rs201562505

Variant summary

Our verdict is Benign. The variant received -13 ACMG points: 0P and 13B. BP4_StrongBP6BS1BS2

The NM_001267550.2(TTN):​c.80701A>G​(p.Ile26901Val) variant causes a missense change. The variant allele was found at a frequency of 0.000927 in 1,613,444 control chromosomes in the GnomAD database, including 12 homozygotes. In-silico tool predicts a benign outcome for this variant. 15/20 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).

Frequency

Genomes: š‘“ 0.00099 ( 2 hom., cov: 33)
Exomes š‘“: 0.00092 ( 10 hom. )

Consequence

TTN
NM_001267550.2 missense

Scores

2
15

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications U:5B:18O:1

Conservation

PhyloP100: 4.92

Publications

8 publications found
Variant links:
Genes affected
TTN (HGNC:12403): (titin) This gene encodes a large abundant protein of striated muscle. The product of this gene is divided into two regions, a N-terminal I-band and a C-terminal A-band. The I-band, which is the elastic part of the molecule, contains two regions of tandem immunoglobulin domains on either side of a PEVK region that is rich in proline, glutamate, valine and lysine. The A-band, which is thought to act as a protein-ruler, contains a mixture of immunoglobulin and fibronectin repeats, and possesses kinase activity. An N-terminal Z-disc region and a C-terminal M-line region bind to the Z-line and M-line of the sarcomere, respectively, so that a single titin molecule spans half the length of a sarcomere. Titin also contains binding sites for muscle associated proteins so it serves as an adhesion template for the assembly of contractile machinery in muscle cells. It has also been identified as a structural protein for chromosomes. Alternative splicing of this gene results in multiple transcript variants. Considerable variability exists in the I-band, the M-line and the Z-disc regions of titin. Variability in the I-band region contributes to the differences in elasticity of different titin isoforms and, therefore, to the differences in elasticity of different muscle types. Mutations in this gene are associated with familial hypertrophic cardiomyopathy 9, and autoantibodies to titin are produced in patients with the autoimmune disease scleroderma. [provided by RefSeq, Feb 2012]
TTN-AS1 (HGNC:44124): (TTN antisense RNA 1) This gene encodes a non-coding RNA transcribed from the opposite strand to the titin gene. [provided by RefSeq, Aug 2016]

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Benign. The variant received -13 ACMG points.

BP4
Computational evidence support a benign effect (MetaRNN=0.0044291914).
BP6
Variant 2-178565431-T-C is Benign according to our data. Variant chr2-178565431-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 165813. Variant chr2-178565431-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 165813. Variant chr2-178565431-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 165813. Variant chr2-178565431-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 165813. Variant chr2-178565431-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 165813. Variant chr2-178565431-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 165813. Variant chr2-178565431-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 165813. Variant chr2-178565431-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 165813. Variant chr2-178565431-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 165813. Variant chr2-178565431-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 165813. Variant chr2-178565431-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 165813. Variant chr2-178565431-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 165813. Variant chr2-178565431-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 165813. Variant chr2-178565431-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 165813. Variant chr2-178565431-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 165813. Variant chr2-178565431-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 165813. Variant chr2-178565431-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 165813. Variant chr2-178565431-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 165813. Variant chr2-178565431-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 165813. Variant chr2-178565431-T-C is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 165813.
BS1
Variant frequency is greater than expected in population mid. GnomAdExome4 allele frequency = 0.00092 (1344/1461246) while in subpopulation MID AF = 0.00538 (31/5758). AF 95% confidence interval is 0.0039. There are 10 homozygotes in GnomAdExome4. There are 694 alleles in the male GnomAdExome4 subpopulation. Median coverage is 37. This position passed quality control check.
BS2
High Homozygotes in GnomAd4 at 2 AD,AR gene

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
TTNNM_001267550.2 linkc.80701A>G p.Ile26901Val missense_variant Exon 326 of 363 ENST00000589042.5 NP_001254479.2 A0A0A0MTS7

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
TTNENST00000589042.5 linkc.80701A>G p.Ile26901Val missense_variant Exon 326 of 363 5 NM_001267550.2 ENSP00000467141.1 A0A0A0MTS7

