rs202003805

Variant names:

• chr7-142750561-C-T
• rs202003805
• NM_002769.5:c.47C>T

Variant summary

Our verdict is Likely pathogenic. The variant received 7 ACMG points: 8P and 1B. PP5_Very_Strong BP4

The NM_002769.5(PRSS1):​c.47C>T​(p.Ala16Val) variant causes a missense change involving the alteration of a non-conserved nucleotide. In-silico tool predicts a benign outcome for this variant. 12/21 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Likely pathogenic (★★). Synonymous variant affecting the same amino acid position (i.e. A16A) has been classified as Likely benign.

• Frequency:
  • Genomes: 𝑓 0.39 (0 hom., cov: 36)
  • Exomes 𝑓: 0.20 (0 hom.)
  • Failed GnomAD Quality Control
• Consequence: PRSS1 NM_002769.5 missense
• Clinical Significance: Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:10 U:2 O:1
• Conservation: PhyloP100: 0.485
• Publications: 102 publications found

Genes affected

PRSS1 (HGNC:9475): (serine protease 1) This gene encodes a trypsinogen, which is a member of the trypsin family of serine proteases. This enzyme is secreted by the pancreas and cleaved to its active form in the small intestine. It is active on peptide linkages involving the carboxyl group of lysine or arginine. Mutations in this gene are associated with hereditary pancreatitis. This gene and several other trypsinogen genes are localized to the T cell receptor beta locus on chromosome 7. [provided by RefSeq, Jul 2008]

PRSS1 Gene-Disease associations (from GenCC):

• hereditary chronic pancreatitis

  Inheritance: AD Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Orphanet, ClinGen, PanelApp Australia, Illumina, Labcorp Genetics (formerly Invitae), Ambry Genetics
• malignant pancreatic neoplasm

  Inheritance: AD Classification: MODERATE Submitted by: Genomics England PanelApp

TRB (HGNC:12155):

ACMG classification

Our verdict: Likely_pathogenic. The variant received 7 ACMG points.

• PP5: Variant 7-142750561-C-T is Pathogenic according to our data. Variant chr7-142750561-C-T is described in ClinVar as Pathogenic/Likely_pathogenic. ClinVar VariationId is 38363.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
• BP4: Computational evidence support a benign effect (MetaRNN=0.0054525733). . Strength limited to SUPPORTING due to the PP5.

Transcripts

RefSeq

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	MANE	Protein	UniProt
PRSS1	NM_002769.5	c.47C>T	p.Ala16Val	missense_variant	Exon 2 of 5	ENST00000311737.12	NP_002760.1

Ensembl

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	TSL	MANE	Protein	Appris	UniProt
PRSS1	ENST00000311737.12	c.47C>T	p.Ala16Val	missense_variant	Exon 2 of 5	1	NM_002769.5	ENSP00000308720.7

Frequencies

GnomAD3 genomes AF: 0.386 AC: 45782 AN: 118562 Hom.: 0 Cov.: 36

Gnomad AFR AF: 0.458

Gnomad AMI AF: 0.365

Gnomad AMR AF: 0.388

Gnomad ASJ AF: 0.381

Gnomad EAS AF: 0.150

Gnomad SAS AF: 0.213

Gnomad FIN AF: 0.388

Gnomad MID AF: 0.324

Gnomad NFE AF: 0.373

Gnomad OTH AF: 0.385

GnomAD2 exomes AF: 0.0000901 AC: 22 AN: 244118 AF XY: 0.0000679

Gnomad AFR exome AF: 0.00

Gnomad AMR exome AF: 0.0000580

Gnomad ASJ exome AF: 0.00

Gnomad EAS exome AF: 0.00

Gnomad FIN exome AF: 0.000106

Gnomad NFE exome AF: 0.000163

Gnomad OTH exome AF: 0.00

GnomAD4 exome Data not reliable, filtered out with message: InbreedingCoeff AF: 0.202 AC: 162367 AN: 803306 Hom.: 0 Cov.: 90 AF XY: 0.205 AC XY: 82190 AN XY: 401142

⚠️ The allele balance in gnomAD version 4 Exomes is significantly skewed from the expected value of 0.5.

African (AFR) AF: 0.387 AC: 7556 AN: 19522

American (AMR) AF: 0.329 AC: 8048 AN: 24442

Ashkenazi Jewish (ASJ) AF: 0.296 AC: 4306 AN: 14544

East Asian (EAS) AF: 0.103 AC: 2918 AN: 28194

South Asian (SAS) AF: 0.119 AC: 6401 AN: 53864

European-Finnish (FIN) AF: 0.368 AC: 12297 AN: 33398

Middle Eastern (MID) AF: 0.187 AC: 612 AN: 3280

European-Non Finnish (NFE) AF: 0.190 AC: 112489 AN: 590836

Other (OTH) AF: 0.220 AC: 7740 AN: 35226

⚠️ The allele balance in gnomAD4 Exomes is highly skewed from 0.5 (p-value = 0), which strongly suggests a high chance of mosaicism in these individuals.

