rs121964972

Variant summary

Our verdict is Pathogenic. Variant got 12 ACMG points: 12P and 0B. PM1PP3_ModeratePP5_Very_Strong

The NM_000071.3(CBS):​c.1058C>T​(p.Thr353Met) variant causes a missense change. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Likely pathogenic (★★). Synonymous variant affecting the same amino acid position (i.e. T353T) has been classified as Likely benign.

Frequency

Genomes: not found (cov: 0)
Exomes 𝑓: 0.000063 ( 0 hom. )

Consequence

CBS
NM_000071.3 missense

Scores

6
6
7

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:11

Conservation

PhyloP100: 4.58
Variant links:
Genes affected
CBS (HGNC:1550): (cystathionine beta-synthase) The protein encoded by this gene acts as a homotetramer to catalyze the conversion of homocysteine to cystathionine, the first step in the transsulfuration pathway. The encoded protein is allosterically activated by adenosyl-methionine and uses pyridoxal phosphate as a cofactor. Defects in this gene can cause cystathionine beta-synthase deficiency (CBSD), which can lead to homocystinuria. This gene is a major contributor to cellular hydrogen sulfide production. Multiple alternatively spliced transcript variants have been found for this gene. [provided by RefSeq, Feb 2016]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 12 ACMG points.

PM1
In a hotspot region, there are 8 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 0 benign, 7 uncertain in NM_000071.3
PP3
MetaRNN computational evidence supports a deleterious effect, 0.936
PP5
Variant 21-43060528-G-A is Pathogenic according to our data. Variant chr21-43060528-G-A is described in ClinVar as [Likely_pathogenic]. Clinvar id is 131.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr21-43060528-G-A is described in Lovd as [Likely_pathogenic]. Variant chr21-43060528-G-A is described in Lovd as [Pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE UniProt
CBSNM_000071.3 linkuse as main transcriptc.1058C>T p.Thr353Met missense_variant 12/17 ENST00000398165.8

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Appris UniProt
CBSENST00000398165.8 linkuse as main transcriptc.1058C>T p.Thr353Met missense_variant 12/171 NM_000071.3 P1P35520-1

Frequencies

GnomAD3 genomes
Cov.:
0
GnomAD3 exomes
AF:
0.0000295
AC:
7
AN:
237672
Hom.:
0
AF XY:
0.0000383
AC XY:
5
AN XY:
130450
show subpopulations
Gnomad AFR exome
AF:
0.000392
Gnomad AMR exome
AF:
0.0000291
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000633
AC:
3
AN:
47412
Hom.:
0
Cov.:
0
AF XY:
0.0000791
AC XY:
2
AN XY:
25288
show subpopulations
Gnomad4 AFR exome
AF:
0.000701
Gnomad4 AMR exome
AF:
0.000248
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.00
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.00
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
Cov.:
0
ESP6500AA
AF:
0.000227
AC:
1
ESP6500EA
AF:
0.00
AC:
0
ExAC
AF:
0.00000827
AC:
1

