rs145873635

Variant summary

Our verdict is Pathogenic. The variant received 15 ACMG points: 15P and 0B. PM1PM2PM5PP3PP5_Very_Strong

The NM_177924.5(ASAH1):​c.125C>T​(p.Thr42Met) variant causes a missense, splice region change. The variant allele was found at a frequency of 0.0000118 in 1,613,932 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. 2/3 splice prediction tools predicting alterations to normal splicing. Variant has been reported in ClinVar as Likely pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. T42A) has been classified as Likely pathogenic.

Frequency

Genomes: 𝑓 0.000033 ( 0 hom., cov: 32)
Exomes 𝑓: 0.0000096 ( 0 hom. )

Consequence

ASAH1
NM_177924.5 missense, splice_region

Scores

5
6
6
Splicing: ADA: 0.9929
2

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:9O:1

Conservation

PhyloP100: 4.44

Publications

17 publications found
Variant links:
Genes affected
ASAH1 (HGNC:735): (N-acylsphingosine amidohydrolase 1) This gene encodes a member of the acid ceramidase family of proteins. Alternative splicing results in multiple transcript variants, at least one of which encodes a preproprotein that is proteolytically processed. Processing of this preproprotein generates alpha and beta subunits that heterodimerize to form the mature lysosomal enzyme, which catalyzes the degradation of ceramide into sphingosine and free fatty acid. This enzyme is overexpressed in multiple human cancers and may play a role in cancer progression. Mutations in this gene are associated with the lysosomal storage disorder, Farber lipogranulomatosis, and a neuromuscular disorder, spinal muscular atrophy with progressive myoclonic epilepsy. [provided by RefSeq, Oct 2015]
ASAH1 Gene-Disease associations (from GenCC):
  • ASAH1-related sphingolipidosis
    Inheritance: AR Classification: DEFINITIVE Submitted by: ClinGen
  • Farber lipogranulomatosis
    Inheritance: AR Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: G2P, Orphanet, Labcorp Genetics (formerly Invitae), Genomics England PanelApp
  • spinal muscular atrophy-progressive myoclonic epilepsy syndrome
    Inheritance: AR Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Labcorp Genetics (formerly Invitae), Orphanet, Genomics England PanelApp, G2P

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Pathogenic. The variant received 15 ACMG points.

PM1
In a hotspot region, there are 3 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 0 benign, 7 uncertain in NM_177924.5
PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chr8-18075542-T-C is described in ClinVar as Conflicting_classifications_of_pathogenicity. ClinVar VariationId is 560955.
PP3
Splicing predictors support a deleterious effect. Scorers claiming Pathogenic: dbscSNV1_ADA, dbscSNV1_RF. No scorers claiming Uncertain. Scorers claiming Benign: max_spliceai.
PP5
Variant 8-18075541-G-A is Pathogenic according to our data. Variant chr8-18075541-G-A is described in ClinVar as Pathogenic/Likely_pathogenic. ClinVar VariationId is 35544.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
ASAH1NM_177924.5 linkc.125C>T p.Thr42Met missense_variant, splice_region_variant Exon 2 of 14 ENST00000637790.2 NP_808592.2 Q13510-1Q53H01A8K0B6

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
ASAH1ENST00000637790.2 linkc.125C>T p.Thr42Met missense_variant, splice_region_variant Exon 2 of 14 1 NM_177924.5 ENSP00000490272.1 Q13510-1

Frequencies

GnomAD3 genomes
AF:
0.0000329
AC:
5
AN:
152144
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.000121
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:
0.00
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.0000119
AC:
3
AN:
251458
AF XY:
0.00000736
show subpopulations
Gnomad AFR exome
AF:
0.000123
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:
0.00
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.00000958
AC:
14
AN:
1461788
Hom.:
0
Cov.:
30
AF XY:
0.00000963
AC XY:
7
AN XY:
727200
show subpopulations
African (AFR)
AF:
0.0000597
AC:
2
AN:
33480
American (AMR)
AF:
0.0000447
AC:
2
AN:
44724
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26130
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39686
South Asian (SAS)
AF:
0.00
AC:
0
AN:
86258
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
53412
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5766
European-Non Finnish (NFE)
AF:
0.00000809
AC:
9
AN:
1111942
Other (OTH)
AF:
0.0000166
AC:
1
AN:
60390
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.464
Heterozygous variant carriers
0
1
2
3
4
5
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:
0.0000329
AC:
5
AN:
152144
Hom.:
0
Cov.:
32
AF XY:
0.0000135
AC XY:
1
AN XY:
74314
show subpopulations
African (AFR)
AF:
0.000121
AC:
5
AN:
41424
American (AMR)
AF:
0.00
AC:
0
AN:
15282
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3466
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5188
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4832
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10610
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
68020
Other (OTH)
AF:
0.00
AC:
0
AN:
2094
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.505
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:
0.0000249
Hom.:
0
Bravo
AF:
0.0000227
ESP6500AA
AF:
0.000454
AC:
2
ESP6500EA
AF:
0.00
AC:
0
ExAC
AF:
0.0000247
AC:
3
EpiCase
AF:
0.0000545
EpiControl
AF:
0.0000593

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:9Other:1
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Spinal muscular atrophy-progressive myoclonic epilepsy syndrome Pathogenic:4Other:1
Dec 03, 2017
Genomic Research Center, Shahid Beheshti University of Medical Sciences
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

