rs199422306

Variant summary

Our verdict is Uncertain significance. The variant received 2 ACMG points: 2P and 0B. PP3_Moderate

The NM_198253.3(TERT):​c.3329C>T​(p.Thr1110Met) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000862 in 1,611,632 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Uncertain significance (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. T1110A) has been classified as Likely benign.

Frequency

Genomes: 𝑓 0.000033 ( 0 hom., cov: 33)
Exomes 𝑓: 0.000092 ( 0 hom. )

Consequence

TERT
NM_198253.3 missense

Scores

1
6
12

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts P:1U:6O:1

Conservation

PhyloP100: 0.0350

Publications

13 publications found
Variant links:
Genes affected
TERT (HGNC:11730): (telomerase reverse transcriptase) Telomerase is a ribonucleoprotein polymerase that maintains telomere ends by addition of the telomere repeat TTAGGG. The enzyme consists of a protein component with reverse transcriptase activity, encoded by this gene, and an RNA component which serves as a template for the telomere repeat. Telomerase expression plays a role in cellular senescence, as it is normally repressed in postnatal somatic cells resulting in progressive shortening of telomeres. Deregulation of telomerase expression in somatic cells may be involved in oncogenesis. Studies in mouse suggest that telomerase also participates in chromosomal repair, since de novo synthesis of telomere repeats may occur at double-stranded breaks. Alternatively spliced variants encoding different isoforms of telomerase reverse transcriptase have been identified; the full-length sequence of some variants has not been determined. Alternative splicing at this locus is thought to be one mechanism of regulation of telomerase activity. [provided by RefSeq, Jul 2008]
TERT Gene-Disease associations (from GenCC):
  • pulmonary fibrosis and/or bone marrow failure, Telomere-related, 1
    Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: Labcorp Genetics (formerly Invitae), Ambry Genetics
  • dyskeratosis congenita, autosomal dominant 2
    Inheritance: AR, AD, SD, Unknown Classification: DEFINITIVE, STRONG, MODERATE Submitted by: Ambry Genetics, G2P, Genomics England PanelApp, Labcorp Genetics (formerly Invitae), ClinGen, Laboratory for Molecular Medicine
  • acute myeloid leukemia
    Inheritance: AD Classification: STRONG, LIMITED Submitted by: Labcorp Genetics (formerly Invitae), Genomics England PanelApp
  • dyskeratosis congenita
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • Hoyeraal-Hreidarsson syndrome
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • melanoma, cutaneous malignant, susceptibility to, 9
    Inheritance: AD Classification: LIMITED Submitted by: Labcorp Genetics (formerly Invitae), Ambry Genetics

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Uncertain_significance. The variant received 2 ACMG points.

PP3
MetaRNN computational evidence supports a deleterious effect, 0.893

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
TERTNM_198253.3 linkc.3329C>T p.Thr1110Met missense_variant Exon 16 of 16 ENST00000310581.10 NP_937983.2 O14746-1
TERTNM_001193376.3 linkc.3140C>T p.Thr1047Met missense_variant Exon 15 of 15 NP_001180305.1 O14746-3
TERTNR_149162.3 linkn.3037C>T non_coding_transcript_exon_variant Exon 13 of 13
TERTNR_149163.3 linkn.3001C>T non_coding_transcript_exon_variant Exon 13 of 13

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
TERTENST00000310581.10 linkc.3329C>T p.Thr1110Met missense_variant Exon 16 of 16 1 NM_198253.3 ENSP00000309572.5 O14746-1

Frequencies

GnomAD3 genomes
AF:
0.0000328
AC:
5
AN:
152228
Hom.:
0
Cov.:
33
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
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:
0.0000735
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.0000330
AC:
8
AN:
242766
AF XY:
0.0000454
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.0000564
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000274
Gnomad OTH exome
AF:
0.000172
GnomAD4 exome
AF:
0.0000918
AC:
134
AN:
1459404
Hom.:
0
Cov.:
31
AF XY:
0.0000896
AC XY:
65
AN XY:
725848
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
33472
American (AMR)
AF:
0.0000224
AC:
1
AN:
44606
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
25930
East Asian (EAS)
AF:
0.0000252
AC:
1
AN:
39660
South Asian (SAS)
AF:
0.000117
AC:
10
AN:
85696
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
52330
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5764
European-Non Finnish (NFE)
AF:
0.000106
AC:
118
AN:
1111638
Other (OTH)
AF:
0.0000663
AC:
4
AN:
60308
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.471
Heterozygous variant carriers
0
8
16
23
31
39
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome 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
GnomAD4 genome
AF:
0.0000328
AC:
5
AN:
152228
Hom.:
0
Cov.:
33
AF XY:
0.0000269
AC XY:
2
AN XY:
74352
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
41466
American (AMR)
AF:
0.00
AC:
0
AN:
15290
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3472
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5182
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4832
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10628
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.0000735
AC:
5
AN:
68036
Other (OTH)
AF:
0.00
AC:
0
AN:
2094
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.475
Heterozygous variant carriers
0
1
1
2
2
3
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance
Alfa
AF:
0.0000580
Hom.:
0
Bravo
AF:
0.0000340
TwinsUK
AF:
0.000270
AC:
1
ALSPAC
AF:
0.00
AC:
0
ExAC
AF:
0.0000496
AC:
6
EpiCase
AF:
0.000109
EpiControl
AF:
0.0000595

