rs201502401

Variant summary

Our verdict is Pathogenic. Variant got 11 ACMG points: 11P and 0B. PM2PP3PP5_Very_Strong

The NM_001378615.1(CC2D2A):​c.4667A>T​(p.Asp1556Val) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.000303 in 1,602,888 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 Likely pathogenic (★★).

Frequency

Genomes: 𝑓 0.00020 ( 0 hom., cov: 32)
Exomes 𝑓: 0.00031 ( 0 hom. )

Consequence

CC2D2A
NM_001378615.1 missense

Scores

6
11
2

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:19

Conservation

PhyloP100: 8.95
Variant links:
Genes affected
CC2D2A (HGNC:29253): (coiled-coil and C2 domain containing 2A) This gene encodes a coiled-coil and calcium binding domain protein that appears to play a critical role in cilia formation. Mutations in this gene cause Meckel syndrome type 6, as well as Joubert syndrome type 9. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Sep 2009]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 11 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
PP3
MetaRNN computational evidence supports a deleterious effect, 0.749
PP5
Variant 4-15599699-A-T is Pathogenic according to our data. Variant chr4-15599699-A-T is described in ClinVar as [Likely_pathogenic]. Clinvar id is 217607.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr4-15599699-A-T is described in Lovd as [Pathogenic]. Variant chr4-15599699-A-T is described in Lovd as [Pathogenic]. Variant chr4-15599699-A-T is described in Lovd as [Likely_pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
CC2D2ANM_001378615.1 linkc.4667A>T p.Asp1556Val missense_variant Exon 36 of 37 ENST00000424120.6 NP_001365544.1
CC2D2ANM_001080522.2 linkc.4667A>T p.Asp1556Val missense_variant Exon 37 of 38 NP_001073991.2 Q9P2K1-4
CC2D2ANM_001378617.1 linkc.4520A>T p.Asp1507Val missense_variant Exon 34 of 35 NP_001365546.1

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
CC2D2AENST00000424120.6 linkc.4667A>T p.Asp1556Val missense_variant Exon 36 of 37 5 NM_001378615.1 ENSP00000403465.1 Q9P2K1-4

Frequencies

GnomAD3 genomes
AF:
0.000204
AC:
31
AN:
152200
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.0000724
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.000262
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:
0.000338
Gnomad OTH
AF:
0.000478
GnomAD3 exomes
AF:
0.000203
AC:
50
AN:
246244
Hom.:
0
AF XY:
0.000217
AC XY:
29
AN XY:
133502
show subpopulations
Gnomad AFR exome
AF:
0.0000648
Gnomad AMR exome
AF:
0.000118
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.000393
Gnomad OTH exome
AF:
0.000168
GnomAD4 exome
AF:
0.000313
AC:
454
AN:
1450570
Hom.:
0
Cov.:
30
AF XY:
0.000354
AC XY:
255
AN XY:
719874
show subpopulations
Gnomad4 AFR exome
AF:
0.0000901
Gnomad4 AMR exome
AF:
0.000181
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.00
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.000391
Gnomad4 OTH exome
AF:
0.000184
GnomAD4 genome
AF:
0.000204
AC:
31
AN:
152318
Hom.:
0
Cov.:
32
AF XY:
0.000201
AC XY:
15
AN XY:
74478
show subpopulations
Gnomad4 AFR
AF:
0.0000722
Gnomad4 AMR
AF:
0.000261
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.000338
Gnomad4 OTH
AF:
0.000473
Alfa
AF:
0.000268
Hom.:
0
Bravo
AF:
0.000227
ESP6500AA
AF:
0.000266
AC:
1
ESP6500EA
AF:
0.000242
AC:
2
ExAC
AF:
0.000166
AC:
20

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:19
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Pathogenic:6
Nov 07, 2017
Eurofins Ntd Llc (ga)
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Mar 11, 2024
Clinical Genetics Laboratory, Skane University Hospital Lund
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Nov 01, 2019
CeGaT Center for Human Genetics Tuebingen
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Jun 17, 2021
Revvity Omics, Revvity
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Jun 06, 2024
Mayo Clinic Laboratories, Mayo Clinic
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

