rs189270875

Variant names:

Variant summary

Our verdict is Likely benign. The variant received -5 ACMG points: 0P and 5B. BP4_StrongBS2_Supporting

The NM_002769.5(PRSS1):c.623G>C(p.Gly208Ala) variant causes a missense change. The variant allele was found at a frequency of 0.000219 in 1,614,144 control chromosomes in the GnomAD database, including 3 homozygotes. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. G208R) has been classified as Uncertain significance.

Frequency

Genomes: 𝑓 0.00035 ( 0 hom., cov: 37)

Exomes 𝑓: 0.00021 ( 3 hom. )

Consequence

PRSS1
NM_002769.5 missense

Scores

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications P:2U:3B:2

Conservation

PhyloP100: 5.59

Publications

27 publications found

Variant links:

Genes affected

PRSS1 (HGNC:9475): (serine protease 1) This gene encodes a trypsinogen, which is a member of the trypsin family of serine proteases. This enzyme is secreted by the pancreas and cleaved to its active form in the small intestine. It is active on peptide linkages involving the carboxyl group of lysine or arginine. Mutations in this gene are associated with hereditary pancreatitis. This gene and several other trypsinogen genes are localized to the T cell receptor beta locus on chromosome 7. [provided by RefSeq, Jul 2008]

PRSS1 Gene-Disease associations (from GenCC):

hereditary chronic pancreatitis
Inheritance: AD Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Orphanet, ClinGen, PanelApp Australia, Illumina, Labcorp Genetics (formerly Invitae), Ambry Genetics
malignant pancreatic neoplasm
Inheritance: AD Classification: MODERATE Submitted by: Genomics England PanelApp

PRSS1 links:

TRB (HGNC:12155):

TRB links:

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Likely_benign. The variant received -5 ACMG points.

BP4

Computational evidence support a benign effect (MetaRNN=0.020391077).

BS2

High AC in GnomAd4 at 53 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 rank	MANE	Protein	UniProt
PRSS1	NM_002769.5 link	c.623G>C	p.Gly208Ala	missense_variant	Exon 5 of 5	ENST00000311737.12	NP_002760.1

Ensembl

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	TSL	MANE	Protein
PRSS1	ENST00000311737.12 link	c.623G>C	p.Gly208Ala	missense_variant	Exon 5 of 5	1	NM_002769.5	ENSP00000308720.7
PRSS1	ENST00000486171.5 link	c.665G>C	p.Gly222Ala	missense_variant	Exon 6 of 6	5		ENSP00000417854.1
PRSS1	ENST00000463701.1 link	n.1087G>C		non_coding_transcript_exon_variant	Exon 3 of 3	2
PRSS1	ENST00000492062.2 link	c.*27G>C		3_prime_UTR_variant	Exon 5 of 5	2		ENSP00000419912.2

Frequencies

GnomAD3 genomes

AF:

0.000348

AC:

AN:

152174

Hom.:

Cov.:

show subpopulations

Gnomad AFR

AF:

0.00

Gnomad AMI

AF:

0.00

Gnomad AMR

AF:

0.0000654

Gnomad ASJ

AF:

0.00

Gnomad EAS

AF:

0.00906

Gnomad SAS

AF:

0.000622

Gnomad FIN

AF:

0.00

Gnomad MID

AF:

0.00

Gnomad NFE

AF:

0.0000147

Gnomad OTH

AF:

0.000478

GnomAD2 exomes

AF:

0.000716

AC:

180

AN:

251472

AF XY:

0.000684

show subpopulations

Gnomad AFR exome

AF:

0.00

Gnomad AMR exome

AF:

0.00

Gnomad ASJ exome

AF:

0.00

Gnomad EAS exome

AF:

0.00951

Gnomad FIN exome

AF:

0.00

Gnomad NFE exome

AF:

0.00

Gnomad OTH exome

AF:

0.000163

GnomAD4 exome

AF:

0.000206

AC:

301

AN:

1461852

Hom.:

Cov.:

AF XY:

0.000216

AC XY:

157

AN XY:

727226

show subpopulations

African (AFR)

AF:

0.00

AC:

AN:

33480

American (AMR)

AF:

0.00

AC:

AN:

44724

Ashkenazi Jewish (ASJ)

AF:

0.00

AC:

AN:

26136

East Asian (EAS)

AF:

0.00678

AC:

269

AN:

39700

South Asian (SAS)

AF:

0.0000580

AC:

AN:

86258

European-Finnish (FIN)

AF:

0.00

AC:

AN:

53420

Middle Eastern (MID)

AF:

0.000173

AC:

AN:

5768

European-Non Finnish (NFE)

AF:

0.00000450

AC:

