rs370157832
Variant summary
Our verdict is Likely benign. The variant received -2 ACMG points: 0P and 2B. BP4_Moderate
The NM_000179.3(MSH6):c.728G>A(p.Arg243His) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.00000929 in 1,613,962 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 Conflicting classifications of pathogenicity (no stars). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R243C) has been classified as Uncertain significance.
Frequency
Consequence
NM_000179.3 missense
Scores
Clinical Significance
Conservation
Publications
- intellectual developmental disorder with dysmorphic facies and behavioral abnormalitiesInheritance: AD Classification: DEFINITIVE, STRONG Submitted by: Labcorp Genetics (formerly Invitae), Ambry Genetics, G2P
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ACMG classification
Our verdict: Likely_benign. The variant received -2 ACMG points.
Variant Effect in Transcripts
ACMG analysis was done for transcript: NM_000179.3. You can select a different transcript below to see updated ACMG assignments.
RefSeq Transcripts
| Selected | Gene | Transcript | Tags | HGVSc | HGVSp | Effect | Exon Rank | Protein | UniProt |
|---|---|---|---|---|---|---|---|---|---|
| MSH6 | NM_000179.3 | MANE Select | c.728G>A | p.Arg243His | missense | Exon 4 of 10 | NP_000170.1 | ||
| MSH6 | NM_001406795.1 | c.824G>A | p.Arg275His | missense | Exon 5 of 11 | NP_001393724.1 | |||
| MSH6 | NM_001406813.1 | c.734G>A | p.Arg245His | missense | Exon 4 of 10 | NP_001393742.1 |
Ensembl Transcripts
| Selected | Gene | Transcript | Tags | HGVSc | HGVSp | Effect | Exon Rank | Protein | UniProt |
|---|---|---|---|---|---|---|---|---|---|
| MSH6 | ENST00000234420.11 | TSL:1 MANE Select | c.728G>A | p.Arg243His | missense | Exon 4 of 10 | ENSP00000234420.5 | ||
| MSH6 | ENST00000445503.5 | TSL:1 | n.*75G>A | non_coding_transcript_exon | Exon 3 of 9 | ENSP00000405294.1 | |||
| MSH6 | ENST00000445503.5 | TSL:1 | n.*75G>A | 3_prime_UTR | Exon 3 of 9 | ENSP00000405294.1 |
Frequencies
GnomAD3 genomes AF: 0.0000197 AC: 3AN: 152130Hom.: 0 Cov.: 32 show subpopulations
GnomAD2 exomes AF: 0.0000119 AC: 3AN: 251062 AF XY: 0.0000147 show subpopulations
GnomAD4 exome AF: 0.00000821 AC: 12AN: 1461832Hom.: 0 Cov.: 34 AF XY: 0.0000138 AC XY: 10AN XY: 727222 show subpopulations
Age Distribution
GnomAD4 genome AF: 0.0000197 AC: 3AN: 152130Hom.: 0 Cov.: 32 AF XY: 0.0000135 AC XY: 1AN XY: 74330 show subpopulations
Age Distribution
ClinVar
Submissions by phenotype
Lynch syndrome Uncertain:2
This missense variant replaces arginine with histidine at codon 243 of the MSH6 protein. Computational prediction suggests that this variant may not impact protein structure and function (internally defined REVEL score threshold <= 0.5, PMID: 27666373). Splice site prediction tools suggest that this variant may not impact RNA splicing. To our knowledge, functional studies have not been reported for this variant. This variant has been reported in individuals affected with ovarian cancer (PMID: 26689913), colorectal cancer (PMID: 29245953), or an unspecified advanced cancer (PMID: 28873162). This variant has been identified in 3/251062 chromosomes in the general population by the Genome Aggregation Database (gnomAD) and in healthy control individuals (PMID: 32980694). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance.
