rs146726731
Variant summary
Our verdict is Uncertain significance. The variant received 4 ACMG points: 5P and 1B. PM1PP2PP3_ModerateBP6
The NM_000138.5(FBN1):c.1027G>A(p.Gly343Arg) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.000205 in 1,614,140 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. 12/19 in silico tools predict a damaging outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars). Synonymous variant affecting the same amino acid position (i.e. G343G) has been classified as Likely benign.
Frequency
Consequence
NM_000138.5 missense
Scores
Clinical Significance
Conservation
Publications
- familial thoracic aortic aneurysm and aortic dissectionInheritance: AD Classification: DEFINITIVE, SUPPORTIVE Submitted by: ClinGen, Orphanet
- Marfan syndromeInheritance: AD, AR Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Labcorp Genetics (formerly Invitae), Genomics England PanelApp, ClinGen, G2P, PanelApp Australia, Orphanet, Ambry Genetics
- Acromicric dysplasiaInheritance: AD Classification: STRONG, SUPPORTIVE Submitted by: Orphanet, Ambry Genetics
- progeroid and marfanoid aspect-lipodystrophy syndromeInheritance: AD Classification: STRONG, MODERATE, SUPPORTIVE Submitted by: Labcorp Genetics (formerly Invitae), Ambry Genetics, Orphanet
- stiff skin syndromeInheritance: AD Classification: STRONG, LIMITED Submitted by: Ambry Genetics, Labcorp Genetics (formerly Invitae)
- Weill-Marchesani syndrome 2, dominantInheritance: AD Classification: STRONG Submitted by: G2P, Labcorp Genetics (formerly Invitae)
- geleophysic dysplasiaInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- isolated ectopia lentisInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- neonatal Marfan syndromeInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- Weill-Marchesani syndromeInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- ectopia lentis 1, isolated, autosomal dominantInheritance: AD Classification: LIMITED Submitted by: G2P
- Shprintzen-Goldberg syndromeInheritance: AD, Unknown Classification: LIMITED, NO_KNOWN Submitted by: ClinGen, Labcorp Genetics (formerly Invitae)
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ACMG classification
Our verdict: Uncertain_significance. The variant received 4 ACMG points.
Transcripts
RefSeq
Ensembl
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
|---|---|---|---|---|---|---|---|---|---|---|
| FBN1 | ENST00000316623.10 | c.1027G>A | p.Gly343Arg | missense_variant | Exon 10 of 66 | 1 | NM_000138.5 | ENSP00000325527.5 | ||
| FBN1 | ENST00000559133.6 | n.1027G>A | non_coding_transcript_exon_variant | Exon 10 of 67 | 1 | ENSP00000453958.2 | ||||
| FBN1 | ENST00000674301.2 | n.1027G>A | non_coding_transcript_exon_variant | Exon 10 of 68 | ENSP00000501333.2 | |||||
| FBN1 | ENST00000537463.6 | n.636+16932G>A | intron_variant | Intron 7 of 30 | 5 | ENSP00000440294.2 |
Frequencies
GnomAD3 genomes AF: 0.000223 AC: 34AN: 152144Hom.: 0 Cov.: 32 show subpopulations
GnomAD2 exomes AF: 0.000187 AC: 47AN: 251314 AF XY: 0.000214 show subpopulations
GnomAD4 exome AF: 0.000203 AC: 297AN: 1461878Hom.: 0 Cov.: 31 AF XY: 0.000197 AC XY: 143AN XY: 727242 show subpopulations
Age Distribution
GnomAD4 genome AF: 0.000223 AC: 34AN: 152262Hom.: 0 Cov.: 32 AF XY: 0.000215 AC XY: 16AN XY: 74454 show subpopulations
Age Distribution
ClinVar
Submissions by phenotype
not provided Uncertain:5
The FBN1 c.1027G>A; p.Gly343Arg variant (rs146726731; ClinVar Variation ID: 161244) has been reported in multiple cohorts of individuals with suspected or confirmed Marfan syndrome (Tjeldhorn 2006, Rand-Hendriksen 2007, Viveiro 2013, Becerra-Munoz 2018, Fernandez-Alvarez 2022), including a purported de novo observation (Fernandez-Alvarez 2022). However, this variant was identified alongside other pathogenic variation in other genes in affected patients (Grond-Ginsbach 2017 and Arbustini 2017), and failed to co-segregate with disease in two cousins affected with cervical artery dissection (Grond-Ginsbach 2017). Additionally, this variant is also found in the non-Finnish European population with an allele frequency of 0.03% (33/129,054 alleles) in the Genome Aggregation Database (v2.1.1) and reported in several additional studies of variant in the general population (Amendola 2015, Groth 2016, Olfson 2015, Yang 2014). This variant is located in the TGF-beta binding (TB) domain of FBN1 (not in an EGF domain), though computational analyses predict that this variant is deleterious (REVEL: 0.863). Due to conflicting information, the clinical significance of this variant is uncertain at this time. References: Amendola et al. Actionable exomic incidental findings in 6503 participants: challenges of variant classification. Genome Res. 2015; 25(3): 305-315. PMID: 25637381 Arbustini E et al. Reply: A Distinct Cardiomyopathy: HCN4 Syndrome Comprising Myocardial Noncompaction, Bradycardia, Mitral Valve Defects, and Aortic Dilation. J Am Coll Cardiol. 