rs1317004203

Variant summary

Our verdict is Uncertain significance. The variant received 2 ACMG points: 2P and 0B. PM2

The NM_001127222.2(CACNA1A):​c.6361A>T​(p.Met2121Leu) variant causes a missense change involving the alteration of a conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. Variant has been reported in ClinVar as Uncertain significance (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. M2121T) has been classified as Uncertain significance.

Frequency

Genomes: not found (cov: 33)
Exomes 𝑓: 0.0 ( 0 hom. )
Failed GnomAD Quality Control

Consequence

CACNA1A
NM_001127222.2 missense

Scores

2
8
9

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:4

Conservation

PhyloP100: 7.81

Publications

0 publications found
Variant links:
Genes affected
CACNA1A (HGNC:1388): (calcium voltage-gated channel subunit alpha1 A) Voltage-dependent calcium channels mediate the entry of calcium ions into excitable cells, and are also involved in a variety of calcium-dependent processes, including muscle contraction, hormone or neurotransmitter release, and gene expression. Calcium channels are multisubunit complexes composed of alpha-1, beta, alpha-2/delta, and gamma subunits. The channel activity is directed by the pore-forming alpha-1 subunit, whereas, the others act as auxiliary subunits regulating this activity. The distinctive properties of the calcium channel types are related primarily to the expression of a variety of alpha-1 isoforms, alpha-1A, B, C, D, E, and S. This gene encodes the alpha-1A subunit, which is predominantly expressed in neuronal tissue. Mutations in this gene are associated with 2 neurologic disorders, familial hemiplegic migraine and episodic ataxia 2. This gene also exhibits polymorphic variation due to (CAG)n-repeats. Multiple transcript variants encoding different isoforms have been found for this gene. In one set of transcript variants, the (CAG)n-repeats occur in the 3' UTR, and are not associated with any disease. But in another set of variants, an insertion extends the coding region to include the (CAG)n-repeats which encode a polyglutamine tract. Expansion of the (CAG)n-repeats from the normal 4-18 to 21-33 in the coding region is associated with spinocerebellar ataxia 6. [provided by RefSeq, Jul 2016]
CACNA1A Gene-Disease associations (from GenCC):
  • episodic ataxia type 2
    Inheritance: AD Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Orphanet, Ambry Genetics, Genomics England PanelApp, Labcorp Genetics (formerly Invitae)
  • undetermined early-onset epileptic encephalopathy
    Inheritance: AD Classification: DEFINITIVE, SUPPORTIVE Submitted by: Orphanet, Illumina
  • developmental and epileptic encephalopathy, 42
    Inheritance: AD Classification: STRONG, MODERATE Submitted by: G2P, Ambry Genetics, Labcorp Genetics (formerly Invitae)
  • migraine, familial hemiplegic, 1
    Inheritance: AD Classification: STRONG Submitted by: Ambry Genetics, Genomics England PanelApp, Labcorp Genetics (formerly Invitae)
  • spinocerebellar ataxia type 6
    Inheritance: AD Classification: STRONG, SUPPORTIVE Submitted by: Ambry Genetics, Genomics England PanelApp, Labcorp Genetics (formerly Invitae), Orphanet
  • benign paroxysmal torticollis of infancy
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • familial or sporadic hemiplegic migraine
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • Lennox-Gastaut syndrome
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Uncertain_significance. The variant received 2 ACMG points.

PM2
Very rare variant in population databases, with high coverage;

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
CACNA1ANM_001127222.2 linkc.6361A>T p.Met2121Leu missense_variant Exon 45 of 47 ENST00000360228.11 NP_001120694.1 O00555-8

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
CACNA1AENST00000360228.11 linkc.6361A>T p.Met2121Leu missense_variant Exon 45 of 47 1 NM_001127222.2 ENSP00000353362.5 O00555-8
CACNA1AENST00000638029.1 linkc.6379A>T p.Met2127Leu missense_variant Exon 46 of 48 5 ENSP00000489829.1 A0A087WW63
CACNA1AENST00000573710.7 linkc.6367A>T p.Met2123Leu missense_variant Exon 45 of 47 5 ENSP00000460092.3 A0A1C7CYY9
CACNA1AENST00000635727.1 linkc.6364A>T p.Met2122Leu missense_variant Exon 45 of 47 5 ENSP00000490001.1 A0A1B0GU81
CACNA1AENST00000637769.1 linkc.6364A>T p.Met2122Leu missense_variant Exon 45 of 47 1 ENSP00000489778.1 A0A1B0GTN7
CACNA1AENST00000636012.1 linkc.6328A>T p.Met2110Leu missense_variant Exon 44 of 46 5 ENSP00000490223.1 A0A1B0GUS3
CACNA1AENST00000637736.1 linkc.6223A>T p.Met2075Leu missense_variant Exon 44 of 46 5 ENSP00000489861.1 A0A1B0GTW2
CACNA1AENST00000636389.1 linkc.6364A>T p.Met2122Leu missense_variant Exon 45 of 47 5 ENSP00000489992.1 A0A1B0GU74
CACNA1AENST00000637432.1 linkc.6379A>T p.Met2127Leu missense_variant Exon 46 of 48 5 ENSP00000490617.1 O00555-2
CACNA1AENST00000636549.1 linkc.6370A>T p.Met2124Leu missense_variant Exon 46 of 48 5 ENSP00000490578.1 B5TYJ1
CACNA1AENST00000637927.1 linkc.6367A>T p.Met2123Leu missense_variant Exon 45 of 47 5 ENSP00000489715.1 A0A1B0GTI4
CACNA1AENST00000635895.1 linkc.6364A>T p.Met2122Leu missense_variant Exon 45 of 47 5 ENSP00000490323.1 A0A384DVW2
CACNA1AENST00000638009.2 linkc.6364A>T p.Met2122Leu missense_variant Exon 45 of 47 1 ENSP00000489913.1 O00555-3
CACNA1AENST00000637276.1 linkc.6328A>T p.Met2110Leu missense_variant Exon 44 of 46 5 ENSP00000489777.1 O00555-5
CACNA1AENST00000636768.2 linkn.*627A>T non_coding_transcript_exon_variant Exon 43 of 45 5 ENSP00000490190.2 A0A1B0GUP3
CACNA1AENST00000713789.1 linkn.*1540A>T non_coding_transcript_exon_variant Exon 45 of 47 ENSP00000519091.1
CACNA1AENST00000636768.2 linkn.*627A>T 3_prime_UTR_variant Exon 43 of 45 5 ENSP00000490190.2 A0A1B0GUP3
CACNA1AENST00000713789.1 linkn.*1540A>T 3_prime_UTR_variant Exon 45 of 47 ENSP00000519091.1

