rs202179988

Variant summary

Our verdict is Pathogenic. Variant got 12 ACMG points: 12P and 0B. PM1PM2PM5PP3_ModeratePP5_Strong

The NM_000492.4(CFTR):​c.3208C>T​(p.Arg1070Trp) variant causes a missense change. The variant allele was found at a frequency of 0.00008 in 1,613,480 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 drug response (★★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R1070Q) has been classified as Pathogenic.

Frequency

Genomes: 𝑓 0.000033 ( 0 hom., cov: 31)
Exomes 𝑓: 0.000085 ( 0 hom. )

Consequence

CFTR
NM_000492.4 missense

Scores

13
4
2

Clinical Significance

drug response reviewed by expert panel P:18O:1

Conservation

PhyloP100: 3.94
Variant links:
Genes affected
CFTR (HGNC:1884): (CF transmembrane conductance regulator) This gene encodes a member of the ATP-binding cassette (ABC) transporter superfamily. The encoded protein functions as a chloride channel, making it unique among members of this protein family, and controls ion and water secretion and absorption in epithelial tissues. Channel activation is mediated by cycles of regulatory domain phosphorylation, ATP-binding by the nucleotide-binding domains, and ATP hydrolysis. Mutations in this gene cause cystic fibrosis, the most common lethal genetic disorder in populations of Northern European descent. The most frequently occurring mutation in cystic fibrosis, DeltaF508, results in impaired folding and trafficking of the encoded protein. Multiple pseudogenes have been identified in the human genome. [provided by RefSeq, Aug 2017]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 12 ACMG points.

PM1
In a topological_domain Cytoplasmic (size 60) in uniprot entity CFTR_HUMAN there are 21 pathogenic changes around while only 1 benign (95%) in NM_000492.4
PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chr7-117611650-G-A is described in Lovd as [Pathogenic].
PP3
MetaRNN computational evidence supports a deleterious effect, 0.86
PP5
Variant 7-117611649-C-T is Pathogenic according to our data. Variant chr7-117611649-C-T is described in ClinVar as [drug_response]. Clinvar id is 53685.Status of the report is reviewed_by_expert_panel, 3 stars. We mark this variant Likely_pathogenic, oryginal submissions are: {Likely_pathogenic=1, drug_response=1, Pathogenic=14}. Variant chr7-117611649-C-T is described in Lovd as [Pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
CFTRNM_000492.4 linkuse as main transcriptc.3208C>T p.Arg1070Trp missense_variant 20/27 ENST00000003084.11 NP_000483.3

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
CFTRENST00000003084.11 linkuse as main transcriptc.3208C>T p.Arg1070Trp missense_variant 20/271 NM_000492.4 ENSP00000003084 P2P13569-1
ENST00000456270.1 linkuse as main transcriptn.177+4580G>A intron_variant, non_coding_transcript_variant 3

Frequencies

GnomAD3 genomes
AF:
0.0000329
AC:
5
AN:
152052
Hom.:
0
Cov.:
31
show subpopulations
Gnomad AFR
AF:
0.0000483
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
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:
0.0000441
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000478
AC:
12
AN:
250962
Hom.:
0
AF XY:
0.0000295
AC XY:
4
AN XY:
135638
show subpopulations
Gnomad AFR exome
AF:
0.0000615
Gnomad AMR exome
AF:
0.0000871
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.0000327
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000617
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000849
AC:
124
AN:
1461310
Hom.:
0
Cov.:
31
AF XY:
0.0000729
AC XY:
53
AN XY:
726964
show subpopulations
Gnomad4 AFR exome
AF:
0.0000299
Gnomad4 AMR exome
AF:
0.0000896
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.0000252
Gnomad4 SAS exome
AF:
0.0000232
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.000103
Gnomad4 OTH exome
AF:
0.0000331
GnomAD4 genome
AF:
0.0000329
AC:
5
AN:
152170
Hom.:
0
Cov.:
31
AF XY:
0.0000269
AC XY:
2
AN XY:
74388
show subpopulations
Gnomad4 AFR
AF:
0.0000482
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.0000441
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.0000796
Hom.:
0
Bravo
AF:
0.0000604
ESP6500AA
AF:
0.00
AC:
0
ESP6500EA
AF:
0.000116
AC:
1
ExAC
AF:
0.0000412
AC:
5
Asia WGS
AF:
0.000289
AC:
1
AN:
3478
EpiCase
AF:
0.00
EpiControl
AF:
0.0000593

