rs201583907
Variant summary
Our verdict is Likely pathogenic. Variant got 9 ACMG points: 9P and 0B. PM1PM2PP2PP3_Strong
The NM_170707.4(LMNA):c.1567G>A(p.Gly523Arg) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0000809 in 1,606,820 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. 13/22 in silico tools predict a damaging outcome for this variant. Variant has been reported in ClinVar as Uncertain significance (★★). Another nucleotide change resulting in the same amino acid substitution has been previously reported as Uncertain significance in ClinVar.
Frequency
Consequence
NM_170707.4 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Likely_pathogenic. Variant got 9 ACMG points.
Transcripts
RefSeq
Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt |
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LMNA | NM_170707.4 | c.1567G>A | p.Gly523Arg | missense_variant | Exon 9 of 12 | ENST00000368300.9 | NP_733821.1 | |
LMNA | NM_005572.4 | c.1567G>A | p.Gly523Arg | missense_variant | Exon 9 of 10 | ENST00000677389.1 | NP_005563.1 |
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
---|---|---|---|---|---|---|---|---|---|---|
LMNA | ENST00000368300.9 | c.1567G>A | p.Gly523Arg | missense_variant | Exon 9 of 12 | 1 | NM_170707.4 | ENSP00000357283.4 | ||
LMNA | ENST00000677389.1 | c.1567G>A | p.Gly523Arg | missense_variant | Exon 9 of 10 | NM_005572.4 | ENSP00000503633.1 |
Frequencies
GnomAD3 genomes AF: 0.0000657 AC: 10AN: 152178Hom.: 0 Cov.: 32
GnomAD3 exomes AF: 0.0000856 AC: 20AN: 233624Hom.: 0 AF XY: 0.0000946 AC XY: 12AN XY: 126878
GnomAD4 exome AF: 0.0000825 AC: 120AN: 1454642Hom.: 0 Cov.: 32 AF XY: 0.0000788 AC XY: 57AN XY: 723212
GnomAD4 genome AF: 0.0000657 AC: 10AN: 152178Hom.: 0 Cov.: 32 AF XY: 0.0000538 AC XY: 4AN XY: 74340
ClinVar
Submissions by phenotype
not provided Uncertain:10Other:1
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The p.Gly523Arg variant in LMNA has been reported in 5 individual with dilated cardiomyopathy (DCM; Millat 2009 PMID: 19318026, Fichna 2018 PMID: 29970176, LMM data), 1 individual with limb-girdle muscular dystrophy (Magri 2015 PMID: 26404900), 1 individual with LVNC, conduction system disease and muscle weakness (LMM data), and in 2 siblings presenting with features of COL6A2 related myopathy as well as Emery-Dreifuss muscular dystrophy (Chapon 2008, conference abstract only). In the family described by Chapon et al, the myopathy present in both sibs was believed to be due recessively inherited COL6A2 variants. The LMNA variant was present in one of the sibs as well as the father, who was clinically normal but showed dystrophic changes as well as mild deficit of collagen 6 fibers. This variant has also been reported by other clinical laboratories in ClinVar (Variation ID: 48045 ) and has been identified in 0.01% (8/68028) of European chromosomes by gnomAD (http://gnomad.broadinstitute.org, v.3.1). Computational prediction tools and conservation analyses suggest that this variant may impact the protein, though this information is not predictive enough to determine pathogenicity. In summary, the clinical significance of this variant is uncertain. ACMG/AMP Criteria applied: PP3. -
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Observed to segregate with DCM, conduction disease, and/or subtle right ventricular abnormalities in individuals from one family, but was also observed in unaffected individuals in this family (PMID: 30919684); Published functional studies demonstrate altered ability of LMNA protein to interact with 5% of its protein targets; however, it is unclear how these studies may translate to a pathogenic role in vivo (PMID: 24623722); 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: 24375749, 24503780, 24846508, 21846512, 26404900, 25163546, 28663758, 28679633, 27576561, 26633542, 29970176, 31744510, 32193531, 31383942, 32041611, 34495297, 34862408, 38979608, 24623722, 37425136, 37624850, 19318026, 35026164, 31476771, 36397776, 34720847, 32826072, 29961767, 30919684, 10939567, 37652022) -
Cardiomyopathy Uncertain:2
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This missense variant replaces glycine with arginine at codon 523 of the LMNA protein. Computational prediction suggests that this variant may have a deleterious impact on protein structure and function (internally defined REVEL score threshold >= 0.7, PMID: 27666373). An experimental study using a yeast two hybrid system has shown that this variant may lead to ~5% lost protein interactions (PMID: 24623722), but functional and clinical significance of this observation is not known. This variant has been reported in individuals affected with dilated cardiomyopathy (PMID: 19318026, 21846512, 24503780, 29961767, 30919684, 31383942), in an individual affected with hypertrophic cardiomyopathy (PMID: 35026164), and in individuals affected with limb girdle muscular dystrophy (PMID: 26404900, 34720847). This variant has been reported in four members of one family (PMID: 30919684); one carrier was affected with subtle right ventricular abnormalities, and the carrier's parent was affected with dilated cardiomyopathy and conduction disease. This variant has also been reported in individuals affected with laminopathy (PMID: 28663758, 31744510, 32193531, 32826072), in individuals affected with chronic kidney disease (PMID: 31383942), and in multiple apparently healthy individuals in a large biobank (PMID: 31383942). This variant has been identified in 22/264998 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -
Left ventricular noncompaction Pathogenic:1
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not specified Uncertain:1
