rs267607571
Variant summary
Our verdict is Pathogenic. The variant received 18 ACMG points: 18P and 0B. PM1PM2PM5PP3_StrongPP5_Very_Strong
The NM_170707.4(LMNA):c.569G>A(p.Arg190Gln) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.00000342 in 1,461,856 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. 14/23 in silico tools predict a damaging 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. R190W) has been classified as Pathogenic.
Frequency
Consequence
NM_170707.4 missense
Scores
Clinical Significance
Conservation
Publications
- dilated cardiomyopathyInheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
- dilated cardiomyopathy 1AInheritance: AD Classification: DEFINITIVE, SUPPORTIVE Submitted by: G2P, Ambry Genetics, Orphanet
- familial partial lipodystrophy, Dunnigan typeInheritance: AD Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Orphanet, Genomics England PanelApp, G2P, Labcorp Genetics (formerly Invitae)
- Hutchinson-Gilford progeria syndromeInheritance: AD, SD Classification: DEFINITIVE, STRONG, MODERATE, SUPPORTIVE Submitted by: Orphanet, G2P, Ambry Genetics, Labcorp Genetics (formerly Invitae)
- restrictive dermopathy 2Inheritance: AR, AD Classification: DEFINITIVE, LIMITED Submitted by: G2P
- Emery-Dreifuss muscular dystrophy 2, autosomal dominantInheritance: SD, AD Classification: DEFINITIVE, STRONG Submitted by: Ambry Genetics, Labcorp Genetics (formerly Invitae), G2P
- atrioventricular blockInheritance: AD Classification: STRONG Submitted by: Genomics England PanelApp
- heart-hand syndrome, Slovenian typeInheritance: AD Classification: STRONG, MODERATE, SUPPORTIVE, LIMITED Submitted by: Labcorp Genetics (formerly Invitae), Orphanet, Ambry Genetics, G2P
- Charcot-Marie-Tooth disease type 2B1Inheritance: AR, AD Classification: STRONG, MODERATE, SUPPORTIVE, LIMITED Submitted by: G2P, Ambry Genetics, Orphanet, Labcorp Genetics (formerly Invitae)
- Emery-Dreifuss muscular dystrophy 3, autosomal recessiveInheritance: AR Classification: STRONG Submitted by: Labcorp Genetics (formerly Invitae)
- mandibuloacral dysplasia with type A lipodystrophyInheritance: AR Classification: STRONG, SUPPORTIVE Submitted by: Labcorp Genetics (formerly Invitae), Orphanet
- atrial fibrillationInheritance: AD Classification: MODERATE Submitted by: Ambry Genetics
- atypical Werner syndromeInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- autosomal dominant Emery-Dreifuss muscular dystrophyInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- congenital muscular dystrophy due to LMNA mutationInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- familial isolated dilated cardiomyopathyInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- lethal restrictive dermopathyInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- LMNA-related cardiocutaneous progeria syndromeInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- autosomal recessive Emery-Dreifuss muscular dystrophyInheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
- dilated cardiomyopathy-hypergonadotropic hypogonadism syndromeInheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
- autosomal semi-dominant severe lipodystrophic laminopathyInheritance: SD Classification: SUPPORTIVE Submitted by: Orphanet
- arrhythmogenic right ventricular cardiomyopathyInheritance: AD Classification: LIMITED Submitted by: ClinGen
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ACMG classification
Our verdict: Pathogenic. The variant received 18 ACMG points.