ClinVar

Significance: drug response
Submissions summary: Pathogenic:18Other:1
Revision: reviewed by expert panel
LINK: link

Submissions by phenotype

Cystic fibrosis Pathogenic:7
Pathogenic, criteria provided, single submitterclinical testingWomen's Health and Genetics/Laboratory Corporation of America, LabCorpJun 20, 2022Variant summary: CFTR c.3208C>T (p.Arg1070Trp) results in a non-conservative amino acid change located in the ABC transporter type 1, transmembrane domain 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 4.8e-05 in 250962 control chromosomes. This frequency is not significantly higher than expected for a pathogenic variant in CFTR causing CFTR-Related Diseases (4.8e-05 vs 0.013), allowing no conclusion about variant significance. c.3208C>T has been reported in the literature in compound heterozygosity with another pathogenic variant in multiple individuals affected with CFTR-Related Diseases, primarily CBAVD (e.g. Jezequel_1995, Steiner_2011) and Non-Classic Cystic Fibrosis (e.g. McGinnis_2005, Sosnay_2013). These data indicate that the variant is likely to be associated with disease. A worldwide survey of patients with the p.Arg1070Trp variant identified 24 patients with complete clinical data (21 of which had the common pathogenic variant p.Phe508del or another severe CFTR mutation), and included 15 patients with CBAVD, 9 with non-classic CF, and 1 with classic CF phenotypes (Krasnov_2008). A second large survey that collected data from CF registries and clinics in the US and Europe reported the variant in a total of 13 CF alleles, but indicated that only 20% of the individuals were pancreatic-insufficient, with a mean lung function of 93.7%. 16.7% of these patients had tested positive for Pseudomonas (Sosnay_2013). Collectively, the clinical data on patients with this variant suggests that c.3208C>T is most likely a relatively mild mutation that is most often associated with either pancreatic-sufficient non-classic CF or CBAVD when present in trans with a more severe CFTR mutation. Several functional studies evaluating an impact on protein function have reported conflicting conclusions regarding the effects of this variant. One study reported that chloride channel function in cells expressing the variant was comparable to wild-type (e.g. Mickle_2000), however, it has also been reported that chloride conductance in cells expressing the variant was <10% that of wild-type (e.g. Van Goor_2013, Sosnay_2013). CFTR maturation and the amount of protein expression was 91% and 67.8% of the wild-type as measured in HeLa cells and FRT cells, respectively (Sosnay_2013), and the variant was reported to retain localization to the apical membrane, albeit less efficiently than the wild-type protein (e.g. Krasnov_2008). Eleven submitters have submitted clinical-significance assessments for this variant to ClinVar after 2014 and classified teh variant VUS (n=1), likely pathogenic (n=1) and pathogenic (n=9). Based on the evidence outlined above, the variant was classified as pathogenic. -
Pathogenic, criteria provided, single submitterclinical testingAmbry GeneticsOct 22, 2021The p.R1070W pathogenic mutation (also known as c.3208C>T), located in coding exon 20 of the CFTR gene, results from a C to T substitution at nucleotide position 3208. The arginine at codon 1070 is replaced by tryptophan, an amino acid with dissimilar properties. In one study, this mutation was identified in conjunction with a second CFTR alteration in 24 individuals with pancreatic sufficient cystic fibrosis or congenital bilateral absence of the vas deferens (CBAVD) (Krasnov KV et al. Hum. Mutat., 2008 Nov;29:1364-72). In vitro functional studies showed that cells with this mutation have significantly decreased chloride conductance compared to wild type (Sosnay PR et al. Nat. Genet., 2013 Oct;45:1160-7; Van Goor F et al. J. Cyst. Fibros., 2014 Jan;13:29-36) and CFTR protein with this mutation was able to process into mature protein but with decreased efficiency compared to wild-type (Krasnov KV et al. Hum. Mutat., 2008 Nov;29:1364-72). The p.R1070W alteration has been reported as a variant of varying clinical consequences (VVCC) (Sosnay PR et al. Nat. Genet. 2013 Oct; 45(10):1160-7; Sosnay PR et al. Pediatr. Clin. North Am. 2016 Aug;63(4):585-98). Based on the supporting evidence, this alteration is interpreted as a disease-causing mutation. -
Pathogenic, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpJan 21, 2024This sequence change replaces arginine, which is basic and polar, with tryptophan, which is neutral and slightly polar, at codon 1070 of the CFTR protein (p.Arg1070Trp). This variant is present in population databases (rs202179988, gnomAD 0.01%). This missense change has been observed in individual(s) with cystic fibrosis and congenital absence of the vas deferens (PMID: 7539342, 10923036, 12167682, 15070876). 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: 53685). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is expected to disrupt CFTR protein function with a positive predictive value of 80%. Experimental studies have shown that this missense change affects CFTR function (PMID: 18951463, 23891399). For these reasons, this variant has been classified as Pathogenic. -
Likely pathogenic, no assertion criteria providedclinical testingCounsylDec 26, 2018- -
