rs200673370

Variant summary

Our verdict is Benign. The variant received -14 ACMG points: 0P and 14B. BP4_ModerateBP6_Very_StrongBS2

The NM_144670.6(A2ML1):​c.1775G>A​(p.Arg592Gln) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.000421 in 1,613,426 control chromosomes in the GnomAD database, including 1 homozygotes. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Likely benign (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R592L) has been classified as Likely benign.

Frequency

Genomes: 𝑓 0.00033 ( 0 hom., cov: 32)
Exomes 𝑓: 0.00043 ( 1 hom. )

Consequence

A2ML1
NM_144670.6 missense

Scores

1
5
13

Clinical Significance

Benign/Likely benign criteria provided, multiple submitters, no conflicts B:4

Conservation

PhyloP100: 2.07

Publications

13 publications found
Variant links:
Genes affected
A2ML1 (HGNC:23336): (alpha-2-macroglobulin like 1) This gene encodes a member of the alpha-macroglobulin superfamily. The encoded protein is thought to be an N-glycosylated monomeric protein that acts as an inhibitor of several proteases. It has been shown to form covalent interactions with proteases, and has been reported as the p170 antigen recognized by autoantibodies in the autoimmune disease paraneoplastic pemphigus (PNP; PMID:20805888). Mutations in these gene have also been associated with some cases of Noonan syndrome (NS; PMID:24939586) as well as some cases of otitis media (PMID:26121085). Alternative splicing results in multiple transcript variants encoding different isoforms. [provided by RefSeq, Aug 2015]
A2ML1 Gene-Disease associations (from GenCC):
  • Noonan syndrome
    Inheritance: AD Classification: SUPPORTIVE, LIMITED, NO_KNOWN Submitted by: Genomics England PanelApp, ClinGen, Orphanet

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Benign. The variant received -14 ACMG points.

BP4
Computational evidence support a benign effect (MetaRNN=0.10895711).
BP6
Variant 12-8847640-G-A is Benign according to our data. Variant chr12-8847640-G-A is described in ClinVar as Benign/Likely_benign. ClinVar VariationId is 413828.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
BS2
High AC in GnomAd4 at 50 AD gene.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
A2ML1NM_144670.6 linkc.1775G>A p.Arg592Gln missense_variant Exon 15 of 36 ENST00000299698.12 NP_653271.3 B3KVV6

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
A2ML1ENST00000299698.12 linkc.1775G>A p.Arg592Gln missense_variant Exon 15 of 36 1 NM_144670.6 ENSP00000299698.7 A8K2U0-1

Frequencies

GnomAD3 genomes
AF:
0.000329
AC:
50
AN:
152144
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.000193
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.000262
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.000193
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.0000943
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.000515
Gnomad OTH
AF:
0.000479
GnomAD2 exomes
AF:
0.000466
AC:
116
AN:
248816
AF XY:
0.000400
show subpopulations
Gnomad AFR exome
AF:
0.000129
Gnomad AMR exome
AF:
0.00160
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.0000464
Gnomad NFE exome
AF:
0.000469
Gnomad OTH exome
AF:
0.000663
GnomAD4 exome
AF:
0.000431
AC:
630
AN:
1461282
Hom.:
1
Cov.:
30
AF XY:
0.000378
AC XY:
275
AN XY:
726942
show subpopulations
African (AFR)
AF:
0.0000598
AC:
2
AN:
33454
American (AMR)
AF:
0.00150
AC:
67
AN:
44688
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26126
East Asian (EAS)
AF:
0.000101
AC:
4
AN:
39648
South Asian (SAS)
AF:
0.0000116
AC:
1
AN:
86178
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
53340
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5768
European-Non Finnish (NFE)
AF:
0.000483
AC:
537
AN:
1111710
Other (OTH)
AF:
0.000315
AC:
19
AN:
60370
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.471
Heterozygous variant carriers
0
35
70
105
140
175
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Variant carriers
0
22
44
66
88
110
<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:
0.000329
AC:
50
AN:
152144
Hom.:
0
Cov.:
32
AF XY:
0.000336
AC XY:
25
AN XY:
74322
show subpopulations
African (AFR)
AF:
0.000193
AC:
8
AN:
41438
American (AMR)
AF:
0.000262
AC:
4
AN:
15276
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3472
East Asian (EAS)
AF:
0.000193
AC:
1
AN:
5186
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4834
European-Finnish (FIN)
AF:
0.0000943
AC:
1
AN:
10602
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.000515
AC:
35
AN:
68020
Other (OTH)
AF:
0.000479
AC:
1
AN:
2088
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.508
Heterozygous variant carriers
0
3
5
8
10
13
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Genome Het
Variant carriers
0
2
4
6
8
10
<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:
0.000950
Hom.:
2
Bravo
AF:
0.000468
TwinsUK
AF:
0.00108
AC:
4
ALSPAC
AF:
0.00
AC:
0
ExAC
AF:
0.000381
AC:
46
EpiCase
AF:
0.000545
EpiControl
AF:
0.000416

ClinVar

Significance: Benign/Likely benign
Submissions summary: Benign:4
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Benign:3
Aug 11, 2020
GeneDx
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Feb 02, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

-
Breakthrough Genomics, Breakthrough Genomics
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:not provided

- -

not specified Benign:1
Oct 19, 2020
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Variant summary: A2ML1 c.1775G>A (p.Arg592Gln) results in a conservative amino acid change in the encoded protein sequence. Five of five in-silico tools predict a benign effect of the variant on protein function. The variant allele was found at a frequency of 0.00047 in 248816 control chromosomes. The observed variant frequency is approximately 116.5-fold the estimated maximal expected allele frequency for a pathogenic variant in A2ML1 causing Noonan Syndrome phenotype (4e-06), strongly suggesting that the variant is benign. To our knowledge, no occurrence of c.1775G>A in individuals affected with Noonan Syndrome and no experimental evidence demonstrating its impact on protein function have been reported. One clinical diagnostic laboratory has submitted clinical-significance assessments for this variant to ClinVar after 2014 without evidence for independent evaluation and cited the variant as likely benign. Based on the evidence outlined above, the variant was classified as likely benign. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.11
BayesDel_addAF
Benign
-0.37
T
BayesDel_noAF
Benign
-0.34
CADD
Benign
17
DANN
Pathogenic
1.0
DEOGEN2
Benign
0.020
T;T;.;T
Eigen
Uncertain
0.24
Eigen_PC
Benign
0.17
FATHMM_MKL
Uncertain
0.88
D
LIST_S2
Benign
0.81
T;T;T;D
M_CAP
Benign
0.038
D
MetaRNN
Benign
0.11
T;T;T;T
MetaSVM
Benign
-0.72
T
MutationAssessor
Uncertain
2.0
M;.;.;.
PhyloP100
2.1
PrimateAI
Uncertain
0.62
T
PROVEAN
Uncertain
-2.9
D;D;D;D
REVEL
Benign
0.28
Sift
Benign
0.12
T;D;D;T
Sift4G
Benign
0.083
T;T;T;D
Polyphen
0.95
P;.;.;.
Vest4
0.12
MutPred
0.63
Loss of methylation at R592 (P = 0.1006);.;.;.;
MVP
0.32
MPC
0.43
ClinPred
0.036
T
GERP RS
2.7
Varity_R
0.16
gMVP
0.45
Mutation Taster
=83/17
polymorphism

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: rs200673370; hg19: chr12-9000236; API