Variant summary: LMNA c.1567G>A (p.Gly523Arg) results in a non-conservative amino acid change located in the Lamin tail domain (IPR001322) of the encoded protein sequence. Five of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 8.6e-05 in 233624 control chromosomes. This frequency is not significantly higher than estimated for a pathogenic variant in LMNA causing Cardiomyopathy (8.6e-05 vs 0.00025), allowing no conclusion about variant significance. c.1567G>A has been reported in the literature in individuals with dilated cardiomyopathy, limb-girdle muscular dystrophy, dyslipidemia, and EmeryDreifuss muscular dystrophy, without strong evidence of causality (example: Hylind_2019, Millat_2009, Millat_2011, Pugh_2014, Haas_2015, Park_2020, Pena-Pena_2021, Magri_2015, Fichna_2018, Dron_2020, McGurk_2023, Cannie_2023, Boen_2024, Garcia-Pavia_2024). These data do not allow any conclusion about variant significance. At least one publication reports experimental evidence evaluating an impact on protein function, however, does not allow convincing conclusions about the variant effect (Dittmer_2014). Two studies have shown the variant is unlikely to contribute to disease (Gregory_2023, and Anderson_2021). The following publications have been ascertained in the context of this evaluation (PMID: 38689299, 37639473, 24623722, 32041611, 29970176, 38979608, 37624850, 25163546, 30919684, 26404900, 37652022, 19318026, 21846512, 31383942, 32826072, 24503780,34862408). ClinVar contains an entry for this variant (Variation ID: 48045). Based on the evidence outlined above, the variant was classified as uncertain significance. -
Charcot-Marie-Tooth disease type 2 Uncertain:1
This sequence change replaces glycine, which is neutral and non-polar, with arginine, which is basic and polar, at codon 523 of the LMNA protein (p.Gly523Arg). This variant is present in population databases (rs201583907, gnomAD 0.01%). This missense change has been observed in individual(s) with limb girdle muscular dystrophy, dilated cardiomyopathy, dyslipidemias, or atrial fibrillation (PMID: 19318026, 24503780, 26404900, 29970176, 32041611, 34495297). ClinVar contains an entry for this variant (Variation ID: 48045). 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) indicates that this missense variant is expected to disrupt LMNA protein function with a positive predictive value of 95%. Experimental studies are conflicting or provide insufficient evidence to determine the effect of this variant on LMNA function (PMID: 24623722). 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. -
Lethal tight skin contracture syndrome Uncertain:1
This variant was determined to be of uncertain significance according to ACMG Guidelines, 2015 [PMID:25741868]. -
Primary dilated cardiomyopathy Uncertain:1
This missense variant replaces glycine with arginine at codon 523 of the LMNA protein. Computational prediction suggests that this variant may have a deleterious impact on protein structure and function (internally defined REVEL score threshold >= 0.7, PMID: 27666373). An experimental study using a yeast two hybrid system has shown that this variant may lead to ~5% lost protein interactions (PMID: 24623722), but functional and clinical significance of this observation is not known. This variant has been reported in individuals affected with dilated cardiomyopathy (PMID: 19318026, 21846512, 24503780, 29961767, 30919684, 31383942), in an individual affected with hypertrophic cardiomyopathy (PMID: 35026164), and in individuals affected with limb girdle muscular dystrophy (PMID: 26404900, 34720847). This variant has been reported in four members of one family (PMID: 30919684); one carrier was affected with subtle right ventricular abnormalities, and the carrier's parent was affected with dilated cardiomyopathy and conduction disease. This variant has also been reported in individuals affected with laminopathy (PMID: 28663758, 31744510, 32193531, 32826072), in individuals affected with chronic kidney disease (PMID: 31383942), and in multiple apparently healthy individuals in a large biobank (PMID: 31383942). This variant has been identified in 22/264998 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -
Dilated cardiomyopathy 1A Uncertain:1
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Hutchinson-Gilford syndrome;C0410190:Emery-Dreifuss muscular dystrophy 2, autosomal dominant;C0796031:Dilated cardiomyopathy-hypergonadotropic hypogonadism syndrome;C1449563:Dilated cardiomyopathy 1A;C1720860:Familial partial lipodystrophy, Dunnigan type;C1854154:Charcot-Marie-Tooth disease type 2B1;C1857829:Heart-hand syndrome, Slovenian type;C2750035:Emery-Dreifuss muscular dystrophy 3, autosomal recessive;C2750785:Congenital muscular dystrophy due to LMNA mutation;C5399785:Mandibuloacral dysplasia with type A lipodystrophy;C5676942:Restrictive dermopathy 2 Uncertain:1
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Cardiovascular phenotype Uncertain:1
The p.G523R variant (also known as c.1567G>A), located in coding exon 9 of the LMNA gene, results from a G to A substitution at nucleotide position 1567. The glycine at codon 523 is replaced by arginine, an amino acid with dissimilar properties. This alteration has been detected in individuals with dilated cardiomyopathy (DCM) (Pugh TJ et al. Genet. Med., 2014 Aug;16:601-8; Millat G et al. Clin. Biochem., 2009 Jun;42:892-8; Millat G et al. Eur J Med Genet Aug;54:e570-5; Hylind RJ et al. Circ Genom Precis Med. 2019 Mar;12(3):e002463). This variant has also been detected in individuals with limb girdle muscular dystrophy (LGMD); however, in some cases, other variants in myopathy-related genes were also detected (Magri F et al. BMC Neurol, 2015 Sep;15:172; Fichna JP et al. Hum. Genomics, 2018 07;12:34). This variant has also been detected in two individual from familial partial lipodystrophy cohort; however details were limited (Vasandani C et al. J Endocr Soc. 2022 Oct;6(12):bvac155). This variant was also reported in 35 individuals from an electronic medical record review exome cohort, including one DCM case and two individuals with chronic kidney disease (Park J et al. Genet Med, 2020 01;22:102-111). This amino acid position is highly conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear. -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at