Frequencies

GnomAD3 genomes
AF:
0.000993
AC:
151
AN:
152080
Hom.:
2
Cov.:
33
show subpopulations
Gnomad AFR
AF:
0.0000241
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00190
Gnomad ASJ
AF:
0.0268
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.000207
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00316
Gnomad NFE
AF:
0.000294
Gnomad OTH
AF:
0.00287
GnomAD2 exomes
AF:
0.00162
AC:
403
AN:
248414
AF XY:
0.00165
show subpopulations
Gnomad AFR exome
AF:
0.0000647
Gnomad AMR exome
AF:
0.000378
Gnomad ASJ exome
AF:
0.0315
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.000498
Gnomad OTH exome
AF:
0.00233
GnomAD4 exome
AF:
0.000920
AC:
1344
AN:
1461246
Hom.:
10
Cov.:
37
AF XY:
0.000955
AC XY:
694
AN XY:
726928
show subpopulations
African (AFR)
AF:
0.000209
AC:
7
AN:
33436
American (AMR)
AF:
0.000447
AC:
20
AN:
44694
Ashkenazi Jewish (ASJ)
AF:
0.0338
AC:
883
AN:
26118
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39652
South Asian (SAS)
AF:
0.0000928
AC:
8
AN:
86224
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
53382
Middle Eastern (MID)
AF:
0.00538
AC:
31
AN:
5758
European-Non Finnish (NFE)
AF:
0.000210
AC:
234
AN:
1111646
Other (OTH)
AF:
0.00267
AC:
161
AN:
60336
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.484
Heterozygous variant carriers
0
86
172
259
345
431
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Exome Hom
Variant carriers
0
24
48
72
96
120
<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:
0.000992
AC:
151
AN:
152198
Hom.:
2
Cov.:
33
AF XY:
0.000981
AC XY:
73
AN XY:
74418
show subpopulations
African (AFR)
AF:
0.0000241
AC:
1
AN:
41550
American (AMR)
AF:
0.00190
AC:
29
AN:
15270
Ashkenazi Jewish (ASJ)
AF:
0.0268
AC:
93
AN:
3470
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5154
South Asian (SAS)
AF:
0.000207
AC:
1
AN:
4826
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10620
Middle Eastern (MID)
AF:
0.00340
AC:
1
AN:
294
European-Non Finnish (NFE)
AF:
0.000294
AC:
20
AN:
67992
Other (OTH)
AF:
0.00284
AC:
6
AN:
2110
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.513
Heterozygous variant carriers
0
8
17
25
34
42
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Genome Het
Genome Hom
Variant carriers
0
4
8
12
16
20
<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:
0.00162
Hom.:
5
Bravo
AF:
0.00114
TwinsUK
AF:
0.00162
AC:
6
ALSPAC
AF:
0.000778
AC:
3
ESP6500AA
AF:
0.00
AC:
0
ESP6500EA
AF:
0.00135
AC:
11
ExAC
AF:
0.00136
AC:
164
EpiCase
AF:
0.000928
EpiControl
AF:
0.00142

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Uncertain:5Benign:18Other:1
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

not specified Uncertain:2Benign:7
Jun 22, 2017
Eurofins Ntd Llc (ga)
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Jul 24, 2017
GeneDx
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant is considered likely benign or benign based on one or more of the following criteria: it is a conservative change, it occurs at a poorly conserved position in the protein, it is predicted to be benign by multiple in silico algorithms, and/or has population frequency not consistent with disease. -

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

- -

May 10, 2019
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The p.Ile24333Val variant in TTN is classified as likely benign because it has been identified in 3.1% (326/10344) of Ashkenazi Jewish chromosomes (including 1 homozygote) and 0.04% (59/127920) of European chromosomes by gnomAD (http://gnomad.broadinstitute.org). Additionally, isoleucine (Ile) at position 24333 is not conserved in evolution and multiple birds and reptiles carry a valine (Val) at this position. Computational prediction tools predict that this variant does not impact the protein. ACMG/AMP Criteria applied: BS1, BP4. -

Nov 17, 2020
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Variant summary: TTN c.72997A>G (p.Ile24333Val) results in a conservative amino acid change located in the A-band region (cardiodb.org) of the encoded protein sequence. Four of five in-silico tools predict a benign effect of the variant on protein function. The variant allele was found at a frequency of 0.0016 in 248414 control chromosomes in the gnomAD database, including 1 homozygote. The observed variant frequency is approximately 4.2- fold the estimated maximal expected allele frequency for a pathogenic variant in TTN causing Dilated Cardiomyopathy phenotype (0.00039), strongly suggesting that the variant is benign. c.72997A>G has been reported in the literature in individuals affected with Cardiomyopathy (e.g. Pugh_2014, Campuzano_2015, Restrepo-Cordoba_2017). These reports do not provide unequivocal conclusions about association of the variant with Dilated Cardiomyopathy. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. Ten other ClinVar submitters (evaluation after 2014) have cited the variant as benign/likely benign (n=8) and uncertain significance (n=2). Based on the evidence outlined above, the variant was classified as benign. -

Dec 01, 2020
Athena Diagnostics
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Apr 09, 2025
Molecular Diagnostic Laboratory for Inherited Cardiovascular Disease, Montreal Heart Institute
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Jul 10, 2015
Genomic Diagnostic Laboratory, Division of Genomic Diagnostics, Children's Hospital of Philadelphia
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Oct 31, 2014
Genetic Services Laboratory, University of Chicago
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

not provided Benign:4
-
Clinical Genetics DNA and cytogenetics Diagnostics Lab, Erasmus MC, Erasmus Medical Center
Significance:Likely benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

