rs199689137

Variant summary

Our verdict is Pathogenic. Variant got 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong

The NM_022436.3(ABCG5):​c.1336C>T​(p.Arg446*) variant causes a stop gained change. The variant allele was found at a frequency of 0.00011 in 1,613,826 control chromosomes in the GnomAD database, including 1 homozygotes. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Likely pathogenic (★★). Variant results in nonsense mediated mRNA decay.

Frequency

Genomes: 𝑓 0.00012 ( 0 hom., cov: 31)
Exomes 𝑓: 0.00011 ( 1 hom. )

Consequence

ABCG5
NM_022436.3 stop_gained

Scores

2
4
1

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:20

Conservation

PhyloP100: 5.11
Variant links:
Genes affected
ABCG5 (HGNC:13886): (ATP binding cassette subfamily G member 5) The protein encoded by this gene is a member of the superfamily of ATP-binding cassette (ABC) transporters. ABC proteins transport various molecules across extra- and intra-cellular membranes. ABC genes are divided into seven distinct subfamilies (ABC1, MDR/TAP, MRP, ALD, OABP, GCN20, White). This protein is a member of the White subfamily. The protein encoded by this gene functions as a half-transporter to limit intestinal absorption and promote biliary excretion of sterols. It is expressed in a tissue-specific manner in the liver, colon, and intestine. This gene is tandemly arrayed on chromosome 2, in a head-to-head orientation with family member ABCG8. Mutations in this gene may contribute to sterol accumulation and atheroschlerosis, and have been observed in patients with sitosterolemia. [provided by RefSeq, Jul 2008]
DYNC2LI1 (HGNC:24595): (dynein cytoplasmic 2 light intermediate chain 1) This gene encodes a protein that is a component of the dynein-2 microtubule motor protein complex that plays a role in the retrograde transport of cargo in primary cilia via the intraflagellar transport system. This gene is ubiquitously expressed and its protein, which localizes to the axoneme and Golgi apparatus, interacts directly with the cytoplasmic dynein 2 heavy chain 1 protein to form part of the multi-protein dynein-2 complex. Mutations in this gene produce defects in the dynein-2 complex which result in several types of ciliopathy including short-rib thoracic dysplasia 15 with polydactyly (SRTD15). Alternative splicing results in multiple transcript variants encoding distinct isoforms. [provided by RefSeq, Feb 2017]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 18 ACMG points.

PVS1
Loss of function variant, product undergoes nonsense mediated mRNA decay. LoF is a known mechanism of disease.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 2-43822924-G-A is Pathogenic according to our data. Variant chr2-43822924-G-A is described in ClinVar as [Likely_pathogenic]. Clinvar id is 30485.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-43822924-G-A is described in Lovd as [Pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
ABCG5NM_022436.3 linkc.1336C>T p.Arg446* stop_gained Exon 10 of 13 ENST00000405322.8 NP_071881.1 Q9H222-1

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
ABCG5ENST00000405322.8 linkc.1336C>T p.Arg446* stop_gained Exon 10 of 13 1 NM_022436.3 ENSP00000384513.2 Q9H222-1
ABCG5ENST00000486512.5 linkn.1857C>T non_coding_transcript_exon_variant Exon 6 of 9 1
ABCG5ENST00000409962.1 linkn.1619C>T non_coding_transcript_exon_variant Exon 6 of 9 2
ABCG5ENST00000644754.1 linkn.1720C>T non_coding_transcript_exon_variant Exon 7 of 10

