:
727156
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
33478
American (AMR)
AF:
0.0000224
AC:
1
AN:
44720
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26136
East Asian (EAS)
AF:
0.0000504
AC:
2
AN:
39698
South Asian (SAS)
AF:
0.0000232
AC:
2
AN:
86254
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
53350
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5736
European-Non Finnish (NFE)
AF:
0.0000234
AC:
26
AN:
1111974
Other (OTH)
AF:
0.0000166
AC:
1
AN:
60380
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.473
Heterozygous variant carriers
0
2
4
7
9
11
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:
0.0000789
AC:
12
AN:
152172
Hom.:
0
Cov.:
32
AF XY:
0.0000538
AC XY:
4
AN XY:
74344
show subpopulations
African (AFR)
AF:
0.000193
AC:
8
AN:
41440
American (AMR)
AF:
0.00
AC:
0
AN:
15280
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3470
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5196
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4824
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10626
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.0000588
AC:
4
AN:
68022
Other (OTH)
AF:
0.00
AC:
0
AN:
2086
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.546
Heterozygous variant carriers
0
1
2
2
3
4
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:
0.0000629
Hom.:
0
Bravo
AF:
0.0000718
ESP6500AA
AF:
0.000227
AC:
1
ESP6500EA
AF:
0.000116
AC:
1
ExAC
AF:
0.0000330
AC:
4
EpiCase
AF:
0.0000545
EpiControl
AF:
0.0000593

ClinVar

Significance: Pathogenic
Submissions summary: Pathogenic:16
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Pathogenic:6
Dec 06, 2021
GeneDx
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Published functional studies demonstrate that R722W disrupts RARB2 mRNA synthesis by deregulating several transcriptional steps and destabilizes the architecture of the evolutionarily conserved general transcription factor IIH (TFIIH) (Singh et al., 2015); 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: 18817897, 25431422, 7920640, 15494306, 26577220, 23232694, 23221806, 23039039, 20944642, 25620205, 22705887, 12820975, 27862069, 8571952, 28724667, 19085937, 31282071, 31589614, 32732226, 31980526, 31803976) -

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

- -

Jul 01, 2018
CeGaT Center for Human Genetics Tuebingen
Significance:Pathogenic
Review Status:criteria provided, single submitter
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

- -

Oct 29, 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 722 of the ERCC2 protein (p.Arg722Trp). This variant is present in population databases (rs121913026, gnomAD 0.004%). This missense change has been observed in individual(s) with photosensitive trichothiodystrophy (PMID: 31282071, 31803976). In at least one individual the data is consistent with being in trans (on the opposite chromosome) from a pathogenic variant. It has also been observed to segregate with disease in related individuals. ClinVar contains an entry for this variant (Variation ID: 16792). 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 ERCC2 protein function with a positive predictive value of 80%. For these reasons, this variant has been classified as Pathogenic. -

-
Genome Diagnostics Laboratory, Amsterdam University Medical Center
Significance:Pathogenic
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Cerebrooculofacioskeletal syndrome 2 Pathogenic:3
Jan 09, 2014
Equipe Genetique des Anomalies du Developpement, Université de Bourgogne
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

-
Service de Génétique Moléculaire, Hôpital Robert Debré
Significance:Pathogenic
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Mar 27, 2024
Baylor Genetics
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

ERCC2-related disorder Pathogenic:2
Nov 20, 2019
Rady Children's Institute for Genomic Medicine, Rady Children's Hospital San Diego
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant has been previously reported as a compound heterozygous and homozygous change in patients with trichothiodystrophy (PMID: 8571952, 19085937, 20944642, 23232694, 26577220). Functional studies using patient fibroblast cell lines show that this variant impedes the recruitment of transcription repair factor TFIIH to sites of DNA damage, at least in part by weakening the interaction of ERCC2 with the GTF2H2 subunit (PMID: 18817897, 25620205). Another study using patient fibroblast cells shows that this variant results in a drastic reduction in the expression of collagen type VI alpha1 subunit, an important component of soft connective tissues, due to impaired TFIIH function (PMID: 23221806). This variant is present in the heterozygous state in the gnomAD population database at a frequency of 0.003% (9/276898) and thus is presumed to be rare. The c.2164C>T (p.Arg722Trp) variant affects a highly conserved amino acid and is predicted by multiple in silico tools to have a deleterious effect on protein function. Based on the available evidence, the c.2164C>T (p.Arg722Trp) variant is classified as Pathogenic. -

