rs144177566

Variant summary

Our verdict is Benign. The variant received -12 ACMG points: 1P and 13B. PP2BP4_StrongBP6BS1BS2

The NM_001080.3(ALDH5A1):​c.1348G>A​(p.Asp450Asn) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.000375 in 1,614,096 control chromosomes in the GnomAD database, including 2 homozygotes. In-silico tool predicts a benign outcome for this variant. 17/22 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. D450E) has been classified as Uncertain significance.

Frequency

Genomes: 𝑓 0.0020 ( 2 hom., cov: 33)
Exomes 𝑓: 0.00020 ( 0 hom. )

Consequence

ALDH5A1
NM_001080.3 missense

Scores

19

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications U:2B:5

Conservation

PhyloP100: 1.57

Publications

4 publications found
Variant links:
Genes affected
ALDH5A1 (HGNC:408): (aldehyde dehydrogenase 5 family member A1) This protein belongs to the aldehyde dehydrogenase family of proteins. This gene encodes a mitochondrial NAD(+)-dependent succinic semialdehyde dehydrogenase. A deficiency of this enzyme, known as 4-hydroxybutyricaciduria, is a rare inborn error in the metabolism of the neurotransmitter 4-aminobutyric acid (GABA). In response to the defect, physiologic fluids from patients accumulate GHB, a compound with numerous neuromodulatory properties. Two transcript variants encoding distinct isoforms have been identified for this gene. [provided by RefSeq, Jul 2008]
ALDH5A1 Gene-Disease associations (from GenCC):
  • succinic semialdehyde dehydrogenase deficiency
    Inheritance: AR Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: G2P, ClinGen, Orphanet, Labcorp Genetics (formerly Invitae)

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Benign. The variant received -12 ACMG points.

PP2
Missense variant in the gene, where a lot of missense mutations are associated with disease in ClinVar. The gene has 55 curated pathogenic missense variants (we use a threshold of 10). The gene has 13 curated benign missense variants. Gene score misZ: 0.73405 (below the threshold of 3.09). Trascript score misZ: 0.28023 (below the threshold of 3.09). GenCC associations: The gene is linked to succinic semialdehyde dehydrogenase deficiency.
BP4
Computational evidence support a benign effect (MetaRNN=0.0119740665).
BP6
Variant 6-24532123-G-A is Benign according to our data. Variant chr6-24532123-G-A is described in ClinVar as Conflicting_classifications_of_pathogenicity. ClinVar VariationId is 287090.
BS1
Variant frequency is greater than expected in population afr. GnomAd4 allele frequency = 0.00202 (307/152294) while in subpopulation AFR AF = 0.00688 (286/41562). AF 95% confidence interval is 0.00623. There are 2 homozygotes in GnomAd4. There are 142 alleles in the male GnomAd4 subpopulation. Median coverage is 33. This position passed quality control check.
BS2
High Homozygotes in GnomAd4 at 2 AR gene

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
ALDH5A1NM_001080.3 linkc.1348G>A p.Asp450Asn missense_variant Exon 9 of 10 ENST00000357578.8 NP_001071.1 P51649-1X5DQN2
ALDH5A1NM_170740.1 linkc.1387G>A p.Asp463Asn missense_variant Exon 10 of 11 NP_733936.1 P51649-2X5D299
ALDH5A1NM_001368954.1 linkc.1204G>A p.Asp402Asn missense_variant Exon 8 of 9 NP_001355883.1

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
ALDH5A1ENST00000357578.8 linkc.1348G>A p.Asp450Asn missense_variant Exon 9 of 10 1 NM_001080.3 ENSP00000350191.3 P51649-1

