Our verdict is Likely benign. Variant got -4 ACMG points: 0P and 4B. BS2
The NM_001148.6(ANK2):c.4369A>G(p.Lys1457Glu) variant causes a missense, splice region change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0000682 in 1,613,118 control chromosomes in the GnomAD database, with no homozygous occurrence. 2/3 splice prediction tools predict no significant impact on normal splicing. Variant has been reported in ClinVar as Uncertain significance (★★).
ANK2 (HGNC:493): (ankyrin 2) This gene encodes a member of the ankyrin family of proteins that link the integral membrane proteins to the underlying spectrin-actin cytoskeleton. Ankyrins play key roles in activities such as cell motility, activation, proliferation, contact and the maintenance of specialized membrane domains. Most ankyrins are typically composed of three structural domains: an amino-terminal domain containing multiple ankyrin repeats; a central region with a highly conserved spectrin binding domain; and a carboxy-terminal regulatory domain which is the least conserved and subject to variation. The protein encoded by this gene is required for targeting and stability of Na/Ca exchanger 1 in cardiomyocytes. Mutations in this gene cause long QT syndrome 4 and cardiac arrhythmia syndrome. Multiple transcript variants encoding different isoforms have been described. [provided by RefSeq, Dec 2011]
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing
The p.Lys1457Glu variant in ANK2 has been reported in 1 individual who died sudd enly in their late teens due to cardiac arrest (GeneDx, personal communication; ClinVar Variation ID 190605). It has also been identified in 5/111962 European c hromosomes by the Genome Aggregation Database (gnomAD, http://gnomad.broadinstit ute.org; dbSNP rs369038140). Computational and conservation analysis suggest tha t this amino acid substitution may impact the protein. Furthermore, this variant is located in the third to last base of the exon, which is part of the 5? splic e region. Computational splice prediction tools suggest a possible impact to spl icing, and the adenine (A) base at this position (c.4369A) is well conserved acr oss species. However, these types of data are not predictive enough to determine pathogenicity. In summary the clinical significance of the p.Lys1457Glu variant is uncertain. -
not provided Uncertain:1
Jan 20, 2012
GeneDx
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing
The Lys1457Glu variant in the ANK2 gene has also not been reported previously as a disease-causing mutation or as a benign polymorphism, to our knowledge. Although Lys1457Glu is a missense change, this subsitution occurs near the splice donor site of exon 35 in the ANK2 gene. Three different splice prediction algorithms predict Lys1457Glu either destroys or significantly reduces the efficiency of the splice donor site, which is expected to lead to aberrant gene splicing and production of an abnormal, truncated protein or absence of protein from this copy of the gene. The NHLBI ESP Exome Variant Server reports Lys1457Glu was observed in 1/7,019 alleles from individuals of European background. However, no splice site or other protein truncating mutations have been reported in the ANK2 gene to our knowledge. In summary, with the clinical and molecular information available at this time, we cannot definitively determine whether the Lys1457Glu variant in the ANK2 gene are disease-causing mutations or rare benign variants. The variant is found in POSTMORTEM panel(s). -
Long QT syndrome Uncertain:1
Aug 15, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing
This sequence change replaces lysine, which is basic and polar, with glutamic acid, which is acidic and polar, at codon 1457 of the ANK2 protein (p.Lys1457Glu). This variant is present in population databases (rs369038140, gnomAD 0.004%). This variant has not been reported in the literature in individuals affected with ANK2-related conditions. ClinVar contains an entry for this variant (Variation ID: 190605). An algorithm developed to predict the effect of missense changes on protein structure and function (PolyPhen-2) suggests that this variant is likely to be disruptive. 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 Uncertain:1
Jan 20, 2024
Ambry Genetics
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing
The p.K1457E variant (also known as c.4369A>G), located in coding exon 35 of the ANK2 gene, results from an A to G substitution at nucleotide position 4369. The lysine at codon 1457 is replaced by glutamic acid, an amino acid with similar properties. This alteration has been reported in a hypertrophic cardiomyopathy (HCM) cohort; however, clinical details were limited (Lopes LR et al. Heart. 2015;101:294-301). This amino acid position is highly conserved in available vertebrate species. Using the BDGP and ESEfinder splice site prediction tools, this alteration is predicted to weaken the efficiency of the native splice donor site; however, direct evidence is unavailable. In addition, the in silico prediction for this alteration is inconclusive. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear. -
Cardiac arrhythmia, ankyrin-B-related Uncertain:1
Oct 05, 2021
Fulgent Genetics, Fulgent Genetics
Significance: Uncertain significance
Review Status: criteria provided, single submitter