Feb 09, 2023
PreventionGenetics, part of Exact Sciences
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The ERCC2 c.2164C>T variant is predicted to result in the amino acid substitution p.Arg722Trp. This variant was reported in the homozygous and compound heterozygous states in individuals with trichothiodystrophy (TTD) (Pehlivan et al. 2012. PubMed ID: 23039039; Takayama et al. 1996. PubMed ID: 8571952; Botta et al. 2008. PubMed ID: 19085937; Usuda et al. 2011. PubMed ID: 20944642; Brauns et al. 2016. PubMed ID: 26577220; Miguet et al. 2016. PubMed ID: 27862069; Leemans et al. 2019. PubMed ID: 31803976). Functional studies of cells isolated from patients with this variant showed high sensitivity to UV light and decreased DNA repair (Takayama et al. 1996. PubMed ID: 8571952; Nishiwaki et al. 2008. PubMed ID: 18817897). A homozygous mouse model for the p.Arg772Trp variant showed an earlier on-set of age-related vascular phenotypes (Durik et al. 2012. PubMed ID: 22705887). This variant is reported in 0.0047% of alleles in individuals of European (Non-Finnish) descent in gnomAD (http://gnomad.broadinstitute.org/variant/19-45855493-G-A). This variant is interpreted as pathogenic. -

Trichothiodystrophy 1, photosensitive Pathogenic:2
Jun 01, 1994
OMIM
Significance:Pathogenic
Review Status:no assertion criteria provided
Collection Method:literature only

- -

-
Juno Genomics, Hangzhou Juno Genomics, Inc
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

PS3+PM3_Strong+PP4+PM2_Supporting -

Trichothiodystrophy Pathogenic:1
May 28, 2020
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Variant summary: ERCC2 c.2164C>T (p.Arg722Trp) 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 2.4e-05 in 251074 control chromosomes. c.2164C>T has been reported in the literature in individuals affected with Trichothiodystrophy (e.g. Takayama_1996, Taylor_1997, Usuda_2011, Zhou_2013). These data indicate that the variant is likely to be associated with disease. At least one publication reports experimental evidence evaluating an impact on protein function and showed that p.Arg722Trp affected normal activity (e.g. Singh_2015). Three 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. Based on the evidence outlined above, the variant was classified as pathogenic. -

Xeroderma pigmentosum, group D;C1853102:Cerebrooculofacioskeletal syndrome 2;C1866504:Trichothiodystrophy 1, photosensitive Pathogenic:1
Oct 31, 2018
Fulgent Genetics, Fulgent Genetics
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Hypotrichosis simplex Pathogenic:1
Mar 05, 2021
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The p.Arg722Trp variant in ERCC2 has been reported in >10 individuals with trichothiodystrophy (TTD) as homozygous or in trans with a second pathogenic ERCC2 variant (Takayama 1996 PMID:8571952, Stefanini 2010 PMID:19931493, Pehlivan 2012 PMID:23039039). It has also been identified in 0.005% (6/128882) of European chromosomes by gnomAD (http://gnomad.broadinstitute.org); however, this frequency is low enough to be consistent with a recessive carrier frequency. This variant has also been reported in ClinVar (Variation ID 16792). In vitro functional studies support an impact on protein function (Pehlivan 2012 PMID:23039039, Singh 2015 PMID:25620205). Mouse models have shown that this variant causes TTD (deBoer 1998 PMID: 9651581). In summary, this variant meets criteria to be classified as pathogenic for autosomal recessive TTD. ACMG/AMP Criteria applied: PS3, PM3_Strong, PM2_Supporting. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.78
BayesDel_addAF
Pathogenic
0.31
D
BayesDel_noAF
Pathogenic
0.31
CADD
Uncertain
25
DANN
Uncertain
1.0
DEOGEN2
Uncertain
0.68
D;T;T
Eigen
Benign
0.023
Eigen_PC
Benign
-0.18
FATHMM_MKL
Benign
0.65
D
LIST_S2
Pathogenic
1.0
D;D;D
M_CAP
Pathogenic
0.42
D
MetaRNN
Pathogenic
0.89
D;D;D
MetaSVM
Uncertain
0.56
D
MutationAssessor
Pathogenic
3.2
M;.;.
PhyloP100
0.26
PrimateAI
Uncertain
0.71
T
PROVEAN
Pathogenic
-6.7
D;D;.
REVEL
Pathogenic
0.80
Sift
Pathogenic
0.0
D;D;.
Sift4G
Pathogenic
0.0010
D;D;D
Polyphen
1.0
D;D;.
Vest4
0.89
MVP
0.94
MPC
0.81
ClinPred
0.96
D
GERP RS
-5.9
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.1
Varity_R
0.92
gMVP
0.71
Mutation Taster
=11/89
disease causing (ClinVar)

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.050
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: rs121913026; hg19: chr19-45855493; API