Frequencies

GnomAD3 genomes
Cov.:
33
GnomAD2 exomes
AF:
0.00
AC:
0
AN:
60898
AF XY:
0.00
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
Data not reliable, filtered out with message: AC0
AF:
0.00
AC:
0
AN:
1181602
Hom.:
0
Cov.:
32
AF XY:
0.00
AC XY:
0
AN XY:
566458
African (AFR)
AF:
0.00
AC:
0
AN:
24826
American (AMR)
AF:
0.00
AC:
0
AN:
14274
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
15752
East Asian (EAS)
AF:
0.00
AC:
0
AN:
30104
South Asian (SAS)
AF:
0.00
AC:
0
AN:
36572
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
40372
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
4238
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
967840
Other (OTH)
AF:
0.00
AC:
0
AN:
47624
GnomAD4 genome
Cov.:
33
Alfa
AF:
0.00
Hom.:
0
Bravo
AF:
0.00000378

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:4
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Episodic ataxia type 2;C4310716:Developmental and epileptic encephalopathy, 42 Uncertain:1
Nov 07, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence change replaces methionine, which is neutral and non-polar, with leucine, which is neutral and non-polar, at codon 2122 of the CACNA1A protein (p.Met2122Leu). This variant is not present in population databases (gnomAD no frequency). This missense change has been observed in individual(s) with clinical features for CACNA1A-related conditions (internal data). ClinVar contains an entry for this variant (Variation ID: 476269). 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 not expected to disrupt CACNA1A protein function with a negative predictive value of 95%. In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. -

Inborn genetic diseases Uncertain:1
Aug 02, 2023
Ambry Genetics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The c.6364A>T (p.M2122L) alteration is located in exon 45 (coding exon 45) of the CACNA1A gene. This alteration results from a A to T substitution at nucleotide position 6364, causing the methionine (M) at amino acid position 2122 to be replaced by a leucine (L). Based on insufficient or conflicting evidence, the clinical significance of this alteration remains unclear. -

not provided Uncertain:1
Feb 28, 2024
GeneDx
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Not observed at significant frequency in large population cohorts (gnomAD); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; Has not been previously published as pathogenic or benign to our knowledge -

CACNA1A-related disorder Uncertain:1
Jul 11, 2024
PreventionGenetics, part of Exact Sciences
Significance:Uncertain significance
Review Status:no assertion criteria provided
Collection Method:clinical testing

The CACNA1A c.6361A>T variant is predicted to result in the amino acid substitution p.Met2121Leu. To our knowledge, this variant has not been reported in the literature or in a large population database, indicating this variant is rare. At this time, the clinical significance of this variant is uncertain due to the absence of conclusive functional and genetic evidence. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.16
BayesDel_addAF
Uncertain
0.082
D
BayesDel_noAF
Benign
-0.12
CADD
Benign
22
DANN
Benign
0.95
DEOGEN2
Benign
0.083
.;.;T;.;.;.;.;.;T;.;.;T;.;.;.;T;.;.
Eigen
Benign
0.028
Eigen_PC
Benign
0.10
FATHMM_MKL
Pathogenic
0.97
D
LIST_S2
Uncertain
0.90
D;D;D;D;D;D;D;D;D;D;.;D;D;D;D;D;D;D
M_CAP
Uncertain
0.16
D
MetaRNN
Uncertain
0.56
D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D;D
MetaSVM
Uncertain
-0.21
T
MutationAssessor
Uncertain
2.6
.;.;.;.;M;.;.;.;.;.;.;.;.;.;.;.;.;.
PhyloP100
7.8
PrimateAI
Pathogenic
0.85
D
PROVEAN
Uncertain
-2.7
.;D;.;.;.;.;.;.;.;.;.;.;.;.;.;.;.;.
REVEL
Uncertain
0.39
Sift
Benign
0.067
.;T;.;.;.;.;.;.;.;.;.;.;.;.;.;.;.;.
Sift4G
Benign
0.11
T;T;.;.;.;T;.;.;.;.;.;.;.;.;.;.;.;.
Vest4
0.48
MutPred
0.34
.;.;Gain of methylation at K2123 (P = 0.0483);Gain of methylation at K2123 (P = 0.0483);Gain of methylation at K2123 (P = 0.0483);.;.;Gain of methylation at K2123 (P = 0.0483);.;.;.;.;Gain of methylation at K2123 (P = 0.0483);.;.;.;.;.;
MVP
0.85
MPC
0.25
ClinPred
0.80
D
GERP RS
3.9
Varity_R
0.42
gMVP
0.39
Mutation Taster
=81/19
polymorphism

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

Other links and lift over

dbSNP: rs1317004203; hg19: chr19-13320291; API