Pathogenic, criteria provided, single submitterclinical testingIllumina Laboratory Services, IlluminaNov 02, 2018The CFTR c.3208C>T (p.Arg1070Trp) missense variant is well described in the literature as a mild or intermediate variant and is reported to have varying clinical consequences including pancreatic sufficient cystic fibrosis (CF) and congenital bilateral absence of the vas deferens (CBAVD). The p.Arg1070Trp variant has been identified in a compound heterozygous state in at least four studies in six individuals with CBAVD (Jezequel et al. 1995; Mickle et al. 2000; Jezequel et al. 2000; Steiner et al. 2011). The variant has also been reported as part of a complex allele in a compound heterozygous state with a pathogenic splice site variant in a proband with CF (de Prada Merino et al. 2010). Functional studies by Van Goor et al. (2014) demonstrated the p.Arg1070Trp variant resulted in 8% of wild type levels of chloride ion transport. The p.Arg1070Trp variant is reported in the CFTR2 mutation database in a total of 13 alleles (Sosnay et al. 2013), and is described as a "mutation of varying clinical consequence." Incomplete penetrance is documented in association with the p.Arg1070Trp variant; not all individuals who carry this variant along with a second disease-causing CFTR variant in trans will display symptoms of a CFTR-related disorder (CFTR2 2016). Control data are unavailable for this variant, which is reported at a frequency of 0.000125 in the African population of the Genome Aggregation Database. Based on the collective evidence, the p.Arg1070Trp variant is classified as pathogenic for CFTR-related disorders. This variant was observed by ICSL as part of a predisposition screen in an ostensibly healthy population. -
Pathogenic, criteria provided, single submitterclinical testingMendelicsNov 05, 2018- -
Pathogenic, criteria provided, single submitterclinical testingGenome Diagnostics Laboratory, The Hospital for Sick ChildrenDec 22, 2020- -
not provided Pathogenic:3
Pathogenic, criteria provided, single submitterclinical testingARUP Laboratories, Molecular Genetics and Genomics, ARUP LaboratoriesAug 15, 2023The CFTR c.3208C>T; p.Arg1070Trp variant (rs202179988) is reported in the literature in dozens of individuals affected with cystic fibrosis (CF) or other CFTR-related disorders (Jezequel 1995, Krasnov 2008, Sosnay 2013, CFTR2 database). Most patients carrying p.Arg1070Trp and a second CF-causing variant exhibit non-classic CF or milder symptoms such as congenital absence of the vas deferens or pancreatitis, although a minority of patients are reported with pancreatic-insufficient CF (Krasnov 2008, CFTR2 database). Functional studies suggest p.Arg1070 affects CFTR function and reduces chloride transport activity (Van Goor 2014). This variant is reported as likely pathogenic or pathogenic in ClinVar (Variation ID: 53685), and it is found in the general population with an overall frequency of 0.005% (14/282342 alleles) in the Genome Aggregation Database. Additionally, other amino acid substitutions at this codon (p.Arg1070Gln, p.Arg1070Pro) have been reported in individuals with CF or CFTR-related disorders and are considered disease-causing (Krasnov 2008, Sosnay 2013, CFTR2 database). Based on available information, the p.Arg1070Trp variant is considered to be pathogenic with varying clinical consequences. References: CFTR2 database: http://cftr2.org/ Jezequel P et al. Structural analysis of CFTR gene in congenital bilateral absence of vas deferens. Clin Chem. 1995 Jun;41(6 Pt 1):833-5. Krasnov KV et al. Localization studies of rare missense mutations in cystic fibrosis transmembrane conductance regulator (CFTR) facilitate interpretation of genotype-phenotype relationships. Hum Mutat. 2008 Nov;29(11):1364-72. Sosnay PR et al. Defining the disease liability of variants in the cystic fibrosis transmembrane conductance regulator gene. Nat Genet. 2013 Oct;45(10):1160-7. Van Goor F et al. Effect of ivacaftor on CFTR forms with missense mutations associated with defects in protein processing or function. J Cyst Fibros. 2014 Jan;13(1):29-36. -
Likely pathogenic, criteria provided, single submitterclinical testingGeneDxDec 05, 2022Published functional studies demonstrate a damaging effect: reduced cell surface expression and chloride transport with defective channel gating (Seibert et al., 1996; Sosnay et al., 2013; VanGoor et al., 2014); Observed with a pathogenic variant in patients with cystic fibrosis or CFTR-related disorders (Jezequel et al., 2000; McGinniss et al., 2005; Krasnov et al., 2008; Lebecque et al., 2011; Baldwin et al., 2019); 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: 8530001, 31036917, 27171515, 30873022, 25087612, 21520337, 23891399, 20460946, 21228398, 27469177, 8662892, 18951463, 10762539, 23974870, 7539342, 26708955, 20837875, 17331079, 11101688, 26014425, 16189704, 12955726, 12815607, 20880762, 35327663, 31268981, 34996830, 33374015, 35451201) -
Pathogenic, criteria provided, single submitterclinical testingQuest Diagnostics Nichols Institute San Juan CapistranoDec 14, 2021In the published literature, the variant has been reported in several individuals affected with CBAVD or non-classic CF (PMID: 18951463 (2008), 20880762 (2010), 21520337 (2011), 26708955 (2016)). In addition, in vitro functional studies show this variant has a deleterious effect on CFTR protein processing, localization, and function (PMID: 18951463 (2008), 23974870 (2013), 23891399 (2014)). However, it was observed to have high chloride channel function in an earlier study (PMID: 10762539 (2000)). Based on the available information, this variant is classified as pathogenic. -
Cystic fibrosis;C0403814:Congenital bilateral aplasia of vas deferens from CFTR mutation Pathogenic:2
Pathogenic, criteria provided, single submitterclinical testingBaylor Genetics-- -