The MSH6 c.728G>A (p.Arg243His) missense change has a maximal subpopulation frequency of 0.0062% in gnomAD v2.1.1 (PM2_Supporting; https://gnomad.broadinstitute.org/variant/2-48025850-G-A). Five of seven in silico tools predict a benign effect of this variant on protein function (BP4), but these predictions have not been confirmed by functional studies. This variant has been reported in an individual with colorectal cancer (PMID: 29245953). It has also been reported somatically in a case of hypermutated pediatric glioblastoma (PMID: 28912153). In summary, this variant meets criteria to be classified as of uncertain significance based on the ACMG/AMP criteria: PM2_Supporting, BP4.
not provided Uncertain:2
Not observed at significant frequency in large population cohorts (gnomAD); In silico analysis supports that this missense variant does not alter protein structure/function; Reported in individuals with ovarian or other cancer (Lu et al., 2015; Mandelker et al., 2017); This variant is associated with the following publications: (PMID: 28912153, 23621914, 26689913, 28002797, 28706299, 21437237, 32566746, 28873162)
The MSH6 c.728G>A (p.Arg243His) variant has been reported in the published literature in individuals with colorectal cancer (PMID: 29245953 (2017)), prostate cancer (PMID: 35467778 (2022)), breast cancer (PMID: 35534704 (2022), 33471991 (2021), see also LOVD (http://databases.lovd.nl/shared/)), ovarian cancer (PMID: 26689913 (2015)), as well as in reportedly healthy individuals (PMIDs: 32658311 (2021), 32980694 (2020), 36243179 (2022)). The frequency of this variant in the general population, 0.000012 (3/251062 chromosomes (Genome Aggregation Database, http://gnomad.broadinstitute.org)), is uninformative in the assessment of its pathogenicity. Analysis of this variant using bioinformatics tools for the prediction of the effect of amino acid changes on protein structure and function yielded predictions that this variant is benign. Based on the available information, we are unable to determine the clinical significance of this variant.
Hereditary cancer-predisposing syndrome Uncertain:2
The p.R243H variant (also known as c.728G>A), located in coding exon 4 of the MSH6 gene, results from a G to A substitution at nucleotide position 728. The arginine at codon 243 is replaced by histidine, an amino acid with highly similar properties. This variant has been reported in an individual diagnosed with ovarian cancer from a cohort of 4034 cancer cases from The Cancer Genome Atlas (Lu C et al. Nat Commun, 2015 Dec;6:10086). This variant was not seen in 732 breast cancer patients or 189 colorectal cancer patients but detected in 1/490 cancer-free elderly controls in a Turkish population (Akcay IM et al. Int J Cancer, 2021 Jan;148:285-295). This amino acid position is not well conserved in available vertebrate species. In addition, the in silico prediction for this alteration is inconclusive. Based on the available evidence, the clinical significance of this variant remains unclear.
This missense variant replaces arginine with histidine at codon 243 of the MSH6 protein. Computational prediction suggests that this variant may not impact protein structure and function (internally defined REVEL score threshold <= 0.5, PMID: 27666373). To our knowledge, functional studies have not been reported for this variant. This variant has been reported in individuals affected with ovarian cancer (PMID: 26689913), colorectal cancer (PMID: 29245953), and unspecified advanced cancer (PMID: 28873162). This variant has been identified in 15/1613962 chromosomes in the general population by the Genome Aggregation Database (gnomAD) and in healthy control individuals (PMID: 32980694). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance.
Lynch syndrome 5 Uncertain:1Benign:1
This variant is considered likely benign. This variant is strongly associated with less severe personal and family histories of cancer, typical for individuals without pathogenic variants in this gene [PMID: 27363726].
not specified Uncertain:1
Variant summary: MSH6 c.728G>A (p.Arg243His) results in a non-conservative amino acid change in the encoded protein sequence. Four of five in-silico tools predict a benign effect of the variant on protein function. The variant allele was found at a frequency of 1.6e-05 in 252042 control chromosomes (gnomAD, Ackay_2021). The available data on variant occurrences in the general population are insufficient to allow any conclusion about variant significance. c.728G>A has been reported in the literature in individuals affected with Prostate Cancer (Brady_2022), Ovarian Cancer (Lu_2015), and Breast Cancer (Dorling_2021) without evidence for causality. These reports do not provide unequivocal conclusions about association of the variant with Prostate Cancer. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. Six ClinVar submitters have assessed the variant since 2014: one classified the variant as benign and five as uncertain significance. Based on the evidence outlined above, the variant was classified as uncertain significance.
Hereditary breast ovarian cancer syndrome Uncertain:1
Endometrial carcinoma Uncertain:1
Hereditary nonpolyposis colorectal neoplasms Benign:1
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at