AN:

1111972

Other (OTH)

AF:

0.000348

AC:

AN:

60394

Allele Balance Distribution

Red line indicates average allele balance

Average allele balance: 0.464

Heterozygous variant carriers

0.00

0.20

0.40

0.60

0.80

0.95

Allele balance

Age Distribution

Exome Het

Exome Hom

Variant carriers

<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:

0.000348

AC:

AN:

152292

Hom.:

Cov.:

AF XY:

0.000403

AC XY:

AN XY:

74468

show subpopulations

African (AFR)

AF:

0.00

AC:

AN:

41566

American (AMR)

AF:

0.0000653

AC:

AN:

15306

Ashkenazi Jewish (ASJ)

AF:

0.00

AC:

AN:

3470

East Asian (EAS)

AF:

0.00908

AC:

AN:

5174

South Asian (SAS)

AF:

0.000623

AC:

AN:

4816

European-Finnish (FIN)

AF:

0.00

AC:

AN:

10622

Middle Eastern (MID)

AF:

0.00

AC:

AN:

294

European-Non Finnish (NFE)

AF:

0.0000147

AC:

AN:

68018

Other (OTH)

AF:

0.000473

AC:

AN:

2114

Allele Balance Distribution

Red line indicates average allele balance

Average allele balance: 0.496

Heterozygous variant carriers

0.00

0.20

0.40

0.60

0.80

0.95

Allele balance

Age Distribution

Genome Het

Variant carriers

<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:

0.000208

Hom.:

Bravo

AF:

0.000336

ExAC

AF:

0.000692

AC:

Asia WGS

AF:

0.000866

AC:

AN:

3478

EpiCase

AF:

0.0000545

EpiControl

AF:

0.00

ClinVar

Significance: Conflicting classifications of pathogenicity

Submissions summary: Pathogenic:2Uncertain:3Benign:2

Revision: criteria provided, conflicting classifications

LINK: link

Submissions by phenotype

Hereditary pancreatitis

Pathogenic:2Uncertain:3Benign:1

Oct 30, 2023

Zotz-Klimas Genetics Lab, MVZ Zotz Klimas

Significance:Uncertain significance

Review Status:no assertion criteria provided

Collection Method:clinical testing

Feb 06, 2023

Department of Pathology and Laboratory Medicine, Sinai Health System

Significance:Uncertain significance

Review Status:criteria provided, single submitter

Collection Method:research

Jan 23, 2025

Labcorp Genetics (formerly Invitae), Labcorp

Significance:Benign

Review Status:criteria provided, single submitter

Collection Method:clinical testing

Jun 29, 2023

ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories

Significance:Uncertain significance

Review Status:criteria provided, single submitter

Collection Method:clinical testing

The PRSS1 c.623G>C; p.Gly208Ala variant (rs189270875) is reported in the literature in multiple individuals affected with pancreatitis, some of whom carry additional pathogenic variants in the CFTR or SPINK1 genes (Cho 2016, Hegyi 2014, Keiles 2006, Lee 2015, Masamune 2014, Saito 2016, Xiao 2017, Zou 2018). However, this variant has also been reported in asymptomatic individuals (Hegyi 2014, Zou 2018). This variant is reported in ClinVar (Variation ID: 258802), and is found in the East Asian population with an allele frequency of 0.99% (197/19954 alleles) in the Genome Aggregation Database. Computational analyses are uncertain whether this variant is neutral or deleterious (REVEL: 0.368). Functional analyses of the variant protein show normal autoactivation but a moderate reduction in secretion (Schnur 2014), which has been shown to cause ER stress and increase the risk of pancreatitis for other PRSS1 variants (Sahin-Toth 2017). While the increased prevalence in pancreatitis patients suggests that this variant may increase the risk for pancreatitis, due to conflicting information, the clinical significance of the p.Gly208Ala variant is uncertain at this time. References: Cho SM et al. PRSS1, SPINK1, CFTR, and CTRC Pathogenic Variants in Korean Patients With Idiopathic Pancreatitis. Ann Lab Med. 2016 Nov;36(6):555-60. PMID: 27578509. Hegyi E et al. Chronic pancreatitis associated with the p.G208A variant of PRSS1 gene in a European patient. JOP. 2014 Jan 10;15(1):49-52. PMID: 24413785. Keiles S and Kammesheidt A. Identification of CFTR, PRSS1, and SPINK1 mutations in 381 patients with pancreatitis. Pancreas. 2006 Oct;33(3):221-7. PMID: 17003641. Lee YJ et al. The PRSS1 c.623G>C (p.G208A) mutation is the most common PRSS1 mutation in Korean children with hereditary pancreatitis. Gut. 2015 Feb;64(2):359-60. PMID: 24780743. Masamune A et al. PRSS1 c.623G>C (p.G208A) variant is associated with pancreatitis in Japan. Gut. 2014 Feb;63(2):366. PMID: 23686146. Sahin-Toth M et al. Genetic risk in chronic pancreatitis: the misfolding-dependent pathway. Curr Opin Gastroenterol. 2017 Sep;33(5):390-395. PMID: 28650851. Saito N et al. Genetic Analysis of Japanese Children With Acute Recurrent and Chronic Pancreatitis. J Pediatr Gastroenterol Nutr. 2016 Oct;63(4):431-6. PMID: 27409067. Schnur A et al. Functional effects of 13 rare PRSS1 variants presumed to cause chronic pancreatitis. Gut. 2014 Feb;63(2):337-43. PMID: 23455445. Xiao Y et al. Targeted Gene Next-Generation Sequencing in Chinese Children with Chronic Pancreatitis and Acute Recurrent Pancreatitis. J Pediatr. 2017 Dec;191:158-163.e3. PMID: 29173301. Zou WB et al. SPINK1, PRSS1, CTRC, and CFTR Genotypes Influence Disease Onset and Clinical Outcomes in Chronic Pancreatitis. Clin Transl Gastroenterol. 2018 Nov 12;9(11):204. PMID: 30420730.

