rs149489325

Variant summary

Our verdict is Uncertain significance. Variant got 1 ACMG points: 2P and 1B. PP3_ModerateBS2_Supporting

The NM_174936.4(PCSK9):​c.706G>A​(p.Gly236Ser) variant causes a missense change. The variant allele was found at a frequency of 0.0000384 in 1,613,126 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 Uncertain significance (★★).

Frequency

Genomes: 𝑓 0.000033 ( 0 hom., cov: 34)
Exomes 𝑓: 0.000039 ( 0 hom. )

Consequence

PCSK9
NM_174936.4 missense

Scores

7
7
5

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:6

Conservation

PhyloP100: 6.60
Variant links:
Genes affected
PCSK9 (HGNC:20001): (proprotein convertase subtilisin/kexin type 9) This gene encodes a member of the subtilisin-like proprotein convertase family, which includes proteases that process protein and peptide precursors trafficking through regulated or constitutive branches of the secretory pathway. The encoded protein undergoes an autocatalytic processing event with its prosegment in the ER and is constitutively secreted as an inactive protease into the extracellular matrix and trans-Golgi network. It is expressed in liver, intestine and kidney tissues and escorts specific receptors for lysosomal degradation. It plays a role in cholesterol and fatty acid metabolism. Mutations in this gene have been associated with autosomal dominant familial hypercholesterolemia. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Feb 2014]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Uncertain_significance. Variant got 1 ACMG points.

PP3
MetaRNN computational evidence supports a deleterious effect, 0.86
BS2
High AC in GnomAd4 at 5 AD gene. Variant has AC lower than other variant known as pathogenic in the gene, so the strength is limited to Supporting.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
PCSK9NM_174936.4 linkuse as main transcriptc.706G>A p.Gly236Ser missense_variant 5/12 ENST00000302118.5 NP_777596.2

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
PCSK9ENST00000302118.5 linkuse as main transcriptc.706G>A p.Gly236Ser missense_variant 5/121 NM_174936.4 ENSP00000303208 P2Q8NBP7-1

Frequencies

GnomAD3 genomes
AF:
0.0000328
AC:
5
AN:
152242
Hom.:
0
Cov.:
34
show subpopulations
Gnomad AFR
AF:
0.0000482
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.000414
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0000147
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000602
AC:
15
AN:
249196
Hom.:
0
AF XY:
0.0000666
AC XY:
9
AN XY:
135172
show subpopulations
Gnomad AFR exome
AF:
0.0000623
Gnomad AMR exome
AF:
0.0000289
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.000109
Gnomad SAS exome
AF:
0.000196
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000447
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000390
AC:
57
AN:
1460766
Hom.:
0
Cov.:
81
AF XY:
0.0000578
AC XY:
42
AN XY:
726700
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.0000224
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.000101
Gnomad4 SAS exome
AF:
0.000209
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.0000288
Gnomad4 OTH exome
AF:
0.0000166
GnomAD4 genome
AF:
0.0000328
AC:
5
AN:
152360
Hom.:
0
Cov.:
34
AF XY:
0.00
AC XY:
0
AN XY:
74498
show subpopulations
Gnomad4 AFR
AF:
0.0000481
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.000414
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.0000147
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.0000654
Hom.:
1
Bravo
AF:
0.0000340
ESP6500AA
AF:
0.000454
AC:
2
ESP6500EA
AF:
0.00
AC:
0
ExAC
AF:
0.0000330
AC:
4
EpiCase
AF:
0.000109
EpiControl
AF:
0.000237

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:6
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Hypercholesterolemia, autosomal dominant, 3 Uncertain:2
Uncertain significance, criteria provided, single submitterclinical testingFulgent Genetics, Fulgent GeneticsOct 12, 2021- -
Uncertain significance, criteria provided, single submitterclinical testingAll of Us Research Program, National Institutes of HealthJan 08, 2024This missense variant replaces glycine with serine at codon 236 of the PCSK9 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). A functional study has shown this variant to cause a loss of PCSK9 function due to the failure of the mutant protein to exit the endoplasmic reticulum (PMID: 18266662). As a result, the cells expressing the mutant protein showed increased LDL uptake (PMID: 18266662). Consistent with this functional study, this variant has been reported in hypocholesterolemic individuals (PMID: 18266662, 34341098). To our knowledge, this variant has not been reported in individuals affected with PCSK9-related disorders in the literature. This variant has been identified in 16/280576 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Although available evidence indicate this variant is unlikely to be disease-causing, additional studies are necessary to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -
not specified Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingLaboratory for Molecular Medicine, Mass General Brigham Personalized MedicineDec 02, 2016Variant identified in a genome or exome case(s) and assessed due to predicted null impact of the variant or pathogenic assertions in the literature or databases. Disclaimer: This variant has not undergone full assessment. The following are preliminary notes: This variant has been in 1 individual with hypocholesterolemia - classified as DM in HGMD. An in vitro cleavage assay showed that the variant had a loss of function effect. Gain of function mutations in this gene lead to hypercholesterolemia, while loss of function lead to hypocholesterolemia. This variant is not classified in ClinVar. The variant was seen in 0.02% of South Asian chrs in gnomAD (6 chrs). -
Hypercholesterolemia, familial, 1 Uncertain:1
Uncertain significance, criteria provided, single submittercuration;literature onlyCardiovascular Research Group, Instituto Nacional de Saude Doutor Ricardo JorgeMar 01, 2016- -
not provided Uncertain:1
Uncertain significance, criteria provided, single submitternot providedBreakthrough Genomics, Breakthrough Genomics-- -
Familial hypercholesterolemia Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingColor Diagnostics, LLC DBA Color HealthDec 07, 2023This missense variant replaces glycine with serine at codon 236 of the PCSK9 protein. Computational prediction tools indicate that this variant has a deleterious impact on protein structure and function. A functional study has shown this variant to cause a loss of PCSK9 function due to the failure of the mutant protein to exit the endoplasmic reticulum (PMID: 18266662). As a result, the cells expressing the mutant protein showed increased LDL uptake (PMID: 18266662). Consistent with this functional study, this variant has been reported in two individuals with low circulating levels of LDL-C (PMID: 18266662, 34341098). To our knowledge, this variant has not been reported in individuals affected with PCSK9-related disorders in the literature. This variant has been identified in 16/280576 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Although available evidence indicate this variant is unlikely to be disease-causing, additional studies are necessary to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.25
BayesDel_addAF
Pathogenic
0.23
D
BayesDel_noAF
Pathogenic
0.37
CADD
Uncertain
25
DANN
Uncertain
1.0
DEOGEN2
Uncertain
0.53
D
Eigen
Uncertain
0.44
Eigen_PC
Uncertain
0.38
FATHMM_MKL
Uncertain
0.95
D
LIST_S2
Uncertain
0.86
D
M_CAP
Benign
0.076
D
MetaRNN
Pathogenic
0.86
D
MetaSVM
Uncertain
0.43
D
MutationAssessor
Benign
1.2
L
MutationTaster
Benign
1.0
D;D;D
PrimateAI
Pathogenic
0.82
D
PROVEAN
Pathogenic
-5.5
D
REVEL
Pathogenic
0.84
Sift
Pathogenic
0.0
D
Sift4G
Benign
0.091
T
Polyphen
1.0
D
Vest4
0.96
MVP
0.91
MPC
0.83
ClinPred
0.51
D
GERP RS
3.1
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.8
Varity_R
0.94
gMVP
0.86

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.010
Details are displayed if max score is > 0.2

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Publications

LitVar

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs149489325; hg19: chr1-55518371; API