rs184412722

Variant summary

Our verdict is Benign. The variant received -13 ACMG points: 0P and 13B. BP4_StrongBP6BS1BS2

The NM_001267550.2(TTN):​c.18824A>G​(p.Asn6275Ser) variant causes a missense change. The variant allele was found at a frequency of 0.00223 in 1,612,842 control chromosomes in the GnomAD database, including 53 homozygotes. In-silico tool predicts a benign outcome for this variant. 12/18 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).

Frequency

Genomes: š‘“ 0.0018 ( 6 hom., cov: 33)
Exomes š‘“: 0.0023 ( 47 hom. )

Consequence

TTN
NM_001267550.2 missense

Scores

1
3
11

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications U:1B:22

Conservation

PhyloP100: 6.26

Publications

8 publications found
Variant links:
Genes affected
TTN (HGNC:12403): (titin) This gene encodes a large abundant protein of striated muscle. The product of this gene is divided into two regions, a N-terminal I-band and a C-terminal A-band. The I-band, which is the elastic part of the molecule, contains two regions of tandem immunoglobulin domains on either side of a PEVK region that is rich in proline, glutamate, valine and lysine. The A-band, which is thought to act as a protein-ruler, contains a mixture of immunoglobulin and fibronectin repeats, and possesses kinase activity. An N-terminal Z-disc region and a C-terminal M-line region bind to the Z-line and M-line of the sarcomere, respectively, so that a single titin molecule spans half the length of a sarcomere. Titin also contains binding sites for muscle associated proteins so it serves as an adhesion template for the assembly of contractile machinery in muscle cells. It has also been identified as a structural protein for chromosomes. Alternative splicing of this gene results in multiple transcript variants. Considerable variability exists in the I-band, the M-line and the Z-disc regions of titin. Variability in the I-band region contributes to the differences in elasticity of different titin isoforms and, therefore, to the differences in elasticity of different muscle types. Mutations in this gene are associated with familial hypertrophic cardiomyopathy 9, and autoantibodies to titin are produced in patients with the autoimmune disease scleroderma. [provided by RefSeq, Feb 2012]
TTN-AS1 (HGNC:44124): (TTN antisense RNA 1) This gene encodes a non-coding RNA transcribed from the opposite strand to the titin gene. [provided by RefSeq, Aug 2016]

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Benign. The variant received -13 ACMG points.

BP4
Computational evidence support a benign effect (MetaRNN=0.005814582).
BP6
Variant 2-178729332-T-C is Benign according to our data. Variant chr2-178729332-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 46646. Variant chr2-178729332-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 46646. Variant chr2-178729332-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 46646. Variant chr2-178729332-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 46646. Variant chr2-178729332-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 46646. Variant chr2-178729332-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 46646. Variant chr2-178729332-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 46646. Variant chr2-178729332-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 46646. Variant chr2-178729332-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 46646. Variant chr2-178729332-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 46646. Variant chr2-178729332-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 46646. Variant chr2-178729332-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 46646. Variant chr2-178729332-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 46646. Variant chr2-178729332-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 46646. Variant chr2-178729332-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 46646. Variant chr2-178729332-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 46646. Variant chr2-178729332-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 46646. Variant chr2-178729332-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 46646. Variant chr2-178729332-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 46646. Variant chr2-178729332-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 46646.
BS1
Variant frequency is greater than expected in population sas. GnomAd4 allele frequency = 0.00183 (279/152276) while in subpopulation SAS AF = 0.0244 (118/4828). AF 95% confidence interval is 0.0209. There are 6 homozygotes in GnomAd4. There are 162 alleles in the male GnomAd4 subpopulation. Median coverage is 33. This position passed quality control check.
BS2
High Homozygotes in GnomAd4 at 6 AD,AR gene

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
TTNNM_001267550.2 linkc.18824A>G p.Asn6275Ser missense_variant Exon 64 of 363 ENST00000589042.5 NP_001254479.2 A0A0A0MTS7