GnomAD4 genome Data not reliable, filtered out with message: InbreedingCoeff AF: 0.386 AC: 45818 AN: 118638 Hom.: 0 Cov.: 36 AF XY: 0.381 AC XY: 22029 AN XY: 57794

⚠️ The allele balance in gnomAD version 4 Genomes is significantly skewed from the expected value of 0.5.

African (AFR) AF: 0.458 AC: 15185 AN: 33144

American (AMR) AF: 0.388 AC: 4494 AN: 11568

Ashkenazi Jewish (ASJ) AF: 0.381 AC: 998 AN: 2616

East Asian (EAS) AF: 0.150 AC: 657 AN: 4390

South Asian (SAS) AF: 0.213 AC: 810 AN: 3806

European-Finnish (FIN) AF: 0.388 AC: 3190 AN: 8218

Middle Eastern (MID) AF: 0.327 AC: 81 AN: 248

European-Non Finnish (NFE) AF: 0.373 AC: 19524 AN: 52308

Other (OTH) AF: 0.380 AC: 616 AN: 1620

⚠️ The allele balance in gnomAD version 4 Genomes is significantly skewed from the expected value of 0.5. (p-value = 0), which strongly suggests a high chance of mosaicism in these individuals.

Alfa AF: 0.115 Hom.: 0

ExAC AF: 0.0173 AC: 2099

EpiCase AF: 0.00

EpiControl AF: 0.0000593

ClinVar

Significance: Pathogenic/Likely pathogenic

Submissions summary: Pathogenic:10 Uncertain:2 Other:1

Revision: criteria provided, multiple submitters, no conflicts

Submissions by phenotype

Hereditary pancreatitis Pathogenic:8 Uncertain:1 Other:1

Sep 01, 2020

Sema4, Sema4

Significance: Likely pathogenic

Review Status: criteria provided, single submitter

Collection Method: curation

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GeneReviews

Significance: not provided

Review Status: no classification provided

Collection Method: literature only

- -

Jun 22, 2023

Neuberg Centre For Genomic Medicine, NCGM

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

The observed missense c.47C>T(p.Ala16Val) variant in PRSS1 gene has been reported previously in heterozygous state in individual(s) affected with Hereditary pancreatitis (Panchoo et al., 2022). Experimental studies have shown that this missense change affects PRSS1 function (Szabó and Sahin-Tóth, 2012). This variant is reported with the allele frequency of 0.009% in the gnomAD Exomes. The frequency data for this variant in the population databases is considered unreliable, as metrics indicate poor data quality at this position in the gnomAD database. This variant has been reported to the ClinVar database as Uncertain Significance / Likely Pathogenic / Pathogenic (multiple submissions). The amino acid Ala at position 16 is changed to a Val changing protein sequence and it might alter its composition and physico-chemical properties. The amino acid change p.Ala16Val in PRSS1 is predicted as conserved by GERP++ and PhyloP across 100 vertebrates. Computational evidence (Polyphen - Benign, SIFT - Tolerated, and MutationTaster - Polymorphism) predicts conflicting evidence on protein structure and function for this variant. For these reasons, this variant has been classified as Pathogenic. -

Jun 19, 2023

Mendelics

Significance: Likely pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

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Jan 28, 2025

Women's Health and Genetics/Laboratory Corporation of America, LabCorp

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

Variant summary: PRSS1 c.47C>T (p.Ala16Val) results in a non-conservative amino acid change in 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 8.9e-05 in 247634 control chromosomes, predominantly at a frequency of 0.00016 within the Non-Finnish European subpopulation in the gnomAD database. Per published data, this variant is the third most commonly inherited mutation in the PRSS1 gene (Moran_2016) and has been reported in numerous affected individuals in dominant or compound recessive inheritance with a reported penetrance of ~50% (Grocock_2010, Rosendahl_2012). c.47C>T has been reported in the literature in individuals affected with Chronic Pancreatitis (e.g. Grocock_2010, Howes_2004, Witt_1999) and observed to segregate with disease. In functional studies, A16V had no effect on trypsinogen secretion and autoactivation in the absence of chymotrypsin C (Kereszturi_2009). In presence of chymotrypsin C, A16V increased the rate of autoactivation compared with wild-type cationic trypsinogen by increasing N-terminal processing, (Nemoda_2006, Nemeth_2017). The following publications have been ascertained in the context of this evaluation (PMID: 17204147, 19191323, 22427236, 22539344, 22749696, 11260229, 24458023, 19951905, 16505482, 26658045, 25546417, 23143602, 28502372, 29173301, 29215622, 30850667, 30113427, 28536777, 15017610, 30018304, 34065437, 10381903). ClinVar contains an entry for this variant (Variation ID: 38363). Based on functional assays and the strong association with Pancreatitis, the variant was classified as pathogenic. -

