rs186924074

Variant summary

Our verdict is Uncertain significance. Variant got 0 ACMG points: 1P and 1B. PP3BS2_Supporting

The NM_000053.4(ATP7B):​c.1922T>C​(p.Leu641Ser) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.000828 in 1,614,082 control chromosomes in the GnomAD database, including 2 homozygotes. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).

Frequency

Genomes: š‘“ 0.00058 ( 0 hom., cov: 32)
Exomes š‘“: 0.00085 ( 2 hom. )

Consequence

ATP7B
NM_000053.4 missense

Scores

12
5
2

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications U:12B:1

Conservation

PhyloP100: 8.39
Variant links:
Genes affected
ATP7B (HGNC:870): (ATPase copper transporting beta) This gene is a member of the P-type cation transport ATPase family and encodes a protein with several membrane-spanning domains, an ATPase consensus sequence, a hinge domain, a phosphorylation site, and at least 2 putative copper-binding sites. This protein is a monomer, and functions as a copper-transporting ATPase which exports copper out of the cells, such as the efflux of hepatic copper into the bile. Alternate transcriptional splice variants, encoding different isoforms with distinct cellular localizations, have been characterized. Mutations in this gene have been associated with Wilson disease which is characterized by copper accumulation. [provided by RefSeq, Dec 2019]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Uncertain_significance. Variant got 0 ACMG points.

PP3
MetaRNN computational evidence supports a deleterious effect, 0.752
BS2
High Homozygotes in GnomAdExome4 at 2 AR geneVariant has number of homozygotes 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 rank MANE Protein UniProt
ATP7BNM_000053.4 linkc.1922T>C p.Leu641Ser missense_variant Exon 6 of 21 ENST00000242839.10 NP_000044.2 P35670-1B7ZLR4A0A024RDX3

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
ATP7BENST00000242839.10 linkc.1922T>C p.Leu641Ser missense_variant Exon 6 of 21 1 NM_000053.4 ENSP00000242839.5 P35670-1

Frequencies

GnomAD3 genomes
AF:
0.000585
AC:
89
AN:
152198
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.0000241
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00144
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.000941
Gnomad OTH
AF:
0.000956
GnomAD3 exomes
AF:
0.000489
AC:
122
AN:
249584
Hom.:
0
AF XY:
0.000473
AC XY:
64
AN XY:
135410
show subpopulations
Gnomad AFR exome
AF:
0.000129
Gnomad AMR exome
AF:
0.000782
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.0000464
Gnomad NFE exome
AF:
0.000768
Gnomad OTH exome
AF:
0.000825
GnomAD4 exome
AF:
0.000854
AC:
1248
AN:
1461766
Hom.:
2
Cov.:
31
AF XY:
0.000802
AC XY:
583
AN XY:
727198
show subpopulations
Gnomad4 AFR exome
AF:
0.0000597
Gnomad4 AMR exome
AF:
0.000872
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.00
Gnomad4 FIN exome
AF:
0.000150
Gnomad4 NFE exome
AF:
0.00103
Gnomad4 OTH exome
AF:
0.000795
GnomAD4 genome
AF:
0.000584
AC:
89
AN:
152316
Hom.:
0
Cov.:
32
AF XY:
0.000604
AC XY:
45
AN XY:
74492
show subpopulations
Gnomad4 AFR
AF:
0.0000241
Gnomad4 AMR
AF:
0.00144
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.000941
Gnomad4 OTH
AF:
0.000946
Alfa
AF:
0.000863
Hom.:
1
Bravo
AF:
0.000669
TwinsUK
AF:
0.000809
AC:
3
ALSPAC
AF:
0.000519
AC:
2
ESP6500AA
AF:
0.000524
AC:
2
ESP6500EA
AF:
0.000243
AC:
2
ExAC
AF:
0.000397
AC:
48
EpiCase
AF:
0.00131
EpiControl
AF:
0.00107

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Uncertain:12Benign:1
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