Transcripts
RefSeq
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt |
|---|---|---|---|---|---|---|---|---|
| LMNA | NM_170707.4 | c.569G>A | p.Arg190Gln | missense_variant | Exon 3 of 12 | ENST00000368300.9 | NP_733821.1 | |
| LMNA | NM_005572.4 | c.569G>A | p.Arg190Gln | missense_variant | Exon 3 of 10 | ENST00000677389.1 | NP_005563.1 |
Ensembl
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
|---|---|---|---|---|---|---|---|---|---|---|
| LMNA | ENST00000368300.9 | c.569G>A | p.Arg190Gln | missense_variant | Exon 3 of 12 | 1 | NM_170707.4 | ENSP00000357283.4 | ||
| LMNA | ENST00000677389.1 | c.569G>A | p.Arg190Gln | missense_variant | Exon 3 of 10 | NM_005572.4 | ENSP00000503633.1 |
Frequencies
GnomAD3 genomes Cov.: 32
GnomAD4 exome AF: 0.00000342 AC: 5AN: 1461856Hom.: 0 Cov.: 32 AF XY: 0.00000413 AC XY: 3AN XY: 727232 show subpopulations
Age Distribution
GnomAD4 genome Cov.: 32
ClinVar
Submissions by phenotype
not provided Pathogenic:4Other:1
PS3, PS4_moderate, PM1, PM2, PM5, PP1, PP3 -
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Identified in at least one individual with Emery-Dreifuss muscular dystrophy type 2 (EDMD2); this individual also harbored a second variant in the same LMNA allele, previously published in association with EDMD2 (PMID: 15744034, 31744510); Not observed at significant frequency in large population cohorts (gnomAD); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; Published functional studies demonstrated COS7 cells expressing GFP-prelamin A fusion constructs including the p.(R190Q) variant showed mild-moderate levels of abnormal nuclear shapes in addition to a significantly greater proportion of nuclei with nuclear envelope-associated aggregates compared to control COS7 cells (PMID: 20160190); This variant is associated with the following publications: (PMID: 24846508, Garcia-Pavia2013[Abstract], 18795223, 28069705, 26899768, 11897440, 28416588, 23701190, 24386194, 29693488, 29764566, 31447099, 31983221, 31383942, 30453078, 31744510, 15744034, 18585512, 36264615, 34862408, 35288587, 36396199, 10939567, 20160190, 37652022) -
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Cardiomyopathy Pathogenic:3
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Variant summary: LMNA c.569G>A (p.Arg190Gln) results in a conservative amino acid change located in the Intermediate filament, rod domain (IPR039008) of the encoded protein sequence. Four of five in-silico tools predict a damaging effect of the variant on protein function. The variant was absent in 251370 control chromosomes. c.569G>A has been reported in the literature in multiple individuals affected with familial dilated cardiomyopathy/Lamin A/C cardiomyopathies (example, Parks_2008, Perrot_2009, Cowan_2010, Cuenca_2016, Te Riele_2017, Park_2020, Gerbino_2021). These data indicate that the variant is very likely to be associated with disease. At least one publication reports experimental evidence evaluating an impact on protein function and demonstrated membrane bound GFP-lamin A aggregates and nuclear shape abnormalities supporting a pathogenic outcome (Cowan_2010). Seven clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 without evidence for independent evaluation. All laboratories classified the variant as pathogenic/likely pathogenic. Based on the evidence outlined above, the variant was classified as pathogenic. -
This missense variant replaces arginine with glutamine at codon 190 in the intermediate filament rod domain of the LMNA protein. Computational prediction tools indicate that this variant has a deleterious impact on protein structure and function. Functional studies have shown that this variant causes abnormal localization of lamin A in the nuclear envelope (PMID: 20160190). This variant has been reported in at least nine unrelated individuals affected with dilated cardiomyopathy (PMID: 18585512, 18795223, 20160190, 26899768, 28790152, 29773157, 31983221, 34773379, 35288587). It has been shown that this variant segregates with disease in three affected individuals in one family (PMID: 20160190). This variant has also been reported in two individuals affected with an unspecified cardiomyopathy (PMID: 31383942) and in one individual affected with arrhythmogenic right ventricular cardiomyopathy (PMID: 28069705). In addition, this variant has been reported in one individual affected with Emery-Dreifuss muscular dystrophy who also carried an additional pathogenic variant in the LMNA gene (PMID: 15744034). This variant has not been identified in the general population by the Genome Aggregation Database (gnomAD). A different variant affecting the same codon, p.Arg190Trp, is considered to be disease-causing (ClinVar variation ID: 66908), suggesting that arginine at this position is important for LMNA protein function. Based on the available evidence, this variant is classified as Likely Pathogenic. -
