rs148812376
Variant summary
Our verdict is Pathogenic. Variant got 14 ACMG points: 14P and 0B. PM1PP3_StrongPP5_Very_Strong
The NM_001009944.3(PKD1):c.9829C>T(p.Arg3277Cys) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.000329 in 1,563,456 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Likely pathogenic (★★).
Frequency
Consequence
NM_001009944.3 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Pathogenic. Variant got 14 ACMG points.
Transcripts
RefSeq
Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt |
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PKD1 | NM_001009944.3 | c.9829C>T | p.Arg3277Cys | missense_variant | Exon 29 of 46 | ENST00000262304.9 | NP_001009944.3 |
Ensembl
Frequencies
GnomAD3 genomes AF: 0.000302 AC: 46AN: 152258Hom.: 0 Cov.: 32
GnomAD3 exomes AF: 0.000167 AC: 29AN: 174022Hom.: 0 AF XY: 0.000161 AC XY: 15AN XY: 92972
GnomAD4 exome AF: 0.000332 AC: 469AN: 1411198Hom.: 0 Cov.: 32 AF XY: 0.000325 AC XY: 227AN XY: 697720
GnomAD4 genome AF: 0.000302 AC: 46AN: 152258Hom.: 0 Cov.: 32 AF XY: 0.000296 AC XY: 22AN XY: 74376
ClinVar
Submissions by phenotype
Polycystic kidney disease, adult type Pathogenic:5Other:1
The heterozygous p.Arg3277Cys variant in PKD1 was identified by our study in one individual with polycystic kidney disease and their unaffected parent. This variant has been seen in 0.04351% (36/82736) of European (non-Finnish) chromosomes. Please note that for diseases with clinical variability, or reduced penetrance, pathogenic variants may be present at a low frequency in the general population. Although this variant has been seen in the general population, its frequency is not high enough to rule out a pathogenic role. Computational prediction tools and conservation analyses suggest that this variant may impact the protein, though this information is not predictive enough to determine pathogenicity. The p.Arg3277Cys variant in PKD1 has been reported in ten individuals in one cosanguineous family with polycystic kidney disease and segregated with disease in eight affected relatives with varying expressivity. The disease status of the remaining two relatives was unknown (PMID: 19165178). This variant was also reported in the compound heterozygous state (with a pathogenic variant in one case) in two unrelated individuals with polycystic kidney disease (PMID: 19165178, 26139440). The presence of this variant in combination with a reported pathogenic variant and in an individual with polycystic kidney disease increases the likelihood that the p.Arg3277Cys variant is pathogenic. Animal models in mice have shown that this variant in the homozygous and compound heterozygous state with a null variant does cause a phenotype matching polycystic kidney disease (PMID: 23064367). In summary, although additional studies are required to fully establish its clinical significance, this variant is likely pathogenic. ACMG/AMP Criteria applied: PP3, PP1_Moderate, PM3, PS3 (Richards 2015). -
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Based on the classification scheme VCGS_Germline_v1.3.4, this variant is classified as Pathogenic. Following criteria are met: 0102 - Loss of function is a known mechanism of disease in this gene and is associated with polycystic kidney disease 1 (MIM#173900). (I) 0107 - This gene is associated with autosomal dominant disease. Polycystic kidney disease 1 (MIM#173900) is predominantly caused by monoallelic variants, with rare reports of biallelic variants causing disease (OMIM). (I) 0200 - Variant is predicted to result in a missense amino acid change from arginine to cysteine. (I) 0251 - This variant is heterozygous. (I) 0302 - Variant is present in gnomAD (v3) <0.001 for a dominant condition (46 heterozygotes, 0 homozygotes). (SP) 0309 - An alternative amino acid change at the same position has been observed in gnomAD (v2) (1 heterozygote, 0 homozygotes). (I) 0501 - Missense variant consistently predicted to be damaging by multiple in silico tools or highly conserved with a major amino acid change. (SP) 0604 - Variant is not located in an established domain, motif, hotspot or informative constraint region. (I) 0705 - No comparable missense variants have previous evidence for pathogenicity. (I) 0801 - This variant has strong previous evidence of pathogenicity in unrelated individuals. This variant has been described as a VUS, however, it is commonly described as a hypomorphic pathogenic or likely pathogenic allele. It has been reported in multiple homozygous and compound heterozygous individuals with polycystic kidney disease, but also in mildly affected heterozygous individuals with renal cysts (ClinVar, GeneReviews, PKD Mutation Database). (SP) 1002 - This variant has moderate functional evidence supporting abnormal protein function through defective PC-1 cleavage, protein folding and trafficking (PMID: 23064367). (SP) 1208 - Inheritance information for this variant is not currently available in this individual. (I) Legend: (SP) - Supporting pathogenic, (I) - Information, (SB) - Supporting benign -
