rs1553565140

Variant summary

Our verdict is Pathogenic. The variant received 17 ACMG points: 17P and 0B. PM2PM5PP2PP3_StrongPP5_Very_Strong

The NM_001271893.4(TWIST2):​c.223G>A​(p.Glu75Lys) variant causes a missense change involving the alteration of a conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. In-silico tool predicts a pathogenic outcome for this variant. 13/22 in silico tools predict a damaging outcome for this variant. Variant has been reported in ClinVar as Pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. E75A) has been classified as Pathogenic.

Frequency

Genomes: not found (cov: 32)
Exomes 𝑓: 7.2e-7 ( 0 hom. )
Failed GnomAD Quality Control

Consequence

TWIST2
NM_001271893.4 missense

Scores

15
3
1

Clinical Significance

Pathogenic criteria provided, multiple submitters, no conflicts P:3

Conservation

PhyloP100: 9.52

Publications

6 publications found
Variant links:
Genes affected
TWIST2 (HGNC:20670): (twist family bHLH transcription factor 2) The protein encoded by this gene is a basic helix-loop-helix type transcription factor and shares similarity with Twist. This protein may inhibit osteoblast maturation and maintain cells in a preosteoblast phenotype during osteoblast development. This gene may be upregulated in certain cancers. Mutations in this gene cause focal facial dermal dysplasia 3, Setleis type. Two transcript variants encoding the same protein have been found. [provided by RefSeq, Apr 2014]
TWIST2 Gene-Disease associations (from GenCC):
  • ablepharon macrostomia syndrome
    Inheritance: AD Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Orphanet, G2P, Labcorp Genetics (formerly Invitae)
  • Barber-Say syndrome
    Inheritance: AD Classification: STRONG, SUPPORTIVE Submitted by: Orphanet, Labcorp Genetics (formerly Invitae)
  • focal facial dermal dysplasia type III
    Inheritance: AD, AR Classification: STRONG, SUPPORTIVE Submitted by: Orphanet, Labcorp Genetics (formerly Invitae), G2P

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Pathogenic. The variant received 17 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chr2-238848439-A-C is described in ClinVar as Pathogenic. ClinVar VariationId is 208076.Status of the report is no_assertion_criteria_provided, 0 stars.
PP2
Missense variant in the gene, where a lot of missense mutations are associated with disease in ClinVar. The gene has 3 curated pathogenic missense variants (we use a threshold of 10). The gene has 0 curated benign missense variants. Gene score misZ: 2.1324 (below the threshold of 3.09). Trascript score misZ: 0.22546 (below the threshold of 3.09). GenCC associations: The gene is linked to ablepharon macrostomia syndrome, focal facial dermal dysplasia type III, Barber-Say syndrome.
PP3
MetaRNN computational evidence supports a deleterious effect, 0.983
PP5
Variant 2-238848438-G-A is Pathogenic according to our data. Variant chr2-238848438-G-A is described in ClinVar as Pathogenic. ClinVar VariationId is 208077.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
TWIST2NM_001271893.4 linkc.223G>A p.Glu75Lys missense_variant Exon 1 of 2 ENST00000612363.2 NP_001258822.1
TWIST2NM_057179.3 linkc.223G>A p.Glu75Lys missense_variant Exon 1 of 2 NP_476527.1
TWIST2XR_007069137.1 linkn.354G>A non_coding_transcript_exon_variant Exon 1 of 2

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
TWIST2ENST00000612363.2 linkc.223G>A p.Glu75Lys missense_variant Exon 1 of 2 1 NM_001271893.4 ENSP00000482581.1
TWIST2ENST00000448943.2 linkc.223G>A p.Glu75Lys missense_variant Exon 1 of 2 1 ENSP00000405176.2
TWIST2ENST00000710607.1 linkc.223G>A p.Glu75Lys missense_variant Exon 1 of 2 ENSP00000518373.1

Frequencies

GnomAD3 genomes
Cov.:
32
GnomAD4 exome
Data not reliable, filtered out with message: AS_VQSR
AF:
7.17e-7
AC:
1
AN:
1395318
Hom.:
0
Cov.:
31
AF XY:
0.00000145
AC XY:
1
AN XY:
689052
show subpopulations
⚠️ The allele balance in gnomAD version 4 Exomes is significantly skewed from the expected value of 0.5.
African (AFR)
AF:
0.00
AC:
0
AN:
31744
American (AMR)
AF:
0.00
AC:
0
AN:
36218
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
25214
East Asian (EAS)
AF:
0.00
AC:
0
AN:
36068
South Asian (SAS)
AF:
0.00
AC:
0
AN:
79508
European-Finnish (FIN)
AF:
0.0000250
AC:
1
AN:
39940
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5708
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
1082610
Other (OTH)
AF:
0.00
AC:
0
AN:
58308
⚠️ The allele balance in gnomAD4 Exomes is highly skewed from 0.5 (p-value = 0), which strongly suggests a high chance of mosaicism in these individuals.
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.225
Heterozygous variant carriers
0
0
1
1
2
2
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance
GnomAD4 genome
Cov.:
32

ClinVar

Significance: Pathogenic
Submissions summary: Pathogenic:3
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Ablepharon macrostomia syndrome Pathogenic:2
Jun 07, 2020
Department of Pediatrics, Prince of Songkla University
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

A heterozygous missense p.Glu75Lys was reported to be associated with Ablepharon macrostomia syndrome in 7 families (Marchegiani et al. 2015). This variant was not found in ExAC database and our in-house Thai exome database (consisted of 1084 Thai exome controls). We classified this as pathogenic variant by ACMG Guidelines, 2015 based on >/=2 strong criteria [PS1, PS2, and PS3 (Functional study by Marchegiani et al. 2015)]. -

Jul 02, 2015
OMIM
Significance:Pathogenic
Review Status:no assertion criteria provided
Collection Method:literature only

- -

Inborn genetic diseases Pathogenic:1
Oct 09, 2017
Ambry Genetics
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
1.0
BayesDel_addAF
Pathogenic
0.58
D
BayesDel_noAF
Pathogenic
0.60
CADD
Pathogenic
35
DANN
Pathogenic
1.0
DEOGEN2
Pathogenic
0.96
D;D
Eigen
Pathogenic
0.96
Eigen_PC
Pathogenic
0.86
FATHMM_MKL
Uncertain
0.93
D
LIST_S2
Pathogenic
0.99
.;D
M_CAP
Pathogenic
0.80
D
MetaRNN
Pathogenic
0.98
D;D
MetaSVM
Pathogenic
0.90
D
MutationAssessor
Pathogenic
3.4
M;M
PhyloP100
9.5
PrimateAI
Pathogenic
0.93
D
PROVEAN
Uncertain
-4.0
D;.
REVEL
Pathogenic
0.97
Sift
Uncertain
0.0010
D;.
Sift4G
Pathogenic
0.0
D;D
Polyphen
1.0
D;D
Vest4
0.95
MutPred
0.87
Gain of MoRF binding (P = 0.0234);Gain of MoRF binding (P = 0.0234);
MVP
0.95
MPC
3.1
ClinPred
1.0
D
GERP RS
4.8
PromoterAI
0.085
Neutral
Varity_R
0.84
gMVP
1.0
Mutation Taster
=11/89
disease causing (ClinVar)

Splicing

Name
Calibrated prediction
Score
Prediction
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: rs1553565140; hg19: chr2-239757079; COSMIC: COSV71820612; API