Frequencies

GnomAD3 genomes
AF:
0.00202
AC:
307
AN:
152176
Hom.:
2
Cov.:
33
show subpopulations
Gnomad AFR
AF:
0.00690
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.000786
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00316
Gnomad NFE
AF:
0.0000588
Gnomad OTH
AF:
0.00191
GnomAD2 exomes
AF:
0.000541
AC:
136
AN:
251436
AF XY:
0.000316
show subpopulations
Gnomad AFR exome
AF:
0.00658
Gnomad AMR exome
AF:
0.000578
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000528
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.000205
AC:
299
AN:
1461802
Hom.:
0
Cov.:
30
AF XY:
0.000194
AC XY:
141
AN XY:
727202
show subpopulations
African (AFR)
AF:
0.00624
AC:
209
AN:
33480
American (AMR)
AF:
0.000514
AC:
23
AN:
44722
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26132
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39698
South Asian (SAS)
AF:
0.0000464
AC:
4
AN:
86252
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
53418
Middle Eastern (MID)
AF:
0.000520
AC:
3
AN:
5768
European-Non Finnish (NFE)
AF:
0.0000288
AC:
32
AN:
1111940
Other (OTH)
AF:
0.000464
AC:
28
AN:
60392
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.465
Heterozygous variant carriers
0
16
32
47
63
79
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Variant carriers
0
10
20
30
40
50
<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:
0.00202
AC:
307
AN:
152294
Hom.:
2
Cov.:
33
AF XY:
0.00191
AC XY:
142
AN XY:
74468
show subpopulations
African (AFR)
AF:
0.00688
AC:
286
AN:
41562
American (AMR)
AF:
0.000785
AC:
12
AN:
15290
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3472
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5192
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4830
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10608
Middle Eastern (MID)
AF:
0.00340
AC:
1
AN:
294
European-Non Finnish (NFE)
AF:
0.0000588
AC:
4
AN:
68018
Other (OTH)
AF:
0.00189
AC:
4
AN:
2116
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.505
Heterozygous variant carriers
0
15
30
44
59
74
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Genome Het
Variant carriers
0
4
8
12
16
20
<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:
0.000771
Hom.:
0
Bravo
AF:
0.00251
ESP6500AA
AF:
0.00794
AC:
35
ESP6500EA
AF:
0.00
AC:
0
ExAC
AF:
0.000782
AC:
95
Asia WGS
AF:
0.000289
AC:
1
AN:
3478
EpiCase
AF:
0.0000545
EpiControl
AF:
0.0000593

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Uncertain:2Benign:5
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

not specified Uncertain:2Benign:1
Dec 14, 2018
Genetic Services Laboratory, University of Chicago
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Apr 12, 2016
Eurofins Ntd Llc (ga)
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Oct 24, 2017
GeneDx
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The D450N variant in the ALDH5A1 gene has not been reported previously as a pathogenic variant, nor as a benign variant, to our knowledge. However, D450N is reported as likely benign in ClinVar by different clinical laboratories, but additional evidence is not available (ClinVar SCV000340750.2; ClinVar SCV000511533.1; Landrum et al., 2016). This variant is observed in 177/24,038 alleles (0.74%) from individuals of African background in large population cohorts, including 2 homozygous control individuals (Lek et al., 2016). The D450N variant is a semi-conservative amino acid substitution, which may impact secondary protein structure as these residues differ in some properties. However, this substitution occurs at a position that is not conserved across species, and in silico analysis is inconsistent in its predictions as to whether or not the variant is damaging to the protein structure/function. We interpret D450N as a variant of uncertain significance. -

Succinate-semialdehyde dehydrogenase deficiency Benign:2
Feb 03, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Jan 13, 2018
Illumina Laboratory Services, Illumina
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as likely benign is not then subjected to further curation. The score for this variant resulted in a classification of likely benign for this disease. -

ALDH5A1-related disorder Benign:1
Jun 21, 2022
PreventionGenetics, part of Exact Sciences
Significance:Benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

This variant is classified as benign based on ACMG/AMP sequence variant interpretation guidelines (Richards et al. 2015 PMID: 25741868, with internal and published modifications). -

not provided Benign:1
Sep 01, 2016
Center for Pediatric Genomic Medicine, Children's Mercy Hospital and Clinics
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.084
BayesDel_addAF
Benign
-0.46
T
BayesDel_noAF
Benign
-0.43
CADD
Benign
11
DANN
Benign
0.95
DEOGEN2
Benign
0.28
T;T;.
Eigen
Benign
-0.91
Eigen_PC
Benign
-0.86
FATHMM_MKL
Benign
0.75
D
LIST_S2
Benign
0.84
T;T;T
M_CAP
Benign
0.070
D
MetaRNN
Benign
0.012
T;T;T
MetaSVM
Benign
-0.65
T
MutationAssessor
Benign
1.8
L;.;.
PhyloP100
1.6
PrimateAI
Benign
0.29
T
PROVEAN
Benign
-0.87
N;N;N
REVEL
Benign
0.20
Sift
Benign
0.26
T;T;T
Sift4G
Benign
0.14
T;T;T
Polyphen
0.0020
B;.;.
Vest4
0.11
MVP
0.78
MPC
0.26
ClinPred
0.018
T
GERP RS
-0.25
Varity_R
0.16
gMVP
0.42
Mutation Taster
=82/18
polymorphism

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.060
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: rs144177566; hg19: chr6-24532351; COSMIC: COSV62372639; API