rs192232907
Variant summary
Our verdict is Likely benign. Variant got -5 ACMG points: 0P and 5B. BP4_StrongBP6
The NM_000071.3(CBS):c.215A>T(p.Lys72Ile) variant causes a missense change involving the alteration of a non-conserved nucleotide. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).
Frequency
Consequence
NM_000071.3 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Likely_benign. Variant got -5 ACMG points.
Transcripts
RefSeq
Ensembl
Frequencies
GnomAD3 genomes AF: 0.00 AC: 2AN: 40890Hom.: 0 Cov.: 5 FAILED QC
GnomAD3 exomes AF: 0.000626 AC: 157AN: 250818Hom.: 0 AF XY: 0.000553 AC XY: 75AN XY: 135700
GnomAD4 exome Data not reliable, filtered out with message: AS_VQSR AF: 0.000270 AC: 100AN: 371044Hom.: 0 Cov.: 0 AF XY: 0.000211 AC XY: 43AN XY: 204022
GnomAD4 genome Data not reliable, filtered out with message: AS_VQSR AF: 0.0000489 AC: 2AN: 40898Hom.: 0 Cov.: 5 AF XY: 0.0000520 AC XY: 1AN XY: 19226
ClinVar
Submissions by phenotype
not provided Uncertain:2
The K72I variant of uncertain significance in the CBS gene has been reported previously in one Chinese individual with severe homocystinuria who harbored a second variant in the CBS gene (Li et al., 2018). This variant has also been identified both independently of and in conjunction with additional cardiogenetic variants in several individuals referred for TAAD / Marfan syndrome genetic testing at GeneDx. However, thus far, segregation data is limited or absent for these individuals due to the lack of clinical information provided and/or insufficient participation by informative family members. The K72I variant is observed 139/18,848 (0.74%) alleles from individuals of East Asian ancestry in large population cohorts (Lek et al., 2016). The K72I variant is a non-conservative amino acid substitution, which is likely to impact secondary protein structure as these residues differ in polarity, charge, size and/or other properties. In-silico analyses, including protein predictors and evolutionary conservation, support a deleterious effect. -
The CBS c.215A>T; p.Lys72Ile variant (rs192232907) is reported in the literature in an individual affected with coronary artery dissection and another individual affected with homocystinuria (Kaadan 2018, Li 2018). The individual affected with homocystinuria also carried a second missense variant, although the clinical significance of the second variant was not demonstrated (Li 2018). The p.Lys72Ile variant is found in the East Asian population with an overall allele frequency of 0.76% (151/19924 alleles) in the Genome Aggregation Database. The lysine at codon 72 is moderately conserved and computational analyses (SIFT, PolyPhen-2) predict that this variant is tolerated. However, due to limited information, the clinical significance of the p.Lys72Ile variant is uncertain at this time. References: Kaadan et al. Prospective Cardiovascular Genetics Evaluation in Spontaneous Coronary Artery Dissection. Circ Genom Precis Med. 2018 Apr;11(4):e001933. Li et al. Eight novel mutations of CBS gene in nine Chinese patients with classical homocystinuria. World J Pediatr. 2018 Apr;14(2):197-203. -
Classic homocystinuria Uncertain:1Benign:1
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. -
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Connective tissue disorder Uncertain:1
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not specified Benign:1
Variant summary: CBS c.215A>T (p.Lys72Ile) results in a non-conservative amino acid change in the encoded protein sequence. Three of five in-silico tools predict a benign effect of the variant on protein function. The variant allele was found at a frequency of 0.00062 in 281244 control chromosomes (gnomAD), predominantly at a frequency of 0.0076 within the East Asian subpopulation in the gnomAD database. The observed variant frequency within East Asian control individuals in the gnomAD database is approximately 2.5 fold of the estimated maximal expected allele frequency for a pathogenic variant in CBS causing Homocystinuria (0.003), strongly suggesting that the variant is a benign polymorphism found primarily in populations of East Asian origin. To our knowledge, no experimental evidence demonstrating its impact on protein function have been reported. Seven ClinVar submitters have assessed the variant since 2014: four classified the variant as uncertain significance, two as likely benign, and one as benign. Based on the evidence outlined above, the variant was classified as likely benign. -
Familial thoracic aortic aneurysm and aortic dissection Benign:1
This alteration is classified as benign based on a combination of the following: seen in unaffected individuals, population frequency, intact protein function, lack of segregation with disease, co-occurrence, RNA analysis, in silico models, amino acid conservation, lack of disease association in case-control studies, and/or the mechanism of disease or impacted region is inconsistent with a known cause of pathogenicity. -
HYPERHOMOCYSTEINEMIA, THROMBOTIC, CBS-RELATED Benign:1
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CBS-related disorder Benign:1
This variant is classified as likely benign based on ACMG/AMP sequence variant interpretation guidelines (Richards et al. 2015 PMID: 25741868, with internal and published modifications). -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at