-
GeneReviews
Significance:not provided
Review Status:no classification provided
Collection Method:literature only

- -

Jul 13, 2012
OMIM
Significance:Pathogenic
Review Status:no assertion criteria provided
Collection Method:literature only

- -

-
Neuberg Centre For Genomic Medicine, NCGM
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The missense variant p.T42M in ASAH1 (NM_177924.5) has been reported previously in affected patients (Zhou et al). Functional studies reveal a damaging effect. The p.T42M variant isobserved in 2/16,256 (0.0123%) alleles from individuals of African background in gnomAD Exomes and is novel (not in any individuals) in 1000 Genomes. There is a moderate physicochemical difference between threonine and methionine. 3 variants within 6 amino acid positions of the variant p.T42M have been shown to be pathogenic, while none have been shown to be benign. For these reasons, this variant has been classified as Pathogenic. -

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

PM2_Supporting+PM3_Strong+PP1+PP4 -

not provided Pathogenic:3
Dec 07, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence change replaces threonine, which is neutral and polar, with methionine, which is neutral and non-polar, at codon 42 of the ASAH1 protein (p.Thr42Met). This variant is present in population databases (rs145873635, gnomAD 0.02%). This missense change has been observed in individual(s) with with spinal muscular atrophy and progressive myoclonic epilepsy (PMID: 22703880, 25578555, 25847462, 27723502). 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: 35544). 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 disruptive. For these reasons, this variant has been classified as Pathogenic. -

Jul 30, 2015
Eurofins Ntd Llc (ga)
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Sep 06, 2019
Revvity Omics, Revvity
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

ASAH1-related disorders Pathogenic:2
Feb 12, 2019
Illumina Laboratory Services, Illumina
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The ASAH1 c.173C>T (p.Thr58Met) variant is a missense variant that has been reported in four studies, in which it is found in a total of 10 individuals with spinal muscular atrophy associated with progressive myoclonic epilepsy, including in eight in a homozygous state and in two in a compound heterozygous state (Zhou et al. 2012; Rubboli et al. 2015; Giráldez et al. 2015; Yildiz et al. 2018). This variant segregated with disease in two families. The p.Thr58Met variant was absent from 95 control subjects but is reported at a frequency of 0.000196 in the African population of the Genome Aggregation Database. Transient expression of the p.Thr58Met cDNA into fibroblasts derived from an individual with Farber disease demonstrated that the acid-ceramidase activity was 32% of the wild type cDNA activity. Although there was no effect on the level of the precursor form or its processing, the α-subunit amount was mildly lower than the β-subunit amount (Zhou et al. 2012). Based on the collective evidence and application of the ACMG criteria, the p.Thr58Met variant is classified as pathogenic for ASAH1-related disorders. -

Aug 26, 2022
PreventionGenetics, part of Exact Sciences
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The ASAH1 c.173C>T variant is predicted to result in the amino acid substitution p.Thr58Met. This variant (also known as c.125C>T, p.Thr42Met in transcript NM_177924.5) was reported in homozygous and compound heterozygous state in several individuals with Spinal muscular atrophy associated with progressive myoclonic epilepsy (Yildiz et al. 2017. PubMed ID: 29169047; Zhou et al. 2012. PubMed ID: 22703880; Akarsu et al. 2016. PubMed ID: 27723502; Giráldez et al. 2014. PubMed ID: 25578555; Rubboli et al. 2015. PubMed ID: 25847462). Functional expression studies of the c.173C>T mutant cDNA in Farber fibroblasts showed that acid-ceramidase activity was only 32% of that generated by normal cDNA, however this reduced activity was able to normalize the ceramide level in Farber cells. Knockdown of the ASAH1 ortholog in zebrafish led to a marked loss of motor-neuron axonal branching, a loss that is associated with increased apoptosis in the spinal cord and authors assume this could be the pathogenic mechanism underlying the CNS involvement in deficient cells in case of enzyme activity reduction in this variant (Zhou et al. 2012. PubMed ID: 22703880). This variant is reported in 0.012% of alleles in individuals of African descent in gnomAD (http://gnomad.broadinstitute.org/variant/8-17933050-G-A). This variant is interpreted as likely pathogenic. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.33
BayesDel_addAF
Uncertain
0.020
T
BayesDel_noAF
Pathogenic
0.14
CADD
Pathogenic
33
DANN
Uncertain
1.0
DEOGEN2
Benign
0.031
.;T
Eigen
Pathogenic
0.76
Eigen_PC
Pathogenic
0.73
FATHMM_MKL
Uncertain
0.97
D
LIST_S2
Benign
0.44
T;T
M_CAP
Pathogenic
0.36
D
MetaRNN
Pathogenic
0.77
D;D
MetaSVM
Uncertain
0.076
D
PhyloP100
4.4
PROVEAN
Benign
-2.1
N;.
REVEL
Uncertain
0.62
Sift
Uncertain
0.012
D;.
Sift4G
Benign
0.21
T;.
Vest4
0.63
MVP
0.86
ClinPred
0.94
D
GERP RS
5.1
PromoterAI
-0.051
Neutral
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.7
Varity_R
0.40
Mutation Taster
=202/98
disease causing (ClinVar)

Splicing

Name
Calibrated prediction
Score
Prediction
dbscSNV1_ADA
Pathogenic
0.99
dbscSNV1_RF
Pathogenic
0.73
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: rs145873635; hg19: chr8-17933050; API