rs146664754
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Variant summary
Our verdict is Benign. Variant got -12 ACMG points: 0P and 12B. BP4_StrongBS1BS2
The NM_001232.4(CASQ2):āc.567C>Gā(p.Phe189Leu) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.000752 in 1,613,870 control chromosomes in the GnomAD database, including 3 homozygotes. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).
Frequency
Genomes: š 0.00053 ( 0 hom., cov: 32)
Exomes š: 0.00077 ( 3 hom. )
Consequence
CASQ2
NM_001232.4 missense
NM_001232.4 missense
Scores
5
12
2
Clinical Significance
Conservation
PhyloP100: 1.71
Genes affected
CASQ2 (HGNC:1513): (calsequestrin 2) The protein encoded by this gene specifies the cardiac muscle family member of the calsequestrin family. Calsequestrin is localized to the sarcoplasmic reticulum in cardiac and slow skeletal muscle cells. The protein is a calcium binding protein that stores calcium for muscle function. Mutations in this gene cause stress-induced polymorphic ventricular tachycardia, also referred to as catecholaminergic polymorphic ventricular tachycardia 2 (CPVT2), a disease characterized by bidirectional ventricular tachycardia that may lead to cardiac arrest. [provided by RefSeq, Jul 2008]
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ACMG classification
Classification made for transcript
Verdict is Benign. Variant got -12 ACMG points.
BP4
Computational evidence support a benign effect (MetaRNN=0.05320248).
BS1
Variant frequency is greater than expected in population amr. gnomad4 allele frequency = 0.000532 (81/152284) while in subpopulation AMR AF= 0.000719 (11/15302). AF 95% confidence interval is 0.000495. There are 0 homozygotes in gnomad4. There are 43 alleles in male gnomad4 subpopulation. Median coverage is 32. This position pass quality control queck.
BS2
High Homozygotes in GnomAdExome4 at 3 AR gene
Transcripts
RefSeq
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | MANE | Protein | UniProt |
---|---|---|---|---|---|---|---|---|
CASQ2 | NM_001232.4 | c.567C>G | p.Phe189Leu | missense_variant | 5/11 | ENST00000261448.6 | NP_001223.2 |
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | TSL | MANE | Protein | Appris | UniProt |
---|---|---|---|---|---|---|---|---|---|---|
CASQ2 | ENST00000261448.6 | c.567C>G | p.Phe189Leu | missense_variant | 5/11 | 1 | NM_001232.4 | ENSP00000261448 | P1 | |
CASQ2 | ENST00000488931.2 | c.291C>G | p.Phe97Leu | missense_variant, NMD_transcript_variant | 6/13 | 3 | ENSP00000518226 |
Frequencies
GnomAD3 genomes AF: 0.000532 AC: 81AN: 152166Hom.: 0 Cov.: 32
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GnomAD3 exomes AF: 0.000716 AC: 180AN: 251354Hom.: 0 AF XY: 0.000721 AC XY: 98AN XY: 135842
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GnomAD4 exome AF: 0.000775 AC: 1132AN: 1461586Hom.: 3 Cov.: 30 AF XY: 0.000763 AC XY: 555AN XY: 727120
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GnomAD4 genome AF: 0.000532 AC: 81AN: 152284Hom.: 0 Cov.: 32 AF XY: 0.000578 AC XY: 43AN XY: 74452
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ClinVar
Significance: Conflicting classifications of pathogenicity
Submissions summary: Uncertain:10Benign:7
Revision: criteria provided, conflicting classifications
LINK: link
Submissions by phenotype
not provided Uncertain:3Benign:2
Uncertain significance, criteria provided, single submitter | clinical testing | Eurofins Ntd Llc (ga) | Sep 03, 2014 | - - |
Uncertain significance, criteria provided, single submitter | clinical testing | CeGaT Center for Human Genetics Tuebingen | Mar 01, 2023 | CASQ2: PM2:Supporting - |
Likely benign, no assertion criteria provided | clinical testing | Clinical Genetics DNA and cytogenetics Diagnostics Lab, Erasmus MC, Erasmus Medical Center | - | - - |
Likely benign, no assertion criteria provided | clinical testing | Joint Genome Diagnostic Labs from Nijmegen and Maastricht, Radboudumc and MUMC+ | - | - - |
Uncertain significance, criteria provided, single submitter | clinical testing | GeneDx | Dec 04, 2023 | In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; This variant is associated with the following publications: (PMID: 22198169, 24025405, 21618644, 22421959, 21454795, 23022705, 27538377, 21063088, 28818208, 28404607, 34426522, 25651173, 26671417, 18543230) - |
Catecholaminergic polymorphic ventricular tachycardia 2 Uncertain:4
Uncertain significance, criteria provided, single submitter | clinical testing | New York Genome Center | May 15, 2023 | - - |
Uncertain significance, criteria provided, single submitter | clinical testing | Illumina Laboratory Services, Illumina | Apr 27, 2017 | This variant was observed as part of a predisposition screen in an ostensibly healthy population. A literature search was performed for the gene, cDNA change, and amino acid change (where applicable). Publications were found based on this search. However, the evidence from the literature, in combination with allele frequency data from public databases where available, was not sufficient to rule this variant in or out of causing disease. Therefore, this variant is classified as a variant of unknown significance. - |
Uncertain significance, criteria provided, single submitter | clinical testing | Revvity Omics, Revvity | Sep 09, 2021 | - - |
Uncertain significance, no assertion criteria provided | clinical testing | Knight Diagnostic Laboratories, Oregon Health and Sciences University | Aug 13, 2015 | - - |