Frequencies

GnomAD3 genomes
AF:
0.000125
AC:
19
AN:
152042
Hom.:
0
Cov.:
31
show subpopulations
Gnomad AFR
AF:
0.000121
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.0000655
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00136
Gnomad SAS
AF:
0.000208
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0000735
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.000179
AC:
45
AN:
250704
Hom.:
0
AF XY:
0.000177
AC XY:
24
AN XY:
135580
show subpopulations
Gnomad AFR exome
AF:
0.0000618
Gnomad AMR exome
AF:
0.000116
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.000870
Gnomad SAS exome
AF:
0.000360
Gnomad FIN exome
AF:
0.0000463
Gnomad NFE exome
AF:
0.0000971
Gnomad OTH exome
AF:
0.000163
GnomAD4 exome
AF:
0.000109
AC:
159
AN:
1461668
Hom.:
1
Cov.:
33
AF XY:
0.000127
AC XY:
92
AN XY:
727128
show subpopulations
Gnomad4 AFR exome
AF:
0.0000299
Gnomad4 AMR exome
AF:
0.000112
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.000454
Gnomad4 SAS exome
AF:
0.000394
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.0000728
Gnomad4 OTH exome
AF:
0.000199
GnomAD4 genome
AF:
0.000125
AC:
19
AN:
152158
Hom.:
0
Cov.:
31
AF XY:
0.0000941
AC XY:
7
AN XY:
74380
show subpopulations
Gnomad4 AFR
AF:
0.000120
Gnomad4 AMR
AF:
0.0000654
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00136
Gnomad4 SAS
AF:
0.000208
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.0000735
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.0000235
Hom.:
0
Bravo
AF:
0.000113
ESP6500AA
AF:
0.00
AC:
0
ESP6500EA
AF:
0.000116
AC:
1
ExAC
AF:
0.000148
AC:
18
Asia WGS
AF:
0.000289
AC:
1
AN:
3478
EpiCase
AF:
0.000164
EpiControl
AF:
0.000237

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:20
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Sitosterolemia 2 Pathogenic:8
Nov 15, 2010
OMIM
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: literature only

- -

Sep 20, 2023
Revvity Omics, Revvity
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Jan 16, 2022
Genetics and Genomic Medicine Centre, NeuroGen Healthcare, NeuroGen Healthcare
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Aug 28, 2020
Baylor Genetics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This variant was determined to be pathogenic according to ACMG Guidelines, 2015 [PMID:25741868]. -

May 25, 2022
New York Genome Center
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Jan 01, 2024
Daryl Scott Lab, Baylor College of Medicine
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

PVS1, PS4, PM3, PP1 -

Sep 14, 2021
Fulgent Genetics, Fulgent Genetics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Mar 26, 2024
Genomic Medicine Center of Excellence, King Faisal Specialist Hospital and Research Centre
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

not provided Pathogenic:5
-
Clinical Genetics DNA and cytogenetics Diagnostics Lab, Erasmus MC, Erasmus Medical Center
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

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

- -

Jul 28, 2022
GeneDx
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Observed with a variant on the opposite allele (in trans) in in patients with sitosterolemia in published literature (Kratz et al., 2007; Rios et al., 2010; Wang et al., 2014; Buonuomo et al., 2017; Hu et al., 2021); Nonsense variant predicted to result in protein truncation or nonsense mediated decay in a gene for which loss of function is a known mechanism of disease; This variant is associated with the following publications: (PMID: 21729603, 27884173, 26813946, 34426522, 25525159, 31589614, 32041611, 32862661, 20521169, 17228349, 19111681, 30528907, 29055934, 28521186, 25665839, 33217533, 29353225, 33269076, 17976197, 24166850, 20719861, 31060161) -

Oct 20, 2021
AiLife Diagnostics, AiLife Diagnostics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Feb 21, 2024
Mayo Clinic Laboratories, Mayo Clinic
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

PP1_strong, PM3_very_strong, PVS1 -

Sitosterolemia Pathogenic:4
Apr 27, 2017
Illumina Laboratory Services, Illumina
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The ABCG5 c.1336C>T (p.Arg446Ter) variant is a stop-gained variant that has been reported in seven studies in which it is found in a total of 11 individuals with sitosterolemia, including four in a homozygous state (of which three are related) and six in a compound heterozygous state. The variant was also detected in a compound heterozygous state in an asymptomatic sibling (Mannucci et al. 2007; Kratz et al. 2007; Nui et al. 2010; Rios et al. 2010; Park et al. 2014; Tada et al. 2015; Li et al. 2016). Control data are unavailable for the p.Arg446Ter variant, which is reported at a frequency of 0.00071 in the East Asian population of the Exome Aggregation Consortium. Due to the potential impact of stop-gained variants and the supporting evidence, the p.Arg446Ter variant is classified as pathogenic for sitosterolemia. This variant was observed by ICSL as part of a predisposition screen in an ostensibly healthy population. -

Sep 01, 2013
Pediatric Genetics Division, Center for Pediatrics and Adolescent Medicine, University Medical Center Freiburg
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: research

