rs368007942
Variant summary
Our verdict is Likely benign. Variant got -2 ACMG points: 2P and 4B. PM2BP4_Strong
The NM_001232.4(CASQ2):c.1186G>A(p.Asp396Asn) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000889 in 1,541,878 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. 15/21 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. D396E) has been classified as Uncertain significance.
Frequency
Consequence
NM_001232.4 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Likely_benign. Variant got -2 ACMG points.
Transcripts
RefSeq
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
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CASQ2 | ENST00000261448.6 | c.1186G>A | p.Asp396Asn | missense_variant | Exon 11 of 11 | 1 | NM_001232.4 | ENSP00000261448.5 | ||
CASQ2 | ENST00000488931.2 | n.*558G>A | non_coding_transcript_exon_variant | Exon 13 of 13 | 3 | ENSP00000518226.1 | ||||
CASQ2 | ENST00000488931.2 | n.*558G>A | 3_prime_UTR_variant | Exon 13 of 13 | 3 | ENSP00000518226.1 |
Frequencies
GnomAD3 genomes AF: 0.0000994 AC: 15AN: 150898Hom.: 0 Cov.: 32
GnomAD3 exomes AF: 0.000148 AC: 37AN: 250458Hom.: 0 AF XY: 0.000140 AC XY: 19AN XY: 135314
GnomAD4 exome AF: 0.0000877 AC: 122AN: 1390980Hom.: 0 Cov.: 29 AF XY: 0.0000983 AC XY: 68AN XY: 691834
GnomAD4 genome AF: 0.0000994 AC: 15AN: 150898Hom.: 0 Cov.: 32 AF XY: 0.000109 AC XY: 8AN XY: 73722
ClinVar
Submissions by phenotype
Catecholaminergic polymorphic ventricular tachycardia 2 Uncertain:3
This variant was observed as part of a predisposition screen in an ostensibly healthy population. A literature search was performed for the gene, cDNA change, and amino acid change (where applicable). Publications were found based on this search. However, the evidence from the literature, in combination with allele frequency data from public databases where available, was not sufficient to rule this variant in or out of causing disease. Therefore, this variant is classified as a variant of unknown significance. -
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not provided Uncertain:2
The p.Asp396Asn variant (rs368007942) has not been reported in the medical literature, gene specific variation databases, nor has it been previously identified by our laboratory. This variant is listed in the Genome Aggregation Database (gnomAD) with a frequency of 0.1 percent in the Ashkenazi Jewish population (identified on 15 out of 10,130 chromosomes) and has been reported to the ClinVar database (Variation ID: 191439). The aspartic acid at position 396 is highly conserved considering 11 species (Alamut v2.11) and computational analyses of the effects of the p.Asp396Asn variant on protein structure and function provide conflicting results (SIFT: damaging, PolyPhen-2: benign). Altogether, there is not enough evidence to classify the p.Asp396Asn variant with certainty. -
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not specified Uncertain:1
Variant summary: CASQ2 c.1186G>A (p.Asp396Asn) results in a conservative amino acid change in the encoded protein sequence. Three of five in-silico tools predict a benign effect of the variant on protein function. The variant allele was found at a frequency of 0.00015 in 250458 control chromosomes. This frequency is not significantly higher than estimated for a pathogenic variant in CASQ2 causing Catecholaminergic Polymorphic Ventricular Tachycardia (0.00015 vs 0.0016), allowing no conclusion about variant significance. c.1186G>A has been reported in the literature in one fetus from a cohort of stillbirth cases, however these report(s) do not provide unequivocal conclusions about association of the variant with Catecholaminergic Polymorphic Ventricular Tachycardia (Sahlin_2019). To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. The following publication has been ascertained in the context of this evaluation (PMID: 30615648). Eight submitters have cited clinical-significance assessments for this variant to ClinVar after 2014; all submitters classified the variant as uncertain significance. Based on the evidence outlined above, the variant was classified as uncertain significance. -
Progressive familial heart block Uncertain:1
The CASQ2 gene variant c.2269C>T (p.Asp396Asn) was found in heterozygous state in proband (female, 2 y.o., Caucasian) with syncope, bradycardia and familial conduction disease. No additional rare candidate variants (Class III-V of pathogenicity) in the CASQ2 gene were found in this proband in the WES data. The substitution affects highly conserved C-terminus region with no functional domains. Variant is present in Genome Aggregation Database (gnomAD) with total MAF 0.0001455. ClinVar contains entry for this variant (Variation ID: 191439). Most of in silico predictors show benign results (varsome.com). Bi-allelic mutations in the CASQ2 gene are the known cause of recessive form of CPVT but multiple studies describe single-heterozygous findings in the CASQ2 gene (PMID: 17655857, 20302875, 27157848) in a relation to HCM and CPVT. This variant is classified as Variant of Uncertain Significance (VUS) with the following ACMG(2015) criteria applied: PM2, BP4. -
Catecholaminergic polymorphic ventricular tachycardia 1;C2677794:Catecholaminergic polymorphic ventricular tachycardia 2 Uncertain:1
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Catecholaminergic polymorphic ventricular tachycardia 1 Uncertain:1
This sequence change replaces aspartic acid, which is acidic and polar, with asparagine, which is neutral and polar, at codon 396 of the CASQ2 protein (p.Asp396Asn). This variant is present in population databases (rs368007942, gnomAD 0.1%). This variant has not been reported in the literature in individuals affected with CASQ2-related conditions. ClinVar contains an entry for this variant (Variation ID: 191439). Algorithms developed to predict the effect of missense changes on protein structure and function are either unavailable or do not agree on the potential impact of this missense change (SIFT: "Tolerated"; PolyPhen-2: "Not Available"; Align-GVGD: "Class C0"). In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. -
Cardiovascular phenotype Benign:1
This alteration is classified as likely benign based on a combination of the following: seen in unaffected individuals, population frequency, intact protein function, lack of segregation with disease, co-occurrence, RNA analysis, in silico models, amino acid conservation, lack of disease association in case-control studies, and/or the mechanism of disease or impacted region is inconsistent with a known cause of pathogenicity. -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at