ClinVar

Significance: Uncertain significance
Submissions summary: Pathogenic:1Uncertain:6Other:1
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Uncertain:2
Sep 19, 2023
GeneDx
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Observed in individuals with shortened telomeres and personal history of idiopathic pulmonary fibrosis or thrombocytopenia in published literature (Armanios et al., 2007; Gutierrez-Rodrigues et al., 2019); In silico analysis supports that this missense variant does not alter protein structure/function; This variant is associated with the following publications: (PMID: 23716176, 21520174, 20301779, 17392301, 28373299, 17825470, 23618685, 31426295, 30523342, 34019641) -

Nov 12, 2024
ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The TERT c.3329C>T; p.Thr1110Met variant (rs199422306, ClinVar Variation ID: 39122) is reported in the literature in individuals affected with idiopathic pulmonary fibrosis or thrombocytopenia and these individuals also had shortened telomeres compared to controls (Armanios 2007, Gutierrez-Rodrigues 2019). Additionally, this variant was found in a patient with myelodysplastic syndrome however the variant was not confirmed to be germline (Reilly 2021). This variant is found in the general population with an overall allele frequency of 0.003% (9/274,156 alleles) in the Genome Aggregation Database (v2.1.1). Computational analyses are uncertain whether this variant is neutral or deleterious (REVEL: 0.509). In vitro functional analyses demonstrate decreased telomere elongation activity compared to wildtype (Armanios 2007, Reilly 2021). However, given the lilmited clinical and functional data, the significance of this variant is uncertain at this time. References: Armanios MY et al. Telomerase mutations in families with idiopathic pulmonary fibrosis. N Engl J Med. 2007 Mar 29;356(13):1317-26. PMID: 17392301. Gutierrez-Rodrigues F et al. Pathogenic TERT promoter variants in telomere diseases. Genet Med. 2019 Jul;21(7):1594-1602. PMID: 30523342. Reilly CR et al. The clinical and functional effects of TERT variants in myelodysplastic syndrome. Blood. 2021 Sep 9;138(10):898-911. PMID: 34019641. -

Pulmonary fibrosis Pathogenic:1
Jun 09, 2022
Garcia Pulmonary Genetics Research Laboratory, Columbia University Irving Medical Center
Significance:Likely risk allele
Review Status:no assertion criteria provided
Collection Method:research

Leukocyte telomere length (by qPCR) less than 10th percentile age-adjusted -

Idiopathic Pulmonary Fibrosis;C3151443:Dyskeratosis congenita, autosomal dominant 2 Uncertain:1
Dec 02, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence change replaces threonine, which is neutral and polar, with methionine, which is neutral and non-polar, at codon 1110 of the TERT protein (p.Thr1110Met). This variant is present in population databases (rs199422306, gnomAD 0.01%). This missense change has been observed in individual(s) with idiopathic pulmonary fibrosis and telomeropathies (PMID: 17392301, 30523342, 34019641). ClinVar contains an entry for this variant (Variation ID: 39122). Invitae Evidence Modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) indicates that this missense variant is not expected to disrupt TERT protein function with a negative predictive value of 95%. Experimental studies have shown that this missense change affects TERT function (PMID: 17392301). 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. -

Aplastic anemia;C0023467:Acute myeloid leukemia;C3151443:Dyskeratosis congenita, autosomal dominant 2;C3553617:Pulmonary fibrosis and/or bone marrow failure, Telomere-related, 1;C3554574:Melanoma, cutaneous malignant, susceptibility to, 9;C4551974:Dyskeratosis congenita, autosomal dominant 1;C5561926:Interstitial lung disease 2 Uncertain:1
Aug 04, 2021
Fulgent Genetics, Fulgent Genetics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Dyskeratosis congenita, autosomal dominant 2 Uncertain:1
Mar 11, 2024
Baylor Genetics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Dyskeratosis congenita Uncertain:1
Dec 14, 2024
Ambry Genetics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The p.T1110M variant (also known as c.3329C>T), located in coding exon 16 of the TERT gene, results from a C to T substitution at nucleotide position 3329. The threonine at codon 1110 is replaced by methionine, an amino acid with similar properties. This amino acid position is poorly conserved in available vertebrate species. In addition, the in silico prediction for this alteration is inconclusive. The evidence for this gene-disease relationship is limited; therefore, the clinical significance of this alteration is unclear. -

Interstitial lung disease 2 Other:1
-
GeneReviews
Significance:not provided
Review Status:no classification provided
Collection Method:literature only

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.076
BayesDel_addAF
Uncertain
0.032
T
BayesDel_noAF
Uncertain
0.010
CADD
Benign
9.8
DANN
Uncertain
0.98
DEOGEN2
Benign
0.37
T;.
Eigen
Benign
-0.59
Eigen_PC
Benign
-0.73
FATHMM_MKL
Benign
0.030
N
LIST_S2
Benign
0.75
T;T
M_CAP
Uncertain
0.25
D
MetaRNN
Pathogenic
0.89
D;D
MetaSVM
Uncertain
0.16
D
MutationAssessor
Benign
0.0
N;.
PhyloP100
0.035
PrimateAI
Benign
0.38
T
PROVEAN
Benign
-0.40
N;N
REVEL
Uncertain
0.51
Sift
Benign
0.092
T;T
Sift4G
Benign
0.076
T;D
Polyphen
0.96
D;P
Vest4
0.65
MutPred
0.71
Loss of glycosylation at T1110 (P = 0.0303);.;
MVP
0.90
MPC
1.6
ClinPred
0.044
T
GERP RS
2.0
Varity_R
0.027
gMVP
0.15
Mutation Taster
=18/82
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: rs199422306; hg19: chr5-1253913; COSMIC: COSV57224829; API