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
TTNENST00000589042.5 linkc.18824A>G p.Asn6275Ser missense_variant Exon 64 of 363 5 NM_001267550.2 ENSP00000467141.1 A0A0A0MTS7

Frequencies

GnomAD3 genomes
AF:
0.00181
AC:
276
AN:
152158
Hom.:
5
Cov.:
33
show subpopulations
Gnomad AFR
AF:
0.000241
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00183
Gnomad ASJ
AF:
0.000865
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.0238
Gnomad FIN
AF:
0.0000942
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.00169
Gnomad OTH
AF:
0.00191
GnomAD2 exomes
AF:
0.00383
AC:
950
AN:
247794
AF XY:
0.00490
show subpopulations
Gnomad AFR exome
AF:
0.000194
Gnomad AMR exome
AF:
0.000784
Gnomad ASJ exome
AF:
0.000899
Gnomad EAS exome
AF:
0.0000557
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00184
Gnomad OTH exome
AF:
0.00366
GnomAD4 exome
AF:
0.00227
AC:
3314
AN:
1460566
Hom.:
47
Cov.:
32
AF XY:
0.00291
AC XY:
2111
AN XY:
726384
show subpopulations
African (AFR)
AF:
0.000419
AC:
14
AN:
33434
American (AMR)
AF:
0.000716
AC:
32
AN:
44682
Ashkenazi Jewish (ASJ)
AF:
0.000843
AC:
22
AN:
26100
East Asian (EAS)
AF:
0.000176
AC:
7
AN:
39670
South Asian (SAS)
AF:
0.0214
AC:
1847
AN:
86200
European-Finnish (FIN)
AF:
0.0000749
AC:
4
AN:
53380
Middle Eastern (MID)
AF:
0.00417
AC:
24
AN:
5754
European-Non Finnish (NFE)
AF:
0.00107
AC:
1185
AN:
1111024
Other (OTH)
AF:
0.00297
AC:
179
AN:
60322
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.491
Heterozygous variant carriers
0
190
380
569
759
949
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Exome Hom
Variant carriers
0
48
96
144
192
240
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
GnomAD4 genome
AF:
0.00183
AC:
279
AN:
152276
Hom.:
6
Cov.:
33
AF XY:
0.00218
AC XY:
162
AN XY:
74448
show subpopulations
African (AFR)
AF:
0.000241
AC:
10
AN:
41572
American (AMR)
AF:
0.00183
AC:
28
AN:
15290
Ashkenazi Jewish (ASJ)
AF:
0.000865
AC:
3
AN:
3470
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5162
South Asian (SAS)
AF:
0.0244
AC:
118
AN:
4828
European-Finnish (FIN)
AF:
0.0000942
AC:
1
AN:
10618
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
294
European-Non Finnish (NFE)
AF:
0.00169
AC:
115
AN:
68014
Other (OTH)
AF:
0.00189
AC:
4
AN:
2116
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.501
Heterozygous variant carriers
0
13
26
40
53
66
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Genome Het
Variant carriers
0
10
20
30
40
50
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
Alfa
AF:
0.00163
Hom.:
1
Bravo
AF:
0.00105
TwinsUK
AF:
0.000270
AC:
1
ALSPAC
AF:
0.00156
AC:
6
ESP6500AA
AF:
0.000530
AC:
2
ESP6500EA
AF:
0.00194
AC:
16
ExAC
AF:
0.00441
AC:
533
Asia WGS
AF:
0.0120
AC:
43
AN:
3478
EpiCase
AF:
0.00267
EpiControl
AF:
0.00273

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Uncertain:1Benign:22
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

not specified Benign:8
Feb 25, 2015
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

p.Asn5031Ser in exon 61 of TTN: This variant is not expected to have clinical si gnificance because it has been identified in 2.4% (391/16028) of South Asian chr omosomes by the Exome Aggregation Consortium (ExAC, http://exac.broadinstitute.o rg; dbSNP rs184412722). -