Cardiomyopathy Uncertain:1Benign:1
Uncertain significance, criteria provided, single submitter | clinical testing | CHEO Genetics Diagnostic Laboratory, Children's Hospital of Eastern Ontario | Nov 04, 2019 | - - |
Likely benign, criteria provided, single submitter | clinical testing | Center for Advanced Laboratory Medicine, UC San Diego Health, University of California San Diego | Jan 24, 2019 | - - |
not specified Uncertain:1
Uncertain significance, criteria provided, single submitter | clinical testing | Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine | Dec 06, 2013 | The Phe189Leu variant in CASQ2 has been reported in the heterozygous state in 1 individual with CPVT (Liu 2008). This variant is present at low frequency in var ious large populations, for example in 0.1% (9/8600) of European American chromo somes screened by the NHLBI Exome Sequencing Project (http://evs.gs.washington.e du/EVS/; dbSNP rs146664754). Studies have shown that the Phe189Leu variant may i mpactthe protein (Eckey 2010). However, this in vitro assay may not accurately r epresent biological function. Computational analyses (biochemical amino acid pro perties, conservation, AlignGVGD, PolyPhen2, and SIFT) suggest that the Phe189Le u variant may impact the protein, though this information is not predictive enou gh to determine pathogenicity. In summary, the available information for this va riant is somewhat conflicting. Additional information is needed to fully assess its clinical significance. - |
Polymorphic ventricular tachycardia Uncertain:1
Uncertain significance, criteria provided, single submitter | research | Biesecker Lab/Clinical Genomics Section, National Institutes of Health | Apr 05, 2018 | - - |
Sudden unexplained death Benign:1
Likely benign, criteria provided, single submitter | research | Agnes Ginges Centre for Molecular Cardiology, Centenary Institute | Feb 09, 2018 | The CASQ2 Phe189Leu variant has been previously reported in 2 CPVT families (Liu QQ, et al, 2008) and one sudden death case (Rajagopalan A & Pollanen MS, 2016). An in vitro functional study performed on Xenopus oocytes, has shown that the variant causes a reduction in hERG function and reduces flexbility of the CASQ2 protein, which suggests it may play a role in the aetiology of CPVT (Eckey K, et al., 2010). However, the use of an in vitro assay on amphibian oocytes may not reflect the actual biological function of the mutated protein in the mammalian heart. The CASQ2 Phe189Leu variant is present in the Exome Aggregation Consortium dataset (MAF= 0.0007, http://exac.broadinstitute.org/) and is particularly common in the European population; allele frequency=0.091, which is higher then expected for an inherited heart condition. We identified this variant in a case of sudden unexplained death in a young male. Genetic testing in this individual also identified two other variants (NEBL Gln682* & PKP2 Glu85Metfs*260), both of which are very rare. Furthermore, one study identified a substantial overrepresentation of CPVT-associated variants in an exome population database (ESP), the authors predict that these variants are not the monogenic cause of CPVT (Jabbari J, et al, 2013). In summary, based on the high allele frequency in the general population and lack of established functional data in mammalian models or other strong data supportive of a pathogenic role, we classify CASQ2 Phe189Leu as "likely benign". - |
Catecholaminergic polymorphic ventricular tachycardia 1 Benign:1
Likely benign, criteria provided, single submitter | clinical testing | Labcorp Genetics (formerly Invitae), Labcorp | Feb 01, 2024 | - - |
Cardiovascular phenotype Benign:1
Likely benign, criteria provided, single submitter | clinical testing | Ambry Genetics | May 29, 2018 | This alteration is classified as likely benign based on a combination of the following: seen in unaffected individuals, population frequency, intact protein function, lack of segregation with disease, co-occurrence, RNA analysis, in silico models, amino acid conservation, lack of disease association in case-control studies, and/or the mechanism of disease or impacted region is inconsistent with a known cause of pathogenicity. - |
CASQ2-related disorder Benign:1
Likely benign, no assertion criteria provided | clinical testing | PreventionGenetics, part of Exact Sciences | Sep 15, 2022 | This variant is classified as likely benign based on ACMG/AMP sequence variant interpretation guidelines (Richards et al. 2015 PMID: 25741868, with internal and published modifications). - |
Computational scores
Source:
Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
BayesDel_addAF
Uncertain
T
BayesDel_noAF
Pathogenic
CADD
Uncertain
DANN
Uncertain
DEOGEN2
Uncertain
D
Eigen
Uncertain
Eigen_PC
Uncertain
FATHMM_MKL
Uncertain
D
LIST_S2
Uncertain
D
M_CAP
Uncertain
D
MetaRNN
Benign
T
MetaSVM
Uncertain
D
MutationAssessor
Uncertain
M
MutationTaster
Benign
D;D
PrimateAI
Uncertain
T
PROVEAN
Pathogenic
D
REVEL
Pathogenic
Sift
Uncertain
D
Sift4G
Pathogenic
D
Polyphen
D
Vest4
MutPred
Loss of sheet (P = 0.0817);
MVP
MPC
ClinPred
T
GERP RS
Varity_R
gMVP
Splicing
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Calibrated prediction
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SpliceAI score (max)
Details are displayed if max score is > 0.2
Find out detailed SpliceAI scores and Pangolin per-transcript scores at