rs28941471

Variant summary

Our verdict is Pathogenic. The variant received 11 ACMG points: 12P and 1B. PM1PM5PP5_Very_StrongBP4

The NM_000026.4(ADSL):​c.569G>A​(p.Arg190Gln) variant causes a missense change. The variant allele was found at a frequency of 0.0000217 in 1,614,198 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign 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. R190G) has been classified as Likely pathogenic.

Frequency

Genomes: 𝑓 0.000059 ( 0 hom., cov: 32)
Exomes 𝑓: 0.000018 ( 0 hom. )

Consequence

ADSL
NM_000026.4 missense

Scores

4
6
9

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:3

Conservation

PhyloP100: 3.61

Publications

9 publications found
Variant links:
Genes affected
ADSL (HGNC:291): (adenylosuccinate lyase) The protein encoded by this gene belongs to the lyase 1 family. It is an essential enzyme involved in purine metabolism, and catalyzes two non-sequential reactions in the de novo purine biosynthetic pathway: the conversion of succinylaminoimidazole carboxamide ribotide (SAICAR) to aminoimidazole carboxamide ribotide (AICAR) and the conversion of adenylosuccinate (S-AMP) to adenosine monophosphate (AMP). Mutations in this gene are associated with adenylosuccinase deficiency (ADSLD), a disorder marked with psychomotor retardation, epilepsy or autistic features. Alternatively spliced transcript variants have been found for this gene. [provided by RefSeq, Dec 2015]
ADSL Gene-Disease associations (from GenCC):
  • adenylosuccinate lyase deficiency
    Inheritance: AR Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: ClinGen, G2P, Orphanet, Labcorp Genetics (formerly Invitae)

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Pathogenic. The variant received 11 ACMG points.

PM1
In a hotspot region, there are 2 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 2 benign, 6 uncertain in NM_000026.4
PM5
Other missense variant is known to change same aminoacid residue: Variant chr22-40358949-C-G is described in ClinVar as [Conflicting_classifications_of_pathogenicity]. Clinvar id is 2725586.We mark this variant Likely_pathogenic, oryginal submission is: [Conflicting_classifications_of_pathogenicity].
PP5
Variant 22-40358950-G-A is Pathogenic according to our data. Variant chr22-40358950-G-A is described in ClinVar as [Likely_pathogenic]. Clinvar id is 2465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
BP4
Computational evidence support a benign effect (MetaRNN=0.07161367). . Strength limited to SUPPORTING due to the PP5.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
ADSLNM_000026.4 linkc.569G>A p.Arg190Gln missense_variant Exon 5 of 13 ENST00000623063.3 NP_000017.1 P30566-1X5D8S6

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
ADSLENST00000623063.3 linkc.569G>A p.Arg190Gln missense_variant Exon 5 of 13 1 NM_000026.4 ENSP00000485525.1 P30566-1
ENSG00000284431ENST00000639722.1 linkn.*265G>A non_coding_transcript_exon_variant Exon 4 of 31 5 ENSP00000492828.1 A0A1W2PRX2
ENSG00000284431ENST00000639722.1 linkn.*265G>A 3_prime_UTR_variant Exon 4 of 31 5 ENSP00000492828.1 A0A1W2PRX2