-
Clinical Genetics, Academic Medical Center
Significance:Benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Sep 01, 2015
Eurofins Ntd Llc (ga)
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Feb 08, 2016
GeneDx
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant is considered likely benign or benign based on one or more of the following criteria: it is a conservative change, it occurs at a poorly conserved position in the protein, it is predicted to be benign by multiple in silico algorithms, and/or has population frequency not consistent with disease. -

Nov 05, 2019
Athena Diagnostics
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Jan 06, 2020
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

-
Joint Genome Diagnostic Labs from Nijmegen and Maastricht, Radboudumc and MUMC+
Significance:Benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Apr 09, 2025
Molecular Diagnostic Laboratory for Inherited Cardiovascular Disease, Montreal Heart Institute
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

not provided Uncertain:1Benign:6
-
Laboratory of Diagnostic Genome Analysis, Leiden University Medical Center (LUMC)
Significance:Likely benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Jun 24, 2013
Biesecker Lab/Clinical Genomics Section, National Institutes of Health
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:research

- -

-
Diagnostic Laboratory, Department of Genetics, University Medical Center Groningen
Significance:Likely benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Nov 14, 2024
ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Apr 01, 2025
CeGaT Center for Human Genetics Tuebingen
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

TTN: BP4, BS1, BS2 -

Mar 17, 2014
Genetic Services Laboratory, University of Chicago
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

-
Clinical Genetics DNA and cytogenetics Diagnostics Lab, Erasmus MC, Erasmus Medical Center
Significance:Likely benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Autosomal recessive limb-girdle muscular dystrophy type 2J Benign:1
Jan 13, 2018
Illumina Laboratory Services, Illumina
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as likely benign is not then subjected to further curation. The score for this variant resulted in a classification of likely benign for this disease. -

Autosomal recessive limb-girdle muscular dystrophy type 2J;C1858763:Dilated cardiomyopathy 1G Benign:1
Feb 02, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Dilated cardiomyopathy 1G Benign:1
Jan 13, 2018
Illumina Laboratory Services, Illumina
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as likely benign is not then subjected to further curation. The score for this variant resulted in a classification of likely benign for this disease. -

Cardiomyopathy Benign:1
May 30, 2019
CHEO Genetics Diagnostic Laboratory, Children's Hospital of Eastern Ontario
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Early-onset myopathy with fatal cardiomyopathy Benign:1
Jan 13, 2018
Illumina Laboratory Services, Illumina
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as likely benign is not then subjected to further curation. The score for this variant resulted in a classification of likely benign for this disease. -

Tibial muscular dystrophy Benign:1
Jan 13, 2018
Illumina Laboratory Services, Illumina
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as benign is not then subjected to further curation. The score for this variant resulted in a classification of benign for this disease. -

Myopathy, myofibrillar, 9, with early respiratory failure Benign:1
Jan 13, 2018
Illumina Laboratory Services, Illumina
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as benign is not then subjected to further curation. The score for this variant resulted in a classification of benign for this disease. -

Primary dilated cardiomyopathy Benign:1
Feb 28, 2017
Center for Advanced Laboratory Medicine, UC San Diego Health, University of California San Diego
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Uncertain
0.35
BayesDel_addAF
Benign
-0.45
T
BayesDel_noAF
Benign
-0.40
CADD
Benign
21
DANN
Benign
0.94
Eigen
Uncertain
0.32
Eigen_PC
Uncertain
0.38
FATHMM_MKL
Pathogenic
0.98
D
LIST_S2
Benign
0.84
T;D;.;D
MetaRNN
Benign
0.0058
T;T;T;T
MetaSVM
Benign
-0.56
T
PhyloP100
6.3
PrimateAI
Benign
0.45
T
PROVEAN
Benign
-2.3
N;.;.;.
REVEL
Benign
0.29
Sift
Benign
0.075
T;.;.;.
Polyphen
0.36
.;.;B;B
Vest4
0.42
MVP
0.17
MPC
0.089
ClinPred
0.027
T
GERP RS
5.9
Mutation Taster
=48/52
disease causing

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: rs184412722; hg19: chr2-179594059; API