Aug 30, 2024

Ambry Genetics

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

The p.A16V pathogenic mutation (also known as c.47C>T), located in coding exon 2 of the PRSS1 gene, results from a C to T substitution at nucleotide position 47. The alanine at codon 16 is replaced by valine, an amino acid with similar properties. In pediatric individuals, heterozygosity for this mutation was associated with chronic pancreatitis (Witt H et al. Gastroenterology, 1999 Jul;117:7-10). Subsequent studies also observed this mutation in affected individuals of all ages, but suggested a reduced penetrance given the presence of asymptomatic family members (Grocock CJ et al. Gut, 2010 Mar;59:357-63; Joergensen MT et al. Am. J. Gastroenterol., 2010 Aug;105:1876-83). In addition, two functional studies demonstrated increased trypsinogen activation in vitro due to a 4- and 5.8-fold increased rate of chymotrypsin C-mediated N-terminal processing relative to wild type, respectively (Nemoda Z et al. J. Biol. Chem., 2006 Apr;281:11879-86; Szabó A et al. J. Biol. Chem., 2012 Jun;287:20701-10). This amino acid position is poorly conserved in available vertebrate species. In addition, the in silico prediction for this alteration is inconclusive. Based on the supporting evidence, this alteration is interpreted as a disease-causing mutation. -

Nov 18, 2024

ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

The PRSS1 c.47C>T; p.Ala16Val variant (rs202003805) is one of the most common pathogenic PRSS1 variants (Rebours 2012), has been reported to co-segregate with disease in families with hereditary pancreatitis (Grocock 2010, Joergensen 2010, Rebours 2012), and is reported in the literature in individuals affected with idiopathic chronic pancreatitis (Grocock 2010, Howes 2004, Witt 1999). This variant is reported in ClinVar (Variation ID: 38363), and is found in the general population with an overall allele frequency of 0.65% (1680/256738 alleles) in the Genome Aggregation Database, but is considered a low confidence variant in the database. This variant has been described to have variable penetrance (Grocock 2010, Joergensen 2010), and in vitro assays have shown p.Ala16Val to increase cationic trypsinogen activity (Nemoda 2006, Szabo 2012). Based on functional assays and this variant's strong association with pancreatitis, the p.Ala16Val variant is considered to be pathogenic. References: Grocock CJ et al. The variable phenotype of the p.A16V mutation of cationic trypsinogen (PRSS1) in pancreatitis families. 2010 Gut. 59(3):357-63. PMID: 19951905. Howes N et al. Clinical and genetic characteristics of hereditary pancreatitis in Europe. Clin Gastroenterol Hepatol. 2004 2(3):252-61. PMID: 15017610. Joergensen MT et al. Genetic, epidemiological, and clinical aspects of hereditary pancreatitis: a population-based cohort study in Denmark. Am J Gastroenterol. 2010 105(8):1876-83. PMID: 20502448. Nemoda Z et al. Chymotrypsin C (caldecrin) stimulates autoactivation of human cationic trypsinogen. J Biol Chem. 2006 281(17):11879-86. PMID: 16505482. Rebours V et al. An overview of hereditary pancreatitis. Dig Liver Dis. 2012 44(1):8-15. PMID: 21907651. Szabo A et al. Increased activation of hereditary pancreatitis-associated human cationic trypsinogen mutants in presence of chymotrypsin C. J Biol Chem. 2012 287(24):20701-10. PMID: 22539344. Witt H et al. A signal peptide cleavage site mutation in the cationic trypsinogen gene is strongly associated with chronic pancreatitis. Gastroenterology. 1999 117(1):7-10. PMID: 10381903. -

Dec 22, 2024

Labcorp Genetics (formerly Invitae), Labcorp

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

This sequence change replaces alanine, which is neutral and non-polar, with valine, which is neutral and non-polar, at codon 16 of the PRSS1 protein (p.Ala16Val). The frequency data for this variant in the population databases is considered unreliable, as metrics indicate poor data quality at this position in the gnomAD database. This missense change has been observed in individual(s) with pancreatic cancer (PMID: 10381903, 11260229, 15017610, 19453252, 19951905, 20502448, 21907651, 22749696). It has also been observed to segregate with disease in related individuals. ClinVar contains an entry for this variant (Variation ID: 38363). An algorithm developed to predict the effect of missense changes on protein structure and function outputs the following: PolyPhen-2: "Benign". The valine amino acid residue is found in multiple mammalian species, which suggests that this missense change does not adversely affect protein function. Experimental studies have shown that this missense change affects PRSS1 function (PMID: 16505482, 22539344). For these reasons, this variant has been classified as Pathogenic. -