Jun 18, 2025

Ambry Genetics

Significance:Likely pathogenic

Review Status:criteria provided, single submitter

Collection Method:clinical testing

The p.G208A variant (also known as c.623G>C), located in coding exon 5 of the PRSS1 gene, results from a G to C substitution at nucleotide position 623. The glycine at codon 208 is replaced by alanine, an amino acid with similar properties. This alteration has been reported in multiple individuals diagnosed with pancreatitis, often with variants in other pancreatitis-associated genes (Hegyi E et al. JOP, 2014 Jan;15:49-52; Lee YJ et al. Gut, 2015 Feb;64:359-60; Cho SM et al. Ann Lab Med, 2016 Nov;36:555-60; Saito N et al. J Pediatr Gastroenterol Nutr, 2016 10;63:431-6). The variant was also significantly associated with idiopathic chronic pancreatitis in Japanese and Chinese cohorts (Masamune A et al. Gut, 2014 Feb;63:366; Zou WB et al. Clin Transl Gastroenterol, 2018 11;9:204). In one functional study, this alteration retained normal trypsin activity; however, it also resulted in reduced trypsinogen secretion (Schnúr A et al. Gut, 2014 Feb;63:337-43), which may be consistent with an alternate mechanism of disease pathogenesis. This amino acid position is well conserved in available vertebrate species. Based on the majority of available evidence to date, this variant is likely to be pathogenic; however, disease penetrance is expected to be variable.

Apr 13, 2016

Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine

Significance:Pathogenic

Review Status:criteria provided, single submitter

Collection Method:clinical testing

proposed classification - variant undergoing re-assessment, contact laboratory

not specified

Benign:1

PreventionGenetics, part of Exact Sciences

Significance:Likely benign

Review Status:criteria provided, single submitter

Collection Method:clinical testing

Computational scores

Source: dbNSFP v4.3

Name

Calibrated prediction

Score

Prediction

AlphaMissense

Uncertain

0.49

BayesDel_addAF

Uncertain

0.086

BayesDel_noAF

Benign

-0.11

CADD

Benign

(source)

DANN

Uncertain

0.99

DEOGEN2

Benign

0.0

.;.;D

Eigen

Benign

0.16

Eigen_PC

Benign

-0.080

FATHMM_MKL

Uncertain

0.95

LIST_S2

Benign

0.0

.;.;.

M_CAP

Uncertain

0.23

MetaRNN

Benign

0.020

T;T;T

MetaSVM

Uncertain

0.56

MutationAssessor

Benign

0.0

.;.;L

PhyloP100

5.6

PrimateAI

Uncertain

0.48

PROVEAN

Pathogenic

-5.5

D;.;D

REVEL

Uncertain

0.37

Sift

Pathogenic

0.0

D;.;D

Sift4G

Uncertain

0.0090

D;D;D

Vest4

0.59

ClinPred

0.22

GERP RS

2.3

Varity_R

0.28

gMVP

0.75

Mutation Taster

=19/81

disease causing (ClinVar)

(source)

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

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Variant summary

Frequency

Consequence

Scores

Clinical Significance

Conservation

Publications

ACMG classification

Transcripts

RefSeq

Ensembl

Frequencies

Age Distribution

Age Distribution

ClinVar

Submissions by phenotype

Computational scores

Splicing

Publications

Other links and lift over