-
Joint Genome Diagnostic Labs from Nijmegen and Maastricht, Radboudumc and MUMC+
Significance:Likely benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

-
Diagnostic Laboratory, Department of Genetics, University Medical Center Groningen
Significance:Likely benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Jun 01, 2025
CeGaT Center for Human Genetics Tuebingen
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

TTN: BP4, BS1, BS2 -

TTN-related disorder Benign:1Other:1
-
GenomeConnect, ClinGen
Significance:not provided
Review Status:no classification provided
Collection Method:phenotyping only

Variant interpretted as Uncertain significance and reported on 07-09-2015 by Lab or GTR ID 500060. GenomeConnect assertions are reported exactly as they appear on the patient-provided report from the testing laboratory. GenomeConnect staff make no attempt to reinterpret the clinical significance of the variant. -

Mar 14, 2019
PreventionGenetics, part of Exact Sciences
Significance:Benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

This variant is classified as benign based on ACMG/AMP sequence variant interpretation guidelines (Richards et al. 2015 PMID: 25741868, with internal and published modifications). -

Autosomal recessive limb-girdle muscular dystrophy type 2J Uncertain:1
Jan 13, 2018
Illumina Laboratory Services, Illumina
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score, this variant could not be ruled out of causing disease and therefore its association with disease required further investigation. A literature search was performed for the gene, cDNA change, and amino acid change (if applicable). No publications were found based on this search. This variant was therefore classified as a variant of unknown significance for this disease. -

Dilated cardiomyopathy 1G Uncertain:1
Jan 13, 2018
Illumina Laboratory Services, Illumina
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score, this variant could not be ruled out of causing disease and therefore its association with disease required further investigation. A literature search was performed for the gene, cDNA change, and amino acid change (if applicable). No publications were found based on this search. This variant was therefore classified as a variant of unknown significance for this disease. -

Early-onset myopathy with fatal cardiomyopathy Uncertain:1
Jan 13, 2018
Illumina Laboratory Services, Illumina
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score, this variant could not be ruled out of causing disease and therefore its association with disease required further investigation. A literature search was performed for the gene, cDNA change, and amino acid change (if applicable). No publications were found based on this search. This variant was therefore classified as a variant of unknown significance for this disease. -

Autosomal recessive limb-girdle muscular dystrophy type 2J;C1858763:Dilated cardiomyopathy 1G Benign:1
Feb 02, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Cardiomyopathy Benign:1
Jul 22, 2019
CHEO Genetics Diagnostic Laboratory, Children's Hospital of Eastern Ontario
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Myopathy, myofibrillar, 9, with early respiratory failure Benign:1
Jan 13, 2018
Illumina Laboratory Services, Illumina
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as benign is not then subjected to further curation. The score for this variant resulted in a classification of benign for this disease. -

Tibial muscular dystrophy Benign:1
Jan 13, 2018
Illumina Laboratory Services, Illumina
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as benign is not then subjected to further curation. The score for this variant resulted in a classification of benign for this disease. -

Primary dilated cardiomyopathy Benign:1
Apr 06, 2018
Center for Advanced Laboratory Medicine, UC San Diego Health, University of California San Diego
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Cardiovascular phenotype Benign:1
Dec 08, 2017
Ambry Genetics
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This alteration is classified as benign based on a combination of the following: seen in unaffected individuals, population frequency, intact protein function, lack of segregation with disease, co-occurrence, RNA analysis, in silico models, amino acid conservation, lack of disease association in case-control studies, and/or the mechanism of disease or impacted region is inconsistent with a known cause of pathogenicity. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.10
BayesDel_addAF
Benign
-0.47
T
BayesDel_noAF
Benign
-0.48
CADD
Benign
18
DANN
Benign
0.89
Eigen
Benign
-0.11
Eigen_PC
Benign
0.12
FATHMM_MKL
Uncertain
0.93
D
LIST_S2
Uncertain
0.87
D;D;D;.;D;D;D
M_CAP
Benign
0.014
T
MetaRNN
Benign
0.0044
T;T;T;T;T;T;T
MetaSVM
Benign
-1.1
T
MutationAssessor
Benign
-0.15
.;.;.;N;.;.;N
PhyloP100
4.9
PrimateAI
Benign
0.45
T
PROVEAN
Benign
-0.61
N;N;.;.;N;N;.
REVEL
Benign
0.11
Sift
Benign
0.24
T;T;.;.;T;T;.
Polyphen
0.020
.;.;.;B;.;.;B
Vest4
0.076
MVP
0.28
MPC
0.078
ClinPred
0.016
T
GERP RS
5.5
Mutation Taster
=81/19
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: rs201562505; hg19: chr2-179430158; COSMIC: COSV60190873; API