Pathogenic, criteria provided, single submitterclinical testingLaboratory for Molecular Medicine, Mass General Brigham Personalized MedicineMay 11, 2015The p.Arg1070Trp variant in CFTR has been reported in >20 compound heterozygous individuals (the majority carrying p.Phe508del) primarily affected by milder for ms of CFTR-related disorders (congenital bilateral absence of the vas deferens a nd cystic fibrosis) and more than half of these individuals were reported to hav e normal to low sweat chloride levels (Jezequel 1995, Feldmann 2003, Krasnov 200 8, Pelletier 2010, de Prada Merino 2010, Steiner 2011, Sosnay 2013). In addition , this variant has been identified in 4/66100 of European chromosomes and 1/1034 0 African chromosomes by the Exome Aggregation Consortium (ExAC, http://exac.bro adinstitute.org; dbSNP rs202179988). Although this variant has been seen in the general population, its frequency is low enough to be consistent with a recessiv e carrier frequency. In vitro functional studies provide some evidence that the p.Arg1070Trp variant may impact protein function (Krasnov 2008, Sosnay 2013, Van Goor 2014). However, these types of assays may not accurately represent biologi cal function. In summary, this variant meets our criteria to be classified as pa thogenic for CTFR-related disorders including CBAVD and cystic fibrosis in an au tosomal recessive manner (http://www.partners.org/personalizedmedicine/LMM) base d upon multiple co-occurrences with pathogenic variants and its low frequency in the general population. -
CFTR-related disorder Pathogenic:2
Likely pathogenic, no assertion criteria providedclinical testingPreventionGenetics, part of Exact SciencesJun 06, 2024The CFTR c.3208C>T variant is predicted to result in the amino acid substitution p.Arg1070Trp. This variant has been reported in cohorts of individuals with suspected cystic fibrosis (see, for example, Krasnov et al. 2008. PubMed ID: 18951463; Pelletier et al. 2010. PubMed ID: 20460946; Ferec et al. 1995. PubMed ID: 8530001) as well as in the compound heterozygous state in patients with congenital bilateral absence of vas deferens (Jezequel et al. 1995. PubMed ID: 7539342; Steiner et al. 2011. PubMed ID: 21520337). In vitro studies suggest that this variant results in a defect of normal CFTR processing (Van Goor et al. 2013. PubMed ID: 23891399; Sosnay et al. 2013. PubMed ID: 23974870), with at least one study suggesting that the p.Arg1070Trp variant may be a more mildly deleterious allele (Krasnov et al. 2008. PubMed ID: 18951463). This variant is reported in 0.0085% of alleles in individuals of Latino descent in gnomAD. This variant is interpreted as likely pathogenic. -
Pathogenic, no assertion criteria providedclinical testingGenome Diagnostics Laboratory, The Hospital for Sick ChildrenDec 22, 2020- -
Congenital bilateral absence of vas deferens Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingMolecular Genetics, Royal Melbourne HospitalMar 30, 2023This sequence change is predicted to replace arginine with tryptophan at codon 1070 of the CFTR protein, p.(Arg1070Trp). The arginine residue is evolutionarily conserved (100 vertebrates, UCSC), and is located in the fourth cytoplasmic loop of the cystic fibrosis transmembrane (CL4). There is a large physicochemical difference between arginine and tryptophan. The variant is present in a large population cohort at a frequency of 0.005%, which is consistent with recessive disease (rs202179988, 14/282,342 alleles, 0 homozygotes in gnomAD v2.1). It is classified as a CFTR variant of varying clinical consequences, and has been identified with a second pathogenic allele (mainly p.Phe508del) in non-classic pancreatic cystic fibrosis (CF), congenital bilateral absence of the vas deferens, and recurrent pancreatitis (for example PMID: 18951463, 31268981). The variant has also been identified as part of a complex allele that causes classic CF, when found in trans with a second pathogenic variant (PMID: 20880762). In vitro functional assays demonstrate that the variant causes mild defects on chloride transport and is inserted into the apical membrane at reduced levels (PMID: 8662892, 18951463, 23891399). Multiple lines of computational evidence predict a deleterious effect for the missense substitution (5/6 algorithms). Additionally, there is a different missense change (p.Arg1070Gln) at the same position determined to be pathogenic (ClinVar). Based on the classification scheme RMH Modified ACMG Guidelines v1.3.2, this variant is classified as PATHOGENIC. Following criteria are met: PM3_VeryStrong, PM5, PS3_Supporting, PM2_Supporting, PP3. -
not specified Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingAl Jalila Children’s Genomics Center, Al Jalila Childrens Speciality HospitalFeb 08, 2020- -
Cystic fibrosis;na:CFTR-related disorder Pathogenic:1
Pathogenic, criteria provided, single submittercurationCFTR-FranceJan 29, 2018when the variant is in trans with another CF-causing variation, can either result in CF or in a CFTR-RD -
Bronchiectasis with or without elevated sweat chloride 1 Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingBaylor GeneticsMar 28, 2024- -
ivacaftor response - Efficacy Other:1
drug response, reviewed by expert panelcurationPharmGKBMar 24, 2021PharmGKB Level of Evidence 1A: Level 1A clinical annotations describe variant-drug combinations that have variant-specific prescribing guidance available in a current clinical guideline annotation or an FDA-approved drug label annotation. Annotations of drug labels or clinical guidelines must give prescribing guidance for specific variants (e.g. CYP2C9*3, HLA-B*57:01) or provide mapping from defined allele functions to diplotypes and phenotypes to be used as supporting evidence for a level 1A clinical annotation. Level 1A clinical annotations must also be supported by at least one publication in addition to a clinical guideline or drug label with variant-specific prescribing guidance. Drug-variant association: Efficacy