PM2, PM3_very_strong, PS4 -

Mar 05, 2025
GeneDx
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; This variant is associated with the following publications: (PMID: 36788019, 34758253, 33084218, 22425360, 22241855, 23012439, 19777577, 26092869, 30609409, 31618753, 33486889, 34426522, 32488064, 34448047, 26477546, 34234304, 31964843, 38439105) -

Joubert syndrome 9 Pathogenic:3
Feb 23, 2015
UW Hindbrain Malformation Research Program, University of Washington
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: research

- -

Apr 27, 2023
Neurometabolic Diseases Laboratory, Bellvitge Biomedical Research Institute (IDIBELL)
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: research

- -

May 21, 2020
Victorian Clinical Genetics Services, Murdoch Childrens Research Institute
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Based on the classification scheme VCGS_Germline_v1.1.1, this variant is classified as Pathogenic. Following criteria are met: 0102 - Loss-of-function is a known mechanism of disease for this gene. NMD-predicted variants resulting in loss of protein function have previously been reported in this gene (ClinVar). (N) 0106 - This gene is known to be associated with autosomal recessive disease. (N) 0200 - Variant is predicted to result in a missense amino acid change from an aspartate to a valine (exon 37). (N) 0251 - Variant is heterozygous. (N) 0304 - Variant is present in gnomAD <0.01 for a recessive condition (51 heterozygotes, 0 homozygotes). (P) 0501 - Missense variant consistently predicted to be damaging by multiple in silico tools or highly conserved with a major amino acid change. (P) 0604 - Variant is not located in an established domain, motif, hotspot or informative constraint region. (N) 0801 - Strong previous evidence of pathogenicity in unrelated individuals. This variant has previously been reported in multiple individuals with Joubert syndrome (ClinVar; PMID 26477546; PMID 22241855). (P) 1208 - Inheritance information for this variant is not currently available. (N) Legend: (P) - Pathogenic, (N) - Neutral, (B) - Benign -

CC2D2A-related disorder Pathogenic:2
May 07, 2018
Illumina Laboratory Services, Illumina
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The CC2D2A c.4667A>T (p.Asp1556Val) missense variant has been reported in six studies in which it is found in 20 individuals with Joubert syndrome, including in 19 in a compound heterozygous state (including two sibling pairs) and in one individual in a heterozygous state in whom a second variant was not found (Mougou-Zerelli et. al. 2009; Bachmann-Gagescu et. al. 2012; Srour et. al. 2012a; Srour et. al. 2012b; Srour et. al. 2015; Bachmann-Gagescu et. al. 2015). The variant was also found in a heterozygous state in one unaffected individual. The variant has not been reported in individuals with Meckel syndrome. The p.Asp1556Val variant was absent from 2376 control chromosomes and is reported at a frequency of 0.00027 in the European (non-Finnish) population of the Exome Aggregation Consortium. The Asp1556 residue is highly conserved. Based on the evidence, the p.Asp1556Val variant is classified as pathogenic for CC2D2A-related disorders. This variant was observed by ICSL as part of a predisposition screen in an ostensibly healthy population. -

Sep 11, 2024
PreventionGenetics, part of Exact Sciences
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

The CC2D2A c.4667A>T variant is predicted to result in the amino acid substitution p.Asp1556Val. This variant has been reported in multiple individuals with Joubert syndrome (for examples see Mougou-Zerelli et al. 2009. PubMedID: 19777577; Srour et al. 2012. PubMedID: 22425360; Bachmann-Gagescu et al. 2015. PubMedID: 26092869; Srour et al. 2015. PubMed ID: 26477546). This variant is reported in 0.035% of alleles in individuals of European (Non-Finnish) descent in gnomAD. This variant is interpreted as pathogenic. -

Meckel-Gruber syndrome;C0431399:Familial aplasia of the vermis Pathogenic:1
Jan 25, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This sequence change replaces aspartic acid, which is acidic and polar, with valine, which is neutral and non-polar, at codon 1556 of the CC2D2A protein (p.Asp1556Val). This variant is present in population databases (rs201502401, gnomAD 0.04%). This missense change has been observed in individual(s) with Joubert syndrome (PMID: 19777577, 22241855, 22425360, 23012439, 26092869, 26477546). In at least one individual the data is consistent with being in trans (on the opposite chromosome) from a pathogenic variant. ClinVar contains an entry for this variant (Variation ID: 217607). 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) has been performed for this missense variant. However, the output from this modeling did not meet the statistical confidence thresholds required to predict the impact of this variant on CC2D2A protein function. For these reasons, this variant has been classified as Pathogenic. -