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The PKD1 c.9829C>T (p.Arg3277Cys) variant is described as a hypomorphic allele proposed to modulate renal cyst development, which when detected in a homozygous or compound heterozygous state may result in a severe PKD phenotype but in a heterozygote state may cause a few cysts or no evidence of disease (Rossetti et al. 2009; Harris and Torres 2018). Across a selection of the available literature, the p.Arg3277Cys variant, a missense variant, has been identified in at least 17 individuals with polycystic kidney disease (PKD), including four in a homozygous state and six in a compound heterozygous state most of whom had severe, early-onset PKD (Rossetti et al. 2009; Vujic et al. 2010; Audrezet et al. 2016; Mantovani et al. 2020; Durkie et al. 2021). In a four generation consanguineous family in which the p.Arg3277Cys variant segregated with disease, the variant was also found in six individuals in a heterozygous state including five individuals presenting with a mild phenotype ranging from one to five simple cysts in adulthood and in one individual with no evidence of disease (Rossetti et al. 2009). Durkie et al. (2021) describe an additional individual heterozygous for the p.Arg3277Cys variant presenting with a severe, prenatal-onset phenotype and death shortly after birth, however a second, unidentified variant is suspected due to his unaffected father carrying the p.Arg3277Cys variant and his affected mother not having an identified variant. The p.Arg3277Cys variant was also found in at least five unaffected parents of an affected individual (Audrezet et al. 2016: Vujic et al. 2010; Durkie et al. 2021), although ages of the parents were not consistently specified. Control data are unavailable for this variant, which is reported at a frequency of 0.000453 in the European (non-Finnish) population of the Genome Aggregation Database v2.1.1. This allele frequency is high but may be consistent with reduced penetrance/hypomorphic allele. A knock-in mouse model found that heterozygous mice did not present with PKD but did find that homozygous, and compound heterozygous mice respectively demonstrated progressively more severe phenotypes consistent with human PKD patients, indicating the p.Arg3277Cys variant is dosage dependent and a hypomorphic modifier of the PKD phenotype (Hopp et al. 2012). Based on the collective evidence, the p.Arg3277Cys variant is classified as pathogenic (hypomorphic) for autosomal dominant polycystic kidney disease, generally associated with mild or no disease when detected in a heterozygous state and with a more severe, earlier-onset phenotype when detected in trans with a second variant. -
Hypomorphic allele -
not provided Pathogenic:1Benign:1
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A knock-in mouse model demonstrated mice that were heterozygous for the R3277C variant had no clinical features, homozygous mice developed gradual cystogenesis, and mice that were compound heterozygous for the R3277C variant and a null allele had rapidly progressive disease (PMID: 23064367); 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: 30249452, 32457805, 28903946, 24907393, 29463793, 31589614, 35325889, 34953771, 34662459, 33639313, 34290017, 34806449, 35037466, 34671066, 33705824, 26139440, 33168999, 33437033, DurkieM2023[Article], 37345660, 37372410, ChenJM2023[Preprint], 37519231, 37231942, 35896062, 37418622, 20558538, 32939031, 35358475, 37543885, 19165178, 23431072, 23064367, 30476936, 20301424, 35372954, 35368817, 39145639, 39026710, 38385746) -
Autosomal dominant polycystic kidney disease Uncertain:1
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Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at