rs137854544

Variant summary

Our verdict is Pathogenic. Variant got 10 ACMG points: 10P and 0B. PM2PP5_Very_Strong

The NM_000308.4(CTSA):​c.745T>A​(p.Tyr249Asn) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000459 in 1,613,036 control chromosomes in the GnomAD database, with no homozygous occurrence. 12/21 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Pathogenic (★★).

Frequency

Genomes: 𝑓 0.000059 ( 0 hom., cov: 33)
Exomes 𝑓: 0.000044 ( 0 hom. )

Consequence

CTSA
NM_000308.4 missense

Scores

6
13

Clinical Significance

Pathogenic criteria provided, multiple submitters, no conflicts P:5

Conservation

PhyloP100: 1.74
Variant links:
Genes affected
CTSA (HGNC:9251): (cathepsin A) This gene encodes a member of the peptidase S10 family of serine carboxypeptidases. Alternative splicing results in multiple transcript variants, at least one of which encodes a preproprotein that is proteolytically processed to generate two chains that comprise the heterodimeric active enzyme. This enzyme possesses deamidase, esterase and carboxypeptidase activities and acts as a scaffold in the lysosomal multienzyme complex. Mutations in this gene are associated with galactosialidosis. [provided by RefSeq, Nov 2015]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 10 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 20-45894040-T-A is Pathogenic according to our data. Variant chr20-45894040-T-A is described in ClinVar as [Pathogenic]. Clinvar id is 381.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
CTSANM_000308.4 linkuse as main transcriptc.745T>A p.Tyr249Asn missense_variant 8/15 ENST00000646241.3 NP_000299.3
CTSANM_001127695.3 linkuse as main transcriptc.745T>A p.Tyr249Asn missense_variant 8/15 NP_001121167.1
CTSANM_001167594.3 linkuse as main transcriptc.694T>A p.Tyr232Asn missense_variant 7/14 NP_001161066.2
CTSANR_133656.2 linkuse as main transcriptn.797T>A non_coding_transcript_exon_variant 8/15

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
CTSAENST00000646241.3 linkuse as main transcriptc.745T>A p.Tyr249Asn missense_variant 8/15 NM_000308.4 ENSP00000493613 P10619-1

Frequencies

GnomAD3 genomes
AF:
0.0000591
AC:
9
AN:
152220
Hom.:
0
Cov.:
33
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:
0.000132
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000358
AC:
9
AN:
251316
Hom.:
0
AF XY:
0.0000442
AC XY:
6
AN XY:
135862
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000791
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000445
AC:
65
AN:
1460816
Hom.:
0
Cov.:
31
AF XY:
0.0000427
AC XY:
31
AN XY:
726796
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.00
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:
0.0000558
Gnomad4 OTH exome
AF:
0.0000497
GnomAD4 genome
AF:
0.0000591
AC:
9
AN:
152220
Hom.:
0
Cov.:
33
AF XY:
0.0000538
AC XY:
4
AN XY:
74370
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.000132
Gnomad4 OTH
AF:
0.00
Bravo
AF:
0.0000378
ExAC
AF:
0.00000824
AC:
1
EpiCase
AF:
0.00
EpiControl
AF:
0.0000593

ClinVar

Significance: Pathogenic
Submissions summary: Pathogenic:5
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Combined deficiency of sialidase AND beta galactosidase Pathogenic:4
Pathogenic, criteria provided, single submitterresearchLupski Lab, Baylor-Hopkins CMG, Baylor College of MedicineJul 01, 2014- -
Pathogenic, criteria provided, single submitterclinical testingWomen's Health and Genetics/Laboratory Corporation of America, LabCorpAug 03, 2023Variant summary: CTSA c.745T>A (p.Tyr249Asn) results in a non-conservative amino acid change in the encoded protein sequence. Three of five in-silico tools predict a benign effect of the variant on protein function. The variant allele was found at a frequency of 3.6e-05 in 251316 control chromosomes (gnomAD). c.745T>A has been reported in the literature in multiple individuals affected with Galactosialidosis (Zhou_1996, Shimmoto_1993, Lehman_2012, Prada_2014), and some were reported as compound heterozygous with other pathogenic variants. These data indicate that the variant is very likely to be associated with disease. Several publications report experimental evidence evaluating an impact on protein function, finding disruption in lysosomal compartmentalization, substantially reduced cathepsin A activity, and more modest reductions in beta-galactosidase and alpha-neuraminidase activity (Zhou_1996, Shimmoto_1993, Takiguchi_2000). The following publications have been ascertained in the context of this evaluation (PMID: 8968752, 8514852, 22386972, 10944848, 24769197). Two submitters have cited clinical-significance assessments for this variant to ClinVar after 2014, and classified the variant as pathogenic. Based on the evidence outlined above, the variant was classified as pathogenic. -
Pathogenic, no assertion criteria providedliterature onlyOMIMApr 14, 2015- -
Pathogenic, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpDec 27, 2023This sequence change replaces tyrosine, which is neutral and polar, with asparagine, which is neutral and polar, at codon 267 of the CTSA protein (p.Tyr267Asn). This variant is present in population databases (rs137854544, gnomAD 0.008%). This missense change has been observed in individual(s) with galactosialidosis (PMID: 8514852, 8968752, 22386972, 24769197; Invitae). In at least one individual the data is consistent with being in trans (on the opposite chromosome) from a pathogenic variant. ClinVar contains an entry for this variant (Variation ID: 381). An algorithm developed to predict the effect of missense changes on protein structure and function (PolyPhen-2) suggests that this variant is likely to be tolerated. Experimental studies have shown that this missense change affects CTSA function (PMID: 8514852, 8968752, 10333491, 10944848). For these reasons, this variant has been classified as Pathogenic. -
Galactosialidosis, late infantile Pathogenic:1
Pathogenic, no assertion criteria providedliterature onlyOMIMDec 01, 1996- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.26
BayesDel_addAF
Benign
-0.069
T
BayesDel_noAF
Benign
-0.14
CADD
Uncertain
25
DANN
Benign
0.97
DEOGEN2
Uncertain
0.57
D;.;D;D;D;D
Eigen
Benign
-0.042
Eigen_PC
Benign
0.019
FATHMM_MKL
Uncertain
0.91
D
LIST_S2
Uncertain
0.94
D;D;.;.;D;D
M_CAP
Benign
0.071
D
MetaRNN
Uncertain
0.68
D;D;D;D;D;D
MetaSVM
Benign
-0.71
T
MutationAssessor
Benign
1.6
.;.;L;L;L;.
MutationTaster
Benign
1.0
A;A;A
PrimateAI
Benign
0.45
T
PROVEAN
Uncertain
-4.1
D;D;.;D;D;.
REVEL
Uncertain
0.46
Sift
Benign
0.050
D;T;.;D;T;.
Sift4G
Benign
0.074
T;T;.;T;T;D
Polyphen
0.23
.;.;B;B;B;.
Vest4
0.81
MutPred
0.80
.;.;Gain of disorder (P = 0.0339);Gain of disorder (P = 0.0339);Gain of disorder (P = 0.0339);.;
MVP
0.87
MPC
0.76
ClinPred
0.33
T
GERP RS
2.4
Varity_R
0.70
gMVP
0.83

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.070
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: rs137854544; hg19: chr20-44522679; COSMIC: COSV51944365; COSMIC: COSV51944365; API