Inborn genetic diseases Pathogenic:1
Nov 10, 2017
Ambry Genetics
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Joubert syndrome 9;C2676790:Meckel syndrome, type 6;C5436837:COACH syndrome 2;C5676970:Retinitis pigmentosa 93 Pathogenic:1
Dec 30, 2023
Fulgent Genetics, Fulgent Genetics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

COACH syndrome 1 Pathogenic:1
-
Genomics England Pilot Project, Genomics England
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

Neurodevelopmental disorder Pathogenic:1
Feb 08, 2022
Laboratory of Molecular Genetics (Pr. Bezieau's lab), CHU de Nantes
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Joubert syndrome and related disorders Pathogenic:1
Jun 14, 2023
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Variant summary: CC2D2A c.4667A>T (p.Asp1556Val) results in a non-conservative amino acid change in the encoded protein sequence. Four of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 0.0002 in 246244 control chromosomes. c.4667A>T has been reported in the literature in multiple individuals affected with Joubert Syndrome And Related Disorders (Examples: Bachmann-Gagescu_2015, Schueler_2016, Srour_2012, Srour_2015). These data indicate that the variant is very likely to be associated with disease. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. The following publications have been ascertained in the context of this evaluation (PMID: 26092869, 26673778, 22425360, 26477546). Multiple clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 and classified as pathogenic (n=10), likely pathogenic (n=2) and VUS (n=1), citing overlapping evidence utilized in the context of this evaluation. Based on the evidence outlined above, the variant was classified as pathogenic. -

Retinal dystrophy Pathogenic:1
Jan 01, 2023
Institute of Human Genetics, Univ. Regensburg, Univ. Regensburg
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Familial aplasia of the vermis Pathogenic:1
Apr 15, 2019
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The p.Asp1556Val variant in CC2D2A has been reported in the compound heterozygous state in at least 7 individuals with Joubert syndrome (Mougou-Zerelli 2009, Bachmann-Gagescu 2015, Srour 2015, Fleming 2017). It segregated with disease in 1 affected family member (Srour 2015). This variant was also detected in 0.035% (45/127440) of European chromosomes by gnomAD (http://gnomad.broadinstitute.org). Although this variant has been seen in the general population, its frequency is low enough to be consistent with a recessive carrier frequency. Additionally, this variant has been classified as Pathogenic in ClinVar (Variation ID 217607). In summary, the p.Asp1556Val variant meets criteria to be classified as pathogenic for Joubert syndrome in an autosomal recessive manner. ACMG/AMP Criteria applied: PM3_VeryStrong, PM2_Supporting, PP1. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Uncertain
0.45
BayesDel_addAF
Uncertain
0.13
D
BayesDel_noAF
Pathogenic
0.28
CADD
Uncertain
26
DANN
Uncertain
0.99
DEOGEN2
Benign
0.24
T;T
Eigen
Pathogenic
0.81
Eigen_PC
Pathogenic
0.81
FATHMM_MKL
Pathogenic
1.0
D
LIST_S2
Uncertain
0.93
D;.
M_CAP
Uncertain
0.12
D
MetaRNN
Pathogenic
0.75
D;D
MetaSVM
Uncertain
-0.0034
T
MutationAssessor
Uncertain
2.6
M;M
PrimateAI
Uncertain
0.49
T
PROVEAN
Uncertain
-3.4
D;D
REVEL
Pathogenic
0.73
Sift
Uncertain
0.022
D;D
Sift4G
Uncertain
0.016
D;D
Polyphen
1.0
D;D
Vest4
0.89
MVP
0.93
MPC
0.11
ClinPred
0.14
T
GERP RS
5.8
Varity_R
0.47
gMVP
0.76

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.020
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: rs201502401; hg19: chr4-15601322; API