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.72
BayesDel_addAF
Pathogenic
0.23
D
BayesDel_noAF
Pathogenic
0.33
CADD
Pathogenic
30
DANN
Pathogenic
1.0
DEOGEN2
Pathogenic
0.82
D;.;.;D;.
Eigen
Uncertain
0.67
Eigen_PC
Pathogenic
0.68
FATHMM_MKL
Pathogenic
0.99
D
LIST_S2
Pathogenic
0.99
D;D;D;D;D
M_CAP
Pathogenic
0.70
D
MetaRNN
Pathogenic
0.86
D;D;D;D;D
MetaSVM
Uncertain
0.58
D
MutationAssessor
Benign
1.6
L;.;.;.;.
MutationTaster
Benign
1.0
D;D
PrimateAI
Pathogenic
0.85
D
PROVEAN
Uncertain
-3.4
D;.;.;D;.
REVEL
Pathogenic
0.80
Sift
Uncertain
0.0040
D;.;.;D;.
Sift4G
Pathogenic
0.0
D;.;.;D;.
Polyphen
1.0
D;.;.;.;.
Vest4
0.98
MVP
0.99
MPC
0.017
ClinPred
0.55
D
GERP RS
5.7
Varity_R
0.65
gMVP
0.98

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.010
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: rs202179988; hg19: chr7-117251703; API