Primary dilated cardiomyopathy Pathogenic:2
This missense variant replaces arginine with glutamine at codon 190 in the intermediate filament rod domain of the LMNA protein. Computational prediction tools indicate that this variant has a deleterious impact on protein structure and function. Functional studies have shown that this variant causes abnormal localization of lamin A in the nuclear envelope (PMID: 20160190). This variant has been reported in at least nine unrelated individuals affected with dilated cardiomyopathy (PMID: 18585512, 18795223, 20160190, 26899768, 28790152, 29773157, 31983221, 34773379, 35288587). It has been shown that this variant segregates with disease in three affected individuals in one family (PMID: 20160190). This variant has also been reported in two individuals affected with an unspecified cardiomyopathy (PMID: 31383942) and in one individual affected with arrhythmogenic right ventricular cardiomyopathy (PMID: 28069705). In addition, this variant has been reported in one individual affected with Emery-Dreifuss muscular dystrophy who also carried an additional pathogenic variant in the LMNA gene (PMID: 15744034). This variant has not been identified in the general population by the Genome Aggregation Database (gnomAD). A different variant affecting the same codon, p.Arg190Trp, is considered to be disease-causing (ClinVar variation ID: 66908), suggesting that arginine at this position is important for LMNA protein function. Based on the available evidence, this variant is classified as Likely Pathogenic. -
The p.Arg190Gln variant in LMNA has been reported in the heterozygous state in 3 individuals with DCM, and in 2 individuals with arrhythmogenic right ventricular cardiomyopathy (ARVC; Cuenta 2016, Parks 2008, Perrot 2009, Poloni 2019, Te Riele 2017). It has also been identified in 1 individual with Emery-Dreifuss muscular dystrophy (EDMD) who harbored a second LMNA variant in cis that has been classified as pathogenic for EDMD (Cenni 2005). This variant has been reported by other clinical laboratories in ClinVar (Variation ID: 66910) and was absent from large population studies. In vitro functional studies support an impact on protein function (Cowan 2010) and computational prediction tools and conservation analysis suggest that the p.Arg190Gln variant may impact the protein. Another variant at the same position, p.Arg190Trp has been reported in several individuals with DCM and is classified as pathogenic by several clinical laboratories in ClinVar (Variation ID 66908, Arbustini 2002, Sylvius 2005, Vaikhanskaya 2014). In summary, although additional studies are required to fully establish its clinical significance, this variant meets criteria to be classified as likely pathogenic for autosomal dominant DCM. ACMG/AMP Criteria applied: PM2, PM5, PP3, PS3_Supporting, PS4_Supporting. -
Cardiovascular phenotype Pathogenic:2
The p.R190Q pathogenic mutation (also known as c.569G>A), located in coding exon 3 of the LMNA gene, results from a G to A substitution at nucleotide position 569. The arginine at codon 190 is replaced by glutamine, an amino acid with highly similar properties. This alteration has been reported in individuals with dilated cardiomyopathy (DCM) (Parks SB et al. Am. Heart J., 2008 Jul;156:161-9; Perrot A et al. Basic Res. Cardiol., 2009 Jan;104:90-9; Park J et al. Genet Med, 2020 01;22:102-111; Mazzarotto F et al. Circulation, 2020 02;141:387-398). This amino acid position is highly conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. This variant is considered to be rare based on population cohorts in the Genome Aggregation Database (gnomAD). Based on the supporting evidence, this alteration is interpreted as a disease-causing mutation. -
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Charcot-Marie-Tooth disease type 2 Pathogenic:1
This sequence change replaces arginine, which is basic and polar, with glutamine, which is neutral and polar, at codon 190 of the LMNA protein (p.Arg190Gln). This variant is not present in population databases (gnomAD no frequency). This missense change has been observed in individuals with autosomal dominant LMNA-related conditions (PMID: 18795223, 20160190, 26899768). It has also been observed to segregate with disease in related individuals. ClinVar contains an entry for this variant (Variation ID: 66910). 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 have shown that this missense change affects LMNA function (PMID: 20160190). This variant disrupts the p.Arg190 amino acid residue in LMNA. Other variant(s) that disrupt this residue have been determined to be pathogenic (PMID: 11897440, 23701190, 24386194, 28416588). 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. -
Dilated cardiomyopathy 1A Pathogenic:1
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Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at