- -

Sep 06, 2018
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The p.Arg446X variant in ABCG5 has been reported in at least 10 individuals with sitosterolemia, all of whom were homozygous or compound heterozygous, and segre gated with disease in 7 affected family members from 4 families (Kratz 2007, Man nucci 2007, Togo 2009, Rios 2010, Niu 2010, Wang 2011, Park 2014, Wang 2014, Tad a 2015, Li 2016, Pek 2017, Buonuomo 2017, Fang 2018). This variant has also been identified in 0.09% (16/18858) of East Asian chromosomes by gnomAD (http://gnom ad.broadinstitute.org). However, this frequency is low enough to be consistent w ith a recessive carrier frequency. This nonsense variant leads to a premature te rmination codon at position 446, which is predicted to lead to a truncated or ab sent protein. Loss of function of the ABCG5 gene is an established disease mecha nism in autosomal recessive sitosterolemia; however, this condition is known to have variable expressivity and reduced penetrance. In summary, this variant meet s criteria to be classified as pathogenic for autosomal recessive sitosterolemia based on case observations, segregation studies, and predicted impact on protei n. ACMG/AMP criteria applied: PVS1, PM3_VeryStrong, PP1_Strong. -

Jan 30, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This sequence change creates a premature translational stop signal (p.Arg446*) in the ABCG5 gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in ABCG5 are known to be pathogenic (PMID: 11138003, 25665839). This variant is present in population databases (rs199689137, gnomAD 0.08%). This premature translational stop signal has been observed in individual(s) with sitosterolemia (PMID: 34304999, 34887220, 34969652). ClinVar contains an entry for this variant (Variation ID: 30485). For these reasons, this variant has been classified as Pathogenic. -

Sitosterolemia 1 Pathogenic:1
Apr 22, 2022
Molecular Genetics, Royal Melbourne Hospital
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This sequence change creates a premature termination codon at position 446 in exon 10 (of 13) of ABCG5 (p.Arg446*). It is expected to result in an absent or disrupted protein product. Loss of function is an established mechanism of disease for ABCG5 in autosomal recessive sitosterolaemia (PVS1). It is present in a large population cohort at a frequency of 0.02% (rs199689137, 48/282,080 alleles in gnomAD v2.1.1), and is most prevalent in the East Asian population with a frequency of 0.09% (17/19,940 alleles). The variant has been reported in multiple individuals diagnosed with sitosterolaemia, all of whom were homozygous or compound heterozygous with a second pathogenic variant in ABCG5 (PMID: 19111681, 20719861, 24166850, 26813946, 28521186 - PM3_VeryStrong), and segregated in affected family members in multiple families (PMID: 17976197, 24166850 - PP1_Strong). Based on the classification scheme RMH ACMG Guidelines v1.1.1, this variant is classified as PATHOGENIC. Following criteria are met: PVS1, PM3_VeryStrong, PP1_Strong. -

Cardiovascular phenotype Pathogenic:1
Aug 01, 2023
Ambry Genetics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The c.1336C>T (p.R446*) alteration, located in exon 10 (coding exon 10) of the ABCG5 gene, consists of a C to T substitution at nucleotide position 1336. This changes the amino acid from an arginine (R) to a stop codon at amino acid position 446. This alteration is expected to result in loss of function by premature protein truncation or nonsense-mediated mRNA decay. Based on data from gnomAD, the T allele has an overall frequency of 0.017% (48/282080) total alleles studied. The highest observed frequency was 0.085% (17/19940) of East Asian alleles. This variant has been reported in the homozygous and compound heterozygous states in multiple individuals and families affected with sitosterolemia (Mannucci, 2007; Niu, 2010; Wang, 2014; Bazerbachi, 2017; Buonuomo, 2017; Veit, 2019; Wang, 2019; Frederiksen, 2021; Kaya, 2021; Zhang, 2022; Xia, 2022). Based on the available evidence, this alteration is classified as pathogenic. -

Short-rib thoracic dysplasia 15 with polydactyly Pathogenic:1
Mar 26, 2024
Genomic Medicine Center of Excellence, King Faisal Specialist Hospital and Research Centre
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
BayesDel_addAF
Pathogenic
0.35
D
BayesDel_noAF
Pathogenic
0.62
CADD
Pathogenic
42
DANN
Uncertain
1.0
Eigen
Uncertain
0.52
Eigen_PC
Uncertain
0.31
FATHMM_MKL
Uncertain
0.94
D
Vest4
0.99
GERP RS
3.0
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.1

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.10
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: rs199689137; hg19: chr2-44050063; COSMIC: COSV53211059; API