2017 Mar 7;69(9):1210-1211. PMID: 28254189. Becerra-Munoz VM et al The importance of genotype-phenotype correlation in the clinical management of Marfan syndrome. Orphanet J Rare Dis. 2018 Jan 22;13(1):16. PMID: 29357934 Fernandez-Alvarez P et al. A systematic study and literature review of parental somatic mosaicism of FBN1 pathogenic variants in Marfan syndrome. J Med Genet. 2022 Jun;59(6):605-612. PMID: 33910934. Grond-Ginsbach C et al. Next generation sequencing analysis of patients with familial cervical artery dissection. Eur Stroke J. 2017 Jun;2(2):137-143. PMID: 31008308 Groth et al. Difficulties in diagnosing Marfan syndrome using current FBN1 databases. Genet Med. 2016; 18(1): 98-102. PMID: 25812041 Olfson et al. Identification of Medically Actionable Secondary Findings in the 1000 Genomes. PLoS One. 2015; 10(9): e0135193. PMID: 26332594 Rand-Hendriksen S et al. Search for correlations between FBN1 genotype and complete Ghent phenotype in 44 unrelated Norwegian patients with Marfan syndrome. Am J Med Genet A. 2007 Sep 1;143A(17):1968-77. PMID: 17663468. Tjeldhorn et al. Rapid and efficient FBN1 mutation detection using automated sample preparation and direct sequencing as the primary strategy. Genet Test. 2006; 10(4): 258-264. PMID: 17253931 Viveiro et al. Spontaneous pneumothorax as manifestation of Marfan syndrome. BMJ Case Rep. 2013; 2013. PMID: 24311428 Yang et al. New population-based exome data question the pathogenicity of some genetic variants previously associated with Marfan syndrome. BMC Genet. 2014; 15:74. PMID: 24941995 -
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Published in association with confirmed or suspected Marfan syndrome as well as carotid artery dissection or thoracic aortic aneurysm; however, one individual was found to harbor another variant that likely contributed to the phenotype, and an affected relative of a different proband was reported to be absent for this variant (PMID: 17253931, 17663468, 24311428, 26684006, 31008308, 29357934, 36889877); Does not affect a cysteine or calcium-binding residue within an EGF-like domain or a TGF-binding protein domain of the FBN1 gene; cysteine substitutions in the EGF-like domains represent the majority of pathogenic missense changes associated with FBN1-related disorders (PMID: 12938084); 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: 25637381, 27647783, 24311428, 24941995, 26332594, 25812041, 26684006, 28254189, 29357934, 30122538, 17663468, 31008308, 17253931, 33910934, 31322791, 35886052, 36889877, 12938084) -
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Marfan syndrome Uncertain:2Benign:1
This missense variant replaces glycine with arginine at codon 343 of the FBN1 protein. Computational prediction suggests that this variant may have deleterious impact on protein structure and function (internally defined REVEL score threshold >= 0.7, PMID: 27666373). To our knowledge, functional studies have not been reported for this variant. This variant has been reported in a few individuals suspected of having Marfan syndrome (PMID: 17253931, 17663468, 24311428). This variant has been reported in an individual affected with cervical artery dissection (PMID: 31008308); this individual also carried a pathogenic variant in the COL3A1 gene. This variant has been identified in 52/282706 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -
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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. The evidence from the literature, in combination with allele frequency data from public databases where available, was sufficient to determine this variant is unlikely to cause disease. Therefore, this variant is classified as likely benign. -
Familial thoracic aortic aneurysm and aortic dissection Uncertain:1Benign:2