Wilson disease Uncertain:7Benign:1
Jun 03, 2024
ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The ATP7B c.1922T>C; p.Leu641Ser variant (rs186924074; ClinVar Variation ID: 420002) is reported in the literature in individuals affected with Wilson disease (Bost 2012, Coffey 2013, Couchonnal 2021, Cox 2005, Ferenci 2019, Nayagam 2023, Vrabelova 2005) but also in presumed healthy cohorts (Collet 2018, Lorente-Arencibia 2022). This variant is found in the general population with an overall allele frequency of 0.046% (130/280,986 alleles) in the Genome Aggregation Database (v2.1.1). Computational analyses predict that this variant is deleterious (REVEL: 0.93). However, functional analyses of the variant protein show similar copper trafficking compared to wild type (Braiterman 2014, de Bie 2007). Due to conflicting information, the clinical significance of the p.Leu641Ser variant is uncertain at this time. References: Bost M et al. Molecular analysis of Wilson patients: direct sequencing and MLPA analysis in the ATP7B gene and Atox1 and COMMD1 gene analysis. J Trace Elem Med Biol. 2012;26(2-3):97-101. PMID: 22677543. Braiterman LT et al. Distinct phenotype of a Wilson disease mutation reveals a novel trafficking determinant in the copper transporter ATP7B. Proc Natl Acad Sci U S A. 2014;111(14):E1364-E1373. PMID: 24706876. Coffey AJ et al. A genetic study of Wilson's disease in the United Kingdom. Brain. 2013;136(Pt 5):1476-1487. PMID: 23518715. Collet C et al. High genetic carrier frequency of Wilson's disease in France: discrepancies with clinical prevalence. BMC Med Genet. 2018 Aug 10;19(1):143. PMID: 30097039. Couchonnal E et al. ATP7B variant spectrum in a French pediatric Wilson disease cohort. Eur J Med Genet. 2021 Oct;64(10):104305. PMID: 34400371. Cox DW et al. Twenty-four novel mutations in Wilson disease patients of predominantly European ancestry. Hum Mutat. 2005;26(3):280. PMID: 16088907. de Bie P et al. Distinct Wilson's disease mutations in ATP7B are associated with enhanced binding to COMMD1 and reduced stability of ATP7B. Gastroenterology. 2007;133(4):1316-1326. PMID: 17919502. Ferenci P et al. Age and Sex but Not ATP7B Genotype Effectively Influence the Clinical Phenotype of Wilson Disease. Hepatology. 2019 Apr;69(4):1464-1476. PMID: 30232804. Lorente-Arencibia P et al. Wilson Disease Prevalence: Discrepancy Between Clinical Records, Registries and Mutation Carrier Frequency. J Pediatr Gastroenterol Nutr. 2022 Feb 1;74(2):192-199. PMID: 34620762. Nayagam JS et al. ATP7B Genotype and Chronic Liver Disease Treatment Outcomes in Wilson Disease: Worse Survival With Loss-of-Function Variants. Clin Gastroenterol Hepatol. 2023 May;21(5):1323-1329.e4. PMID: 36096368. Vrabelova S et al. Mutation analysis of the ATP7B gene and genotype/phenotype correlation in 227 patients with Wilson disease. Mol Genet Metab. 2005;86(1-2):277-285. PMID: 15967699. -

Jun 13, 2024
Fulgent Genetics, Fulgent Genetics
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Jan 29, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This sequence change replaces leucine, which is neutral and non-polar, with serine, which is neutral and polar, at codon 641 of the ATP7B protein (p.Leu641Ser). This variant is present in population databases (rs186924074, gnomAD 0.08%), and has an allele count higher than expected for a pathogenic variant. This missense change has been observed in individual(s) with Wilson disease (PMID: 15967699, 16088907, 22677543, 23518715, 34400371). ClinVar contains an entry for this variant (Variation ID: 420002). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) has been performed at Invitae for this missense variant, however the output from this modeling did not meet the statistical confidence thresholds required to predict the impact of this variant on ATP7B protein function. Experimental studies have shown that this missense change does not substantially affect ATP7B function (PMID: 17919502, 24706876). In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. -

Nov 08, 2021
Myriad Genetics, Inc.
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

NM_000053.3(ATP7B):c.1922T>C(L641S) is a missense variant classified as a variant of uncertain significance in the context of Wilson disease. L641S has been observed in cases with relevant disease (PMID: 30232804, 15967699, 16088907, 22677543). Functional assessments of this variant are available in the literature (PMID: 24706876, 17919502). L641S has been observed in population frequency databases (gnomAD: NFE 0.08%). In summary, there is insufficient evidence to classify NM_000053.3(ATP7B):c.1922T>C(L641S) as pathogenic or benign. Please note: this variant was assessed in the context of healthy population screening. -

