rs35993655

Variant summary

Our verdict is Pathogenic. Variant got 14 ACMG points: 14P and 0B. PM2PP3_StrongPP5_Very_Strong

The NM_000558.5(HBA1):​c.389T>C​(p.Leu130Pro) variant causes a missense change. The variant allele was found at a frequency of 0.00000657 in 152,220 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 (★★).

Frequency

Genomes: 𝑓 0.0000066 ( 0 hom., cov: 32)
Exomes 𝑓: 0.0000014 ( 0 hom. )
Failed GnomAD Quality Control

Consequence

HBA1
NM_000558.5 missense

Scores

11
4
3

Clinical Significance

Likely pathogenic criteria provided, multiple submitters, no conflicts P:3O:1

Conservation

PhyloP100: 7.06
Variant links:
Genes affected
HBA1 (HGNC:4823): (hemoglobin subunit alpha 1) The human alpha globin gene cluster located on chromosome 16 spans about 30 kb and includes seven loci: 5'- zeta - pseudozeta - mu - pseudoalpha-1 - alpha-2 - alpha-1 - theta - 3'. The alpha-2 (HBA2) and alpha-1 (HBA1) coding sequences are identical. These genes differ slightly over the 5' untranslated regions and the introns, but they differ significantly over the 3' untranslated regions. Two alpha chains plus two beta chains constitute HbA, which in normal adult life comprises about 97% of the total hemoglobin; alpha chains combine with delta chains to constitute HbA-2, which with HbF (fetal hemoglobin) makes up the remaining 3% of adult hemoglobin. Alpha thalassemias result from deletions of each of the alpha genes as well as deletions of both HBA2 and HBA1; some nondeletion alpha thalassemias have also been reported. [provided by RefSeq, Jul 2008]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 14 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
PP3
MetaRNN computational evidence supports a deleterious effect, 0.967
PP5
Variant 16-177371-T-C is Pathogenic according to our data. Variant chr16-177371-T-C is described in ClinVar as [Likely_pathogenic]. Clinvar id is 15865.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
HBA1NM_000558.5 linkc.389T>C p.Leu130Pro missense_variant Exon 3 of 3 ENST00000320868.9 NP_000549.1 P69905D1MGQ2

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
HBA1ENST00000320868.9 linkc.389T>C p.Leu130Pro missense_variant Exon 3 of 3 1 NM_000558.5 ENSP00000322421.5 P69905

Frequencies

GnomAD3 genomes
AF:
0.00000657
AC:
1
AN:
152220
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.0000241
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:
0.00
Gnomad OTH
AF:
0.00
GnomAD4 exome
Data not reliable, filtered out with message: AS_VQSR
AF:
0.00000137
AC:
2
AN:
1461462
Hom.:
0
Cov.:
32
AF XY:
0.00000138
AC XY:
1
AN XY:
727042
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.00
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.00
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.00000180
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
AF:
0.00000657
AC:
1
AN:
152220
Hom.:
0
Cov.:
32
AF XY:
0.00
AC XY:
0
AN XY:
74366
show subpopulations
Gnomad4 AFR
AF:
0.0000241
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:
0.00
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.0000386
Hom.:
0
Bravo
AF:
0.0000189

ClinVar

Significance: Likely pathogenic
Submissions summary: Pathogenic:3Other:1
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

alpha Thalassemia Pathogenic:1
Sep 16, 2020
Natera, Inc.
Significance: Likely pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

alpha Thalassemia;C0700299:Heinz body anemia;C3161174:Hemoglobin H disease;C4693798:Methemoglobinemia, alpha type;C4693823:Erythrocytosis, familial, 7 Pathogenic:1
Jun 21, 2024
Fulgent Genetics, Fulgent Genetics
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

not provided Pathogenic:1
Jun 29, 2018
ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The Hb Tunis-Bizerte variant (HBA1: c.389T>C; Leu129Pro) (rs35993655), has been described in the heterozygous state in individuals with no clinical presentation, but in the homozygous state in an individual with marked anemia and microcytosis (Darbellay 1995, HbVar database). Based on mass spectrometric analysis of the globins from both a heterozygote and homozygote, these authors concluded that the HBA1 chain harboring Leu129Pro represented <1% of the alpha globin chains and, thus, the variant is associated with a thalassemic phenotype. This variant is listed in ClinVar (Variation ID: 15865), and is absent from general population databases (1000 Genomes Project, Exome Variant Server, and Genome Aggregation Database), indicating it is not a common polymorphism. Additionally, the corresponding amino acid change in HBA2 (Leu129Pro, Hb Utrecht) is predicted to be very unstable, with heterozygous carriers reported with a mild alpha-thalassemic phenotype (Harteveld 1996, HbVar database). The lysine at codon 129 is highly conserved, and computational analyses (SIFT, PolyPhen-2) predict that this variant is deleterious. Based on available evidence, the Hb Tunis-Bizerte variant is predicted to be likely pathogenic for alpha-thalassemia, although to the best of our knowledge its effect in combination with deletional alpha thalassemia variants is not known. References: Link to HbVar database for Hb Tunis-Bizerte: http://globin.bx.psu.edu/cgi-bin/hbvar/query_vars3?mode=output&display_format=page&i=195 Link to HbVar database for Hb Utrecht: http://globin.bx.psu.edu/cgi-bin/hbvar/query_vars3?mode=output&display_format=page&i=196&.cgifields=histD Darbellay R et al. Haemoglobin Tunis-Bizerte: a new alpha 1 globin 129 Leu>Pro unstable variant with thalassaemic phenotype. Br J Haematol. 1995 May;90(1):71-6. Harteveld CL et al. Hb Utrecht (alpha 2 129(H12)Leu-->Pro), a new unstable alpha 2-chain variant associated with a mild alpha-thalassaemic phenotype. Br J Haematol. 1996 Sep;94(3):483-5. -

HEMOGLOBIN TUNIS-BIZERTE Other:1
Jul 20, 2016
OMIM
Significance: other
Review Status: no assertion criteria provided
Collection Method: literature only

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.98
BayesDel_addAF
Pathogenic
0.50
D
BayesDel_noAF
Pathogenic
0.48
CADD
Uncertain
25
DANN
Uncertain
1.0
DEOGEN2
Pathogenic
0.83
D;.
Eigen
Benign
-0.0038
Eigen_PC
Benign
-0.066
FATHMM_MKL
Uncertain
0.92
D
LIST_S2
Uncertain
0.95
D;D
M_CAP
Pathogenic
0.81
D
MetaRNN
Pathogenic
0.97
D;D
MetaSVM
Pathogenic
0.90
D
PrimateAI
Uncertain
0.54
T
PROVEAN
Pathogenic
-5.9
D;D
REVEL
Pathogenic
0.79
Sift
Pathogenic
0.0
D;D
Sift4G
Pathogenic
0.0
D;D
Vest4
0.95
MVP
1.0
ClinPred
1.0
D
GERP RS
4.2
Varity_R
0.92
gMVP
1.0

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

LitVar

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs35993655; hg19: chr16-227370; API