rs199989617

Variant summary

Our verdict is Pathogenic. Variant got 11 ACMG points: 11P and 0B. PM1PM2PM5PP3_StrongPP5

The NM_001048174.2(MUTYH):​c.606G>C​(p.Gln202His) variant causes a missense, splice region change. The variant was absent in control chromosomes in GnomAD project. 3/3 splice prediction tools predicting alterations to normal splicing. 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. Q202R) has been classified as Likely pathogenic.

Frequency

Genomes: not found (cov: 33)

Consequence

MUTYH
NM_001048174.2 missense, splice_region

Scores

2
12
5
Splicing: ADA: 1.000
2

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications P:1U:1

Conservation

PhyloP100: 5.83
Variant links:
Genes affected
MUTYH (HGNC:7527): (mutY DNA glycosylase) This gene encodes a DNA glycosylase involved in oxidative DNA damage repair. The enzyme excises adenine bases from the DNA backbone at sites where adenine is inappropriately paired with guanine, cytosine, or 8-oxo-7,8-dihydroguanine, a major oxidatively damaged DNA lesion. The protein is localized to the nucleus and mitochondria. This gene product is thought to play a role in signaling apoptosis by the introduction of single-strand breaks following oxidative damage. Mutations in this gene result in heritable predisposition to colorectal cancer, termed MUTYH-associated polyposis (MAP). Multiple transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Apr 2017]

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ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 11 ACMG points.

PM1
In a hotspot region, there are 4 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 0 benign, 15 uncertain in NM_001048174.2
PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chr1-45332575-T-C is described in ClinVar as [Conflicting_classifications_of_pathogenicity]. Clinvar id is 964790.We mark this variant Likely_pathogenic, oryginal submissions are: {Likely_pathogenic=1, Uncertain_significance=2}.
PP3
Splicing scoreres supports a deletorius effect: Scorers claiming Pathogenic: dbscSNV1_ADA, dbscSNV1_RF, max_spliceai. No scorers claiming Uncertain. No scorers claiming Benign.
PP5
Variant 1-45332574-C-G is Pathogenic according to our data. Variant chr1-45332574-C-G is described in ClinVar as [Conflicting_classifications_of_pathogenicity]. Clinvar id is 826699.We mark this variant Likely_pathogenic, oryginal submissions are: {Likely_pathogenic=1, Uncertain_significance=1}.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
MUTYHNM_001048174.2 linkc.606G>C p.Gln202His missense_variant, splice_region_variant Exon 8 of 16 ENST00000456914.7 NP_001041639.1 Q9UIF7-6

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
MUTYHENST00000456914.7 linkc.606G>C p.Gln202His missense_variant, splice_region_variant Exon 8 of 16 1 NM_001048174.2 ENSP00000407590.2 Q9UIF7-6
ENSG00000288208ENST00000671898.1 linkn.1194G>C splice_region_variant, non_coding_transcript_exon_variant Exon 12 of 21 ENSP00000499896.1 A0A5F9ZGZ0

Frequencies

GnomAD3 genomes
Cov.:
33
GnomAD4 exome
Cov.:
36
GnomAD4 genome
Cov.:
33

ClinVar

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

Submissions by phenotype

Hereditary cancer-predisposing syndrome Pathogenic:1
Sep 20, 2019
Ambry Genetics
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The p.Q230H variant (also known as c.690G>C), located in coding exon 8 of the MUTYH gene, results from a G to C substitution at nucleotide position 690. The amino acid change results in glutamine to histidine at codon 230, an amino acid with highly similar properties. However, this change occurs in the last base pair of coding exon 8, which makes it likely to have some effect on normal mRNA splicing. Though this exact alteration has not been reported in the literature, a similar alteration, c.690G>A, has been reported in a compound heterozygous state with another MUTYH mutation in individuals with polyposis and/or colorectal cancer (Vogt S et al. Gastroenterology 2009 Dec; 137(6):1976-85.e1-10; Dallosso AR et al. Gut 2008 Sep; 57(9):1252-5). RNA studies on c.690G>A have also demonstrated that this alteration causes exon 8 skipping (Dallosso et al.). This nucleotide position is highly conserved in available vertebrate species. Using two different splice site prediction tools, this alteration is predicted by BDGP to abolish the native splice donor site, but is predicted to weaken (but not abolish) the efficiency of the native splice donor site by ESEfinder; however, direct evidence is unavailable. In addition, the in silico prediction for this alteration is inconclusive. Based on the majority of available evidence to date, this variant is likely to be pathogenic. -

Familial adenomatous polyposis 2 Uncertain:1
Mar 31, 2023
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

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. This sequence change replaces glutamine, which is neutral and polar, with histidine, which is basic and polar, at codon 230 of the MUTYH protein (p.Gln230His). This variant also falls at the last nucleotide of exon 8, which is part of the consensus splice site for this exon. This variant is not present in population databases (gnomAD no frequency). This variant has not been reported in the literature in individuals affected with MUTYH-related conditions. ClinVar contains an entry for this variant (Variation ID: 826699). An algorithm developed to predict the effect of missense changes on protein structure and function (PolyPhen-2) suggests that this variant  is likely to be tolerated. Variants that disrupt the consensus splice site are a relatively common cause of aberrant splicing (PMID: 17576681, 9536098). Algorithms developed to predict the effect of sequence changes on RNA splicing suggest that this variant may disrupt the consensus splice site. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Uncertain
0.44
BayesDel_addAF
Pathogenic
0.22
D
BayesDel_noAF
Uncertain
0.070
CADD
Pathogenic
29
DANN
Uncertain
0.99
DEOGEN2
Benign
0.27
.;.;.;.;.;T;.;.;.;T;.;T
Eigen
Benign
0.12
Eigen_PC
Uncertain
0.29
FATHMM_MKL
Pathogenic
0.99
D
LIST_S2
Uncertain
0.97
.;D;.;D;D;D;D;D;D;D;D;D
M_CAP
Uncertain
0.098
D
MetaRNN
Uncertain
0.63
D;D;D;D;D;D;D;D;D;D;D;D
MetaSVM
Uncertain
-0.12
T
MutationAssessor
Benign
1.5
.;.;.;.;.;L;.;.;.;.;.;.
PrimateAI
Uncertain
0.55
T
PROVEAN
Uncertain
-3.3
D;D;D;D;D;D;D;D;D;D;D;D
REVEL
Uncertain
0.55
Sift
Uncertain
0.0040
D;D;D;D;D;D;D;D;D;T;D;D
Sift4G
Benign
0.065
T;T;T;T;T;T;T;T;T;T;T;D
Polyphen
0.032, 0.026
.;.;.;.;.;B;B;.;B;.;.;.
Vest4
0.54
MutPred
0.53
.;.;.;.;.;.;.;.;Gain of sheet (P = 0.0827);.;.;.;
MVP
0.92
MPC
0.15
ClinPred
0.92
D
GERP RS
5.4
Varity_R
0.64
gMVP
0.78

Splicing

Name
Calibrated prediction
Score
Prediction
dbscSNV1_ADA
Pathogenic
1.0
dbscSNV1_RF
Pathogenic
0.97
SpliceAI score (max)
0.94
Details are displayed if max score is > 0.2
DS_DL_spliceai
0.94
Position offset: 0

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: rs199989617; hg19: chr1-45798246; API