rs267607161
Variant summary
Our verdict is Pathogenic. Variant got 18 ACMG points: 18P and 0B. PM1PM2PM5PP3_StrongPP5_Very_Strong
The NM_000371.4(TTR):c.349G>T(p.Ala117Ser) variant causes a missense change. The variant allele was found at a frequency of 0.00000657 in 152,172 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 (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. A117G) has been classified as Pathogenic.
Frequency
Consequence
NM_000371.4 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Pathogenic. Variant got 18 ACMG points.
Transcripts
RefSeq
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | MANE | UniProt |
---|---|---|---|---|---|---|---|
TTR | NM_000371.4 | c.349G>T | p.Ala117Ser | missense_variant | 4/4 | ENST00000237014.8 | |
LOC124904277 | XR_007066326.1 | n.129-2885C>A | intron_variant, non_coding_transcript_variant |
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | TSL | MANE | Appris | UniProt |
---|---|---|---|---|---|---|---|---|---|
TTR | ENST00000237014.8 | c.349G>T | p.Ala117Ser | missense_variant | 4/4 | 1 | NM_000371.4 | P1 | |
TTR | ENST00000649620.1 | c.349G>T | p.Ala117Ser | missense_variant | 6/6 | P1 | |||
TTR | ENST00000610404.5 | c.253G>T | p.Ala85Ser | missense_variant | 4/4 | 5 |
Frequencies
GnomAD3 genomes ? AF: 0.00000657 AC: 1AN: 152172Hom.: 0 Cov.: 33
GnomAD3 exomes AF: 0.00000398 AC: 1AN: 251012Hom.: 0 AF XY: 0.00000737 AC XY: 1AN XY: 135706
GnomAD4 exome Cov.: 31
GnomAD4 genome ? AF: 0.00000657 AC: 1AN: 152172Hom.: 0 Cov.: 33 AF XY: 0.0000135 AC XY: 1AN XY: 74328
ClinVar
Submissions by phenotype
Familial amyloid neuropathy Pathogenic:4
Pathogenic, criteria provided, single submitter | clinical testing | Women's Health and Genetics/Laboratory Corporation of America, LabCorp | Feb 14, 2017 | Variant summary: The TTR c.349G>T (p.Ala117Ser) variant involves the alteration of a conserved nucleotide. 3/4 in silico tools predict a damaging outcome for this variant (SNPs&GO not captured due to low reliability index). 5/5 splice prediction tools predict no significant impact on normal splicing, however, 3/5 tools predict that this variant may remove a cryptic 3' splicing acceptor site. ESE finder predicts that this variant may affect multiple ESE sites. However, these predictions have yet to be confirmed by functional studies. This variant has been reported in multiple ATTR patients in Chinese population and is absent in 121750 control chromosomes. In addition, multiple clinical diagnostic laboratories/reputable databases classified this variant as pathogenic. Taken together, this variant is classified as pathogenic. - |
Pathogenic, criteria provided, single submitter | clinical testing | Invitae | Jan 24, 2024 | This sequence change replaces alanine, which is neutral and non-polar, with serine, which is neutral and polar, at codon 117 of the TTR protein (p.Ala117Ser). This variant is present in population databases (rs267607161, gnomAD 0.01%). This missense change has been observed in individuals with transthyretin amyloidosis (PMID: 10611950, 18022643, 20697105, 22412233, 23713495). This variant is also known as Ala97Ser. ClinVar contains an entry for this variant (Variation ID: 13468). 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 TTR protein function with a positive predictive value of 95%. Experimental studies have shown that this missense change affects TTR function (PMID: 20697105). This variant disrupts the p.Ala117 (also known as p.Ala97) amino acid residue in TTR. Other variant(s) that disrupt this residue have been determined to be pathogenic (PMID: 8133316, 10611950, 14986482, 20209591). This suggests that this residue is clinically significant, and that variants that disrupt this residue are likely to be disease-causing. For these reasons, this variant has been classified as Pathogenic. - |
Pathogenic, no assertion criteria provided | literature only | OMIM | Aug 10, 2010 | - - |
Pathogenic, criteria provided, single submitter | clinical testing | Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine | May 18, 2010 | - - |
not provided Pathogenic:2
Likely pathogenic, criteria provided, single submitter | clinical testing | Athena Diagnostics | Feb 15, 2017 | - - |