Sep 23, 2024
All of Us Research Program, National Institutes of Health
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This missense variant replaces leucine with serine at codon 641 of the ATP7B 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). Functional studies have shown that this variant does not impact protein expression, copper transport activity, and binding to COMMD1 (PMID: 17919502, 24706876). This variant has been reported in individuals affected with Wilson disease (PMID: 15967699, 16088907, 22677543, 23518715, 30232804, 34400371) as well as in unaffected individuals (PMID: 30097039, 34620762). This variant has been identified in 130/280986 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. -

Aug 10, 2021
Genome-Nilou Lab
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Jan 01, 2019
Institute of Human Genetics, University of Leipzig Medical Center
Significance: Likely benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Apr 27, 2017
Illumina Laboratory Services, Illumina
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

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. However, the evidence from the literature, in combination with allele frequency data from public databases where available, was not sufficient to rule this variant in or out of causing disease. Therefore, this variant is classified as a variant of unknown significance. -

not provided Uncertain:3
Dec 01, 2019
CeGaT Center for Human Genetics Tuebingen
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Jan 05, 2021
Mayo Clinic Laboratories, Mayo Clinic
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Dec 26, 2024
GeneDx
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Published functional studies demonstrated that p.(L641S) behaved similarly to the wild-type protein (PMID: 24706876, 17919502); 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: 15967699, 23518715, 17919502, 18371106, 34426522, Cumpata2022[Review], 34400371, 36096368, 34620762, 35132767, 30097039, 32248359, 39502306, 24253677, 22677543, 16088907, 24706876) -

not specified Uncertain:1
May 14, 2021
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Variant summary: ATP7B c.1922T>C (p.Leu641Ser) results in a non-conservative amino acid change in 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 0.0005 in 251632 control chromosomes (gnomAD). This frequency is not significantly higher than expected for a pathogenic variant in ATP7B causing Wilson Disease (0.0005 vs 0.0054), allowing no conclusion about variant significance. The variant c.1922T>C has been reported in the literature in individuals affected with Wilson Disease (example: Cox_2005, Vrabelova_2005, Bost_2012, Ferenci_2019), however, in most of these cases no full gene sequencing was performed, and/or the other pathogenic variant in trans was not specified and/or phase was not provided. These data therefore do not allow clear conclusions about the variant significance. Publications also reported experimental evidence evaluating an impact on protein function. These results showed no damaging effect of this variant on protein localization, copper transport activity, and copper-responsive trafficking (Braiterman_2014) and no effect on interaction with COMMD1 (de Bie_2007). Seven other ClinVar submitters (evaluation after 2014) cite the variant as uncertain significance (n=5) or likely benign (n=2). Based on the evidence outlined above, the variant was classified as uncertain significance. -

Inborn genetic diseases Uncertain:1
Sep 30, 2022
Ambry Genetics
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The c.1922T>C (p.L641S) alteration is located in exon 6 (coding exon 6) of the ATP7B gene. This alteration results from a T to C substitution at nucleotide position 1922, causing the leucine (L) at amino acid position 641 to be replaced by a serine (S). The altered amino acid is conserved throughout evolution:_x000D_ _x000D_ The p.L641 amino acid is conserved in available vertebrate species. The p.L641S alteration is predicted to be deleterious by in silico analysis. Based on insufficient or conflicting evidence, the clinical significance of this alteration remains unclear. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.59
BayesDel_addAF
Pathogenic
0.25
D
BayesDel_noAF
Pathogenic
0.50
CADD
Uncertain
25
DANN
Uncertain
1.0
DEOGEN2
Pathogenic
0.82
D;T;.;.;.
Eigen
Uncertain
0.63
Eigen_PC
Uncertain
0.59
FATHMM_MKL
Pathogenic
0.99
D
LIST_S2
Uncertain
0.94
D;D;D;D;D
M_CAP
Pathogenic
0.64
D
MetaRNN
Pathogenic
0.75
D;D;D;D;D
MetaSVM
Pathogenic
0.95
D
MutationAssessor
Pathogenic
3.4
M;.;.;.;.
PrimateAI
Benign
0.47
T
PROVEAN
Pathogenic
-4.8
D;D;D;.;D
REVEL
Pathogenic
0.93
Sift
Pathogenic
0.0
D;T;D;.;D
Sift4G
Uncertain
0.019
D;D;D;D;D
Polyphen
1.0
D;D;B;P;D
Vest4
0.81
MVP
0.95
MPC
0.42
ClinPred
0.23
T
GERP RS
4.3
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.7
Varity_R
0.77
gMVP
0.73

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.040
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: rs186924074; hg19: chr13-52535997; API