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:11
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Pathogenic:4
Pathogenic, criteria provided, single submitterclinical testingCeGaT Center for Human Genetics TuebingenAug 01, 2023CBS: PM3:Strong, PM1, PM2, PP4:Moderate, PS3:Supporting -
Pathogenic, criteria provided, single submitterclinical testingGeneDxNov 08, 2021Functional studies have demonstrated that this variant results in reduced enzymatic activity (Mayfield et al., 2012); This variant is associated with the following publications: (PMID: 14635102, 20066033, 17540596, 18849566, 9156316, 23685761, 21520339, 22267502, 21626167, 24211323, 16479318, 12124992, 16205833, 31589614, 23812867) -
Pathogenic, criteria provided, single submitterclinical testingGreenwood Genetic Center Diagnostic Laboratories, Greenwood Genetic CenterJul 23, 2020PS3, PM1, PM2, PM3 -
Pathogenic, criteria provided, single submitterclinical testingEurofins Ntd Llc (ga)Feb 11, 2013- -
Classic homocystinuria Pathogenic:3
Pathogenic, no assertion criteria providedclinical testingNatera, Inc.Sep 16, 2020- -
Pathogenic, criteria provided, single submitterclinical testingBaylor GeneticsFeb 21, 2024- -
Likely pathogenic, criteria provided, single submitterliterature onlyCounsylNov 21, 2014- -
Homocystinuria, pyridoxine-nonresponsive Pathogenic:1
Pathogenic, no assertion criteria providedliterature onlyOMIMJul 18, 2017- -
Familial thoracic aortic aneurysm and aortic dissection Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingAmbry GeneticsAug 31, 2021The c.1058C>T (p.T353M) alteration is located in exon 12 (coding exon 10) of the CBS gene. This alteration results from a C to T substitution at nucleotide position 1058, causing the threonine (T) at amino acid position 353 to be replaced by a methionine (M). Based on data from gnomAD, the T allele has an overall frequency of <0.01% (8/269064) total alleles studied. The highest observed frequency was 0.03% (7/24008) of African alleles. This alteration has been reported in the homozygous state and in trans with a second CBS alteration in patients with homocystinuria across various ethnicities (Kruger, 2003; Lee, 2005; Karaca, 2014; Poloni, 2018). In vitro functional studies of this alteration showed a substantial reduction in CBS activity and low growth in yeast assays (Kruger, 2003; Mayfield, 2012). In vitro expression studies of this alteration also demonstrated reduced enzyme activity in COS7 and NIH3T3 cells (Lee, 2005). The in silico prediction for this alteration is inconclusive. Based on the available evidence, this alteration is classified as pathogenic. -
HYPERHOMOCYSTEINEMIA, THROMBOTIC, CBS-RELATED Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingInvitaeJan 28, 2024This sequence change replaces threonine, which is neutral and polar, with methionine, which is neutral and non-polar, at codon 353 of the CBS protein (p.Thr353Met). This variant is present in population databases (rs121964972, gnomAD 0.03%). This missense change has been observed in individual(s) with homocystinuria (PMID: 9156316, 11774777, 12124992, 14635102, 16205833, 16479318, 21520339, 23812867). ClinVar contains an entry for this variant (Variation ID: 131). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) has been performed at Invitae for this missense variant, however the output from this modeling did not meet the statistical confidence thresholds required to predict the impact of this variant on CBS protein function. Experimental studies have shown that this missense change affects CBS function (PMID: 9156316, 14635102, 22267502). For these reasons, this variant has been classified as Pathogenic. -
Homocystinuria Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingWomen's Health and Genetics/Laboratory Corporation of America, LabCorpJun 13, 2022Variant summary: CBS c.1058C>T (p.Thr353Met) results in a non-conservative amino acid change located in the Pyridoxal-phosphate dependent enzyme domain (IPR001926) of the encoded protein sequence. Four of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 2.9e-05 in 237672 control chromosomes (gnomAD). c.1058C>T has been reported in the literature in multiple individuals affected with Homocystinuria (e.g. Dawson_1997, Trondle_2001, Kruger_2003, Lee_2005). These data indicate that the variant is very likely to be associated with disease. The variants' impact on protein function was evaluated in several different publications using recombinant protein recovered from E. coli cultures (Dawson_1997), yeast (Kruger_2003) and human cell lines (Lee_2005). In all instances, the variant protein had <10% of normal activity. Five ClinVar submitters have assessed the variant since 2014: all five classified the variant as pathogenic. Based on the evidence outlined above, the variant was classified as pathogenic. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.13
BayesDel_addAF
Uncertain
0.12
D
BayesDel_noAF
Pathogenic
0.25
CADD
Benign
18
DANN
Uncertain
1.0
DEOGEN2
Pathogenic
0.88
D;D;D;D
Eigen
Benign
-0.27
Eigen_PC
Benign
-0.31
FATHMM_MKL
Uncertain
0.90
D
LIST_S2
Pathogenic
0.98
.;.;.;D
M_CAP
Pathogenic
0.78
D
MetaRNN
Pathogenic
0.94
D;D;D;D
MetaSVM
Pathogenic
1.1
D
MutationAssessor
Benign
0.88
L;L;L;L
MutationTaster
Benign
0.016
A;A;A;A;A;A;A;A;A;A;A;A
PrimateAI
Benign
0.32
T
PROVEAN
Benign
-1.2
N;N;N;N
REVEL
Uncertain
0.61
Sift
Uncertain
0.0010
D;D;D;D
Sift4G
Uncertain
0.0020
D;D;D;D
Polyphen
0.059
B;B;B;B
Vest4
0.47
MVP
0.85
MPC
0.70
ClinPred
0.14
T
GERP RS
3.2
Varity_R
0.44
gMVP
0.82

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: rs121964972; hg19: chr21-44480638; API