Pathogenic, no assertion criteria provided | clinical testing | Stanford Center for Inherited Cardiovascular Disease, Stanford University | - | Note this variant was found in clinical genetic testing performed by one or more labs who may also submit to ClinVar. Thus any internal case data may overlap with the internal case data of other labs. The interpretation reviewed below is that of the Stanford Center for Inherited Cardiovascular Disease. This variant has been previously reported in multiple families with amyloidosis. The variant was first reported by Tachibana et al (1999) in a cohort of Chinese patients with familial amyloid polyneuropathy (FAP). Unfortunately only the abstract is available and this does not list segregation, functional, or control data. Lachmann et al (2000) briefly reported this variant in a family in which two brothers with progressive peripheral and autonomic neuropathy as well as subclinical cardiac and renal amyloid deposition. The variant was observed in two Chinese-Taiwanese brothers who presented with amyloidosis at ages 56 and 60. Liu et al (2008) reported the variant in five unrelated Chinese-Taiwanese patients between the ages of 55 and 67 with amyloidosis. The phenotype included late-onset polyneuropathy, carpel tunnel syndrome, autonomic dysfunction, and cardiac involvement. Interestingly, haplotype analysis was inconsistent with a founder effect. Yang et al (2010) observed the variant in 19 unrelated Taiwanese patients with polyneuropathy between the ages of 48 and 68. Another variant at the same codon has also been reported in association with amyloidosis: p.Ala97Gly (Yasude et al 1994). In silico analysis with Polyphen2 predicts the variant to be possibly damaging. The Alanine at codon 97 is completely conserved as are the neighboring residues. Lachmann et al (2000) reported the variant was absent in at least 50 control individuals. Liu et al (2008) did not observe it in 100 Chinese control individuals. Yang et al (2010) reported the variant was not seen in their sample of 365 Taiwanese controls, for a total of 515 control individuals. - |
Hyperthyroxinemia, dystransthyretinemic;C2751492:Familial amyloid neuropathy;C5779776:Carpal tunnel syndrome 1 Pathogenic:1
Pathogenic, criteria provided, single submitter | clinical testing | Fulgent Genetics, Fulgent Genetics | May 11, 2022 | - - |
Cardiovascular phenotype Pathogenic:1
Pathogenic, criteria provided, single submitter | clinical testing | Ambry Genetics | Mar 03, 2021 | The p.A117S pathogenic mutation (also known as c.349G>T and A97S) located in coding exon 4 of the TTR gene, results from a G to T substitution at nucleotide position 349. The alanine at codon 117 is replaced by serine, an amino acid with similar properties. This variant has been reported in multiple individuals with TTR amyloidosis (Tachibana N et al. Amyloid, 1999 Dec;6:282-8; Yang NC et al. Neurology, 2010 Aug;75:532-8; Hsu HC et al. BMC Neurol, 2017 Sep;17:178; Chen Q et al. Mol. Neurobiol., 2018 Jun;55:4911-4917; Yuan Z et al. J Clin Neurosci, 2019 Feb;60:164-166; Chao HC et al. Ann Clin Transl Neurol, 2019 May;6:913-922; Liao CH et al. Diagnostics (Basel), 2019 Apr;9:). This variant was proposed as a hot spot in the Chinese-Taiwanese population based on 5 unrelated individuals of this ethnic group with familial TTR and a clinical picture including carpal tunnel syndrome, late-onset polyneuropathy, and autonomic dysfunction with cardiac involvement (Liu YT et al. J. Neurol. Sci., 2008 Apr;267:91-9). Mouse heterozygous knock-in models demonstrated consistent neuropathy phenotype and amyloid deposits confirmed by anti-TTR immunohistochemistry (Kan HW et al. Neuropathol. Appl. Neurobiol., 2018 12;44:673-686). A disease-causing mutation, p.A117G, has been described in the same codon in individuals with TTR amyloidosis (Barreiros AP et al. Liver Transpl., 2010 Mar;16:314-23; Koike H et al. J. Neurol. Sci., 2018 Nov;394:99-106). Based on the supporting evidence, this alteration is interpreted as a disease-causing mutation. - |
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at