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Department of Pathology and Laboratory Medicine, Sinai Health System

Significance: Uncertain significance

Review Status: flagged submission

Collection Method: clinical testing

The variant PRSS1:c.47C>T (p.Ala16Val) was identified in dbSNP (ID: rs202003805) and Clinvar (classified as pathogenic). The PRSS1 p.Ala16Val variant is the third most common PRSS1 mutation and is significantly associated with pancreatitis. The variant was identified in 22 individuals across 10 different families, with 15 individuals across 6 families reporting symptoms of pancreatitis. Of these, two individuals confirmed as being PRSS1 p.Ala16Val carriers had pancreatic cancer (Grocock_2009_ PMID:19951905). In another study, the variant was detected in 4 out of 44 patients. Three of these patients had no family history of chronic pancreatitis, although the mutation was inherited in all cases by one parent. Only 1 of 7 first-degree relatives with p.Ala16Val was affected, indicating a low penetrance of this mutation (Witt_2001_PMID:12120220). The variant was identified in control databases in 22 of 244,118 chromosomes (0 homozygous) at a frequency of 0.009%, and was observed at the highest frequency in the European-Non Finnish (NFE) population in 1800 of 110,396 chromosomes (freq: 0.0163%) (Genome Aggregation Database March 6, 2019, v2.1.1. The p.Ala16Val residue is conserved in mammals and computational analyses (MUT Assesor, PolyPhen-2, SIFT, MutationTaster, Revel, FATHMM, MetaLR, DANN) provide inconsistent predictions regarding the impact to the protein; this information is not very predictive of pathogenicity. The variant occurs outside of the splicing consensus sequence and in silico or computational prediction software programs (Splice AI exome) do not predict a deleterious effect on splicing. In summary, based on the above information the clinical significance of this variant cannot be determined with certainty at this time. This variant is classified as a variant of uncertain significance. -

Nov 01, 2016

Center for Human Genetics, Inc, Center for Human Genetics, Inc

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

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not provided Pathogenic:2

Jun 05, 2024

Mayo Clinic Laboratories, Mayo Clinic

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

- -

May 16, 2022

GeneDx

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

One of the most common PRSS1 pathogenic variants observed in families with pancreatitis and suggested to have a reduced penetrance compared to other pathogenic PRSS1 variants given unaffected carriers in some families (Witt 1999, Howes 2004, Grocock 2010, Joergensen 2010, Chen 2012); Published functional studies demonstrate a damaging effect: increased rate of chymotrypsin C (CTRC)-mediated trypsinogen activation (Nemoda 2006); Case control studies suggest this variant is associated with pancreatitis (Rosendahl 2013); In silico analysis supports that this missense variant does not alter protein structure/function; This variant is associated with the following publications: (PMID: 17204147, 24002981, 15082592, 19453252, 19191323, 22539344, 23143602, 27535533, 19951905, 10381903, 26658045, 25546417, 22749696, 15017610, 11788572, 16791840, 16542853, 24458023, 21907651, 11260229, 22427236, 20502448, 32547704, 32268488, 27555793, 34065437, 33504001, 34036232, 16505482) -

Recurrent pancreatitis Uncertain:1

Jan 01, 2017

Centre for Mendelian Genomics, University Medical Centre Ljubljana

Significance: Uncertain significance

Review Status: flagged submission

Collection Method: clinical testing

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Computational scores

Source: dbNSFP v4.3

Name	Calibrated prediction	Score	Prediction
AlphaMissense	Benign	0.12
BayesDel_addAF	Uncertain	0.12	D
BayesDel_noAF	Uncertain	-0.070
CADD	Benign	2.8
DANN	Benign	0.31
DEOGEN2	Benign	0.21	.;.;T
Eigen	Benign	-1.3
Eigen_PC	Benign	-1.3
FATHMM_MKL	Benign	0.016	N
MetaRNN	Benign	0.0055	T;T;T
MetaSVM	Benign	-0.58	T
MutationAssessor	Benign	0.63	.;.;N
PhyloP100		0.48
PrimateAI	Benign	0.23	T
PROVEAN	Benign	-0.010	N;.;N
REVEL	Uncertain	0.52
Sift	Benign	0.57	T;.;T
Sift4G	Benign	0.35	T;T;T
Polyphen		0.0	.;.;B
Vest4		0.072
MPC		0.16
ClinPred		0.026	T
GERP RS		0.99
PromoterAI		-0.0012	Neutral
Varity_R		0.017
gMVP		0.57
Mutation Taster		=9/91	disease causing (ClinVar)

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

Other links and lift over

dbSNP: rs202003805; hg19: chr7-142458412; COSMIC: COSV61191325; COSMIC: COSV61191325;