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rs369038140

Variant summary

Our verdict is Likely benign. Variant got -3 ACMG points: 1P and 4B. PP2BS2

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 (★★).

Frequency

Genomes: 𝑓 0.000033 ( 0 hom., cov: 32)
Exomes 𝑓: 0.000072 ( 0 hom. )

Consequence

ANK2
NM_001148.6 missense, splice_region

Scores

4
11
3
Splicing: ADA: 0.8191
2

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:5

Conservation

PhyloP100: 9.32
Variant links:
Genes affected
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]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Likely_benign. Variant got -3 ACMG points.

PP2
Missense variant where missense usually causes diseases, ANK2
BS2
High AC in GnomAd at 5 AD gene.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE UniProt
ANK2NM_001148.6 linkuse as main transcriptc.4369A>G p.Lys1457Glu missense_variant, splice_region_variant 35/46 ENST00000357077.9

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Appris UniProt
ANK2ENST00000357077.9 linkuse as main transcriptc.4369A>G p.Lys1457Glu missense_variant, splice_region_variant 35/461 NM_001148.6 A2Q01484-4

Frequencies

GnomAD3 genomes
AF:
0.0000329
AC:
5
AN:
152206
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:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0000735
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000159
AC:
4
AN:
251154
Hom.:
0
AF XY:
0.0000147
AC XY:
2
AN XY:
135720
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000352
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000719
AC:
105
AN:
1460912
Hom.:
0
Cov.:
33
AF XY:
0.0000715
AC XY:
52
AN XY:
726790
show subpopulations
Gnomad4 AFR exome
AF:
0.0000299
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:
0.0000927
Gnomad4 OTH exome
AF:
0.0000166
GnomAD4 genome
AF:
0.0000329
AC:
5
AN:
152206
Hom.:
0
Cov.:
32
AF XY:
0.0000269
AC XY:
2
AN XY:
74352
show subpopulations
Gnomad4 AFR
AF:
0.00
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:
0.0000735
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.0000773
Hom.:
0
Bravo
AF:
0.0000264
ESP6500AA
AF:
0.00
AC:
0
ESP6500EA
AF:
0.000116
AC:
1
ExAC
AF:
0.00000824
AC:
1
EpiCase
AF:
0.0000545
EpiControl
AF:
0.0000593

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:5
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not specified Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingLaboratory for Molecular Medicine, Mass General Brigham Personalized MedicineNov 14, 2016The 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
Uncertain significance, criteria provided, single submitterclinical testingGeneDxJan 20, 2012The 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
Uncertain significance, criteria provided, single submitterclinical testingInvitaeJul 25, 2022This variant is present in population databases (rs369038140, gnomAD 0.004%). 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 has not been reported in the literature in individuals affected with ANK2-related conditions. ClinVar contains an entry for this variant (Variation ID: 190605). 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: "Probably Damaging"; Align-GVGD: "Class C0"). Algorithms developed to predict the effect of sequence changes on RNA splicing suggest that this variant may create or strengthen a splice site. 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
Uncertain significance, criteria provided, single submitterclinical testingAmbry GeneticsJan 20, 2024The 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
Uncertain significance, criteria provided, single submitterclinical testingFulgent Genetics, Fulgent GeneticsOct 05, 2021- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.65
BayesDel_addAF
Uncertain
0.12
D
BayesDel_noAF
Uncertain
0.070
Cadd
Pathogenic
32
Dann
Uncertain
1.0
DEOGEN2
Uncertain
0.46
T;.;T;.;D;T;T;.
Eigen
Pathogenic
0.84
Eigen_PC
Pathogenic
0.84
FATHMM_MKL
Pathogenic
0.99
D
LIST_S2
Uncertain
0.97
D;D;D;D;D;D;D;D
M_CAP
Benign
0.049
D
MetaRNN
Uncertain
0.55
D;D;D;D;D;D;D;D
MetaSVM
Benign
-0.42
T
MutationTaster
Benign
1.0
D;D;D;D;D;D
PrimateAI
Uncertain
0.68
T
PROVEAN
Uncertain
-3.5
D;D;D;D;D;D;D;N
REVEL
Uncertain
0.38
Sift
Uncertain
0.0050
D;T;D;T;D;D;T;T
Sift4G
Uncertain
0.037
D;T;D;D;D;D;D;T
Polyphen
0.70, 0.99
.;P;.;D;.;.;D;.
Vest4
0.83, 0.81, 0.70, 0.68, 0.84, 0.78
MVP
0.75
MPC
1.8
ClinPred
0.87
D
GERP RS
5.9
Varity_R
0.76
gMVP
0.54

Splicing

Name
Calibrated prediction
Score
Prediction
dbscSNV1_ADA
Benign
0.82
dbscSNV1_RF
Benign
0.49
SpliceAI score (max)
0.26
Details are displayed if max score is > 0.2
DS_DG_spliceai
0.26
Position offset: 33

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: rs369038140; hg19: chr4-114267176; API