Frequencies

GnomAD3 genomes
AF:
0.0000591
AC:
9
AN:
152192
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00135
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0000294
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.0000318
AC:
8
AN:
251460
AF XY:
0.0000441
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.000217
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000352
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000178
AC:
26
AN:
1461888
Hom.:
0
Cov.:
32
AF XY:
0.0000179
AC XY:
13
AN XY:
727246
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
33480
American (AMR)
AF:
0.0000224
AC:
1
AN:
44724
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26136
East Asian (EAS)
AF:
0.000126
AC:
5
AN:
39700
South Asian (SAS)
AF:
0.0000348
AC:
3
AN:
86258
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
53420
Middle Eastern (MID)
AF:
0.000173
AC:
1
AN:
5768
European-Non Finnish (NFE)
AF:
0.0000144
AC:
16
AN:
1112006
Other (OTH)
AF:
0.00
AC:
0
AN:
60396
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.498
Heterozygous variant carriers
0
2
4
7
9
11
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Variant carriers
0
2
4
6
8
10
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
GnomAD4 genome
AF:
0.0000591
AC:
9
AN:
152310
Hom.:
0
Cov.:
32
AF XY:
0.0000537
AC XY:
4
AN XY:
74482
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
41560
American (AMR)
AF:
0.00
AC:
0
AN:
15298
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3472
East Asian (EAS)
AF:
0.00135
AC:
7
AN:
5182
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4826
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10618
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
294
European-Non Finnish (NFE)
AF:
0.0000294
AC:
2
AN:
68038
Other (OTH)
AF:
0.00
AC:
0
AN:
2110
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.486
Heterozygous variant carriers
0
1
2
2
3
4
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Genome Het
Variant carriers
0
2
4
6
8
10
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
Alfa
AF:
0.0000488
Hom.:
0
Bravo
AF:
0.0000340
ExAC
AF:
0.0000659
AC:
8
Asia WGS
AF:
0.000289
AC:
1
AN:
3478
EpiCase
AF:
0.00
EpiControl
AF:
0.0000593

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:3
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Adenylosuccinate lyase deficiency Pathogenic:2
Dec 28, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence change replaces arginine, which is basic and polar, with glutamine, which is neutral and polar, at codon 190 of the ADSL protein (p.Arg190Gln). This variant is present in population databases (rs28941471, gnomAD 0.03%). This missense change has been observed in individual(s) with deficiency of adenylosuccinate lyase (PMID: 10090474, 10888601). ClinVar contains an entry for this variant (Variation ID: 2465). 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 not expected to disrupt ADSL protein function with a negative predictive value of 80%. Experimental studies are conflicting or provide insufficient evidence to determine the effect of this variant on ADSL function (PMID: 20127976, 22180458). For these reasons, this variant has been classified as Pathogenic. -

Jan 01, 1999
OMIM
Significance:Pathogenic
Review Status:no assertion criteria provided
Collection Method:literature only

- -

not provided Pathogenic:1
Oct 02, 2024
GeneDx
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Published functional studies demonstrate a damaging effect as this variant decreases enzyme stability (PMID: 20127976, 10888601); 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: 10888601, 10090474, 37842880, 36338215, 22180458, 20127976) -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.15
BayesDel_addAF
Uncertain
0.10
D
BayesDel_noAF
Pathogenic
0.22
CADD
Benign
21
DANN
Uncertain
0.99
DEOGEN2
Benign
0.033
T;D;.;T;T;T;T;.
Eigen
Benign
-0.29
Eigen_PC
Benign
-0.24
FATHMM_MKL
Uncertain
0.96
D
LIST_S2
Uncertain
0.93
D;D;D;D;D;D;D;D
M_CAP
Pathogenic
0.31
D
MetaRNN
Benign
0.072
T;T;T;T;T;T;T;T
MetaSVM
Pathogenic
1.1
D
MutationAssessor
Uncertain
2.8
.;M;M;.;.;.;.;.
PhyloP100
3.6
PrimateAI
Benign
0.37
T
PROVEAN
Uncertain
-2.7
.;.;D;.;.;.;.;.
REVEL
Pathogenic
0.68
Sift
Benign
0.26
.;.;T;.;.;.;.;.
Sift4G
Benign
0.55
T;T;T;.;T;T;.;.
Polyphen
0.017, 0.69
.;B;P;.;.;.;.;.
Vest4
0.43, 0.55, 0.77
MutPred
0.68
.;.;.;.;Loss of helix (P = 0.028);.;.;.;
MVP
0.95
MPC
0.34
ClinPred
0.24
T
GERP RS
2.8
Varity_R
0.58
gMVP
0.91
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

Publications

Other links and lift over

dbSNP: rs28941471; hg19: chr22-40754954; API