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The p.G343R variant (also known as c.1027G>A), located in coding exon 9 of the FBN1 gene, results from a G to A substitution at nucleotide position 1027. The glycine at codon 343 is replaced by arginine, an amino acid with dissimilar properties. This alteration was first reported in a cohort of 105 patients with suspected Marfan syndrome (MFS) (Tjeldhorn L et al. Genet. Test., 2006;10:258-64). Later, the same group reported that the individual carrying this alteration was diagnosed with MFS (Rand-Hendriksen S et al. Am. J. Med. Genet. A. 2007;143A:1968-77), and had increased FBN1 mRNA in fibroblasts (Tjeldhorn L et al. BMC Med. Genet. 2015;16:113). This alteration was also described in a patient with spontaneous pneumothorax and Marfanoid habitus, and was detected in two relatives reported to have MFS in another study (Viveiro C et al. BMJ Case Rep, 2013;2013; Becerra-Muñoz VM. Orphanet J Rare Dis. 2018;13(1):16). This variant co-occurred with an alteration in COL3A1 in a family with carotid artery dissection, where the current variant was absent in one affected relative (Grond-Ginsbach C et al. Eur Stroke J, 2017 Jun;2:137-143). In addition, this variant has been seen in an exome cohort, but cardiovascular history was not provided (Amendola LM et al. Genome Res., 2015 Mar;25:305-15). This amino acid position is highly conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear. -
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). No publications were found based on this search. Allele frequency data from public databases allowed determination this variant is unlikely to cause disease. Therefore, this variant is classified as likely benign. -
Connective tissue disorder Uncertain:1
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not specified Benign:1
Variant summary: FBN1 c.1027G>A (p.Gly343Arg) results in a non-conservative amino acid change located in the TB domain (IPR017878) of the encoded protein sequence. Five of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 0.00019 in 251406 control chromosomes, predominantly at a frequency of 0.00043 within the Latino subpopulation in the gnomAD database. The observed variant frequency within Latino control individuals in the gnomAD database is approximately 4 fold of the estimated maximal expected allele frequency for a pathogenic variant in FBN1 causing Aortopathy phenotype (0.00011). c.1027G>A has been reported in the literature in individuals affected with Aortopathy or MFS without strong evidence for causality (Tjeldhorn_2006, Tjeldhorn_2015, Rand-Hendriksen_2007, Viveiro_2013, Grond-Ginsbach_2017, Becerra-Munoz_2018, Kasak_2019). These report(s) do not provide unequivocal conclusions about association of the variant with Aortopathy. Co-occurrences with other pathogenic variant(s) have been reported ( COL3A1 c.970G>A, p.G324S), providing supporting evidence for a benign role. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. The following publications have been ascertained in the context of this evaluation (PMID: 17253931, 17663468, 24941995, 26332594, 25637381, 25812041, 24311428, 29357934, 31008308, 31322791, 26684006). ClinVar contains an entry for this variant (Variation ID: 161244). Based on the evidence outlined above, the variant was classified as likely benign. -
Stiff skin syndrome Benign:1
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). No publications were found based on this search. Allele frequency data from public databases allowed determination this variant is unlikely to cause disease. Therefore, this variant is classified as likely benign. -
Weill-Marchesani syndrome Benign:1
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). No publications were found based on this search. Allele frequency data from public databases allowed determination this variant is unlikely to cause disease. Therefore, this variant is classified as likely benign. -
Geleophysic dysplasia Benign:1
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). No publications were found based on this search. Allele frequency data from public databases allowed determination this variant is unlikely to cause disease. Therefore, this variant is classified as likely benign. -
Acromicric dysplasia Benign:1
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). No publications were found based on this search. Allele frequency data from public databases allowed determination this variant is unlikely to cause disease. Therefore, this variant is classified as likely benign. -
Marfan syndrome;C4707243:Familial thoracic aortic aneurysm and aortic dissection Benign:1
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Ectopia lentis 1, isolated, autosomal dominant Benign:1
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). No publications were found based on this search. Allele frequency data from public databases allowed determination this variant is unlikely to cause disease. Therefore, this variant is classified as likely benign. -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at