rs372030650

Variant summary

Our verdict is Pathogenic. Variant got 16 ACMG points: 16P and 0B. PM1PM2PP3_StrongPP5_Very_Strong

The NM_000271.5(NPC1):​c.2621A>T​(p.Asp874Val) variant causes a missense change. The variant allele was found at a frequency of 0.00018 in 1,613,934 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 0.00011 ( 0 hom., cov: 33)
Exomes 𝑓: 0.00019 ( 0 hom. )

Consequence

NPC1
NM_000271.5 missense

Scores

10
5
4

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:16

Conservation

PhyloP100: 6.10
Variant links:
Genes affected
NPC1 (HGNC:7897): (NPC intracellular cholesterol transporter 1) This gene encodes a large protein that resides in the limiting membrane of endosomes and lysosomes and mediates intracellular cholesterol trafficking via binding of cholesterol to its N-terminal domain. It is predicted to have a cytoplasmic C-terminus, 13 transmembrane domains, and 3 large loops in the lumen of the endosome - the last loop being at the N-terminus. This protein transports low-density lipoproteins to late endosomal/lysosomal compartments where they are hydrolized and released as free cholesterol. Defects in this gene cause Niemann-Pick type C disease, a rare autosomal recessive neurodegenerative disorder characterized by over accumulation of cholesterol and glycosphingolipids in late endosomal/lysosomal compartments.[provided by RefSeq, Aug 2009]

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ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 16 ACMG points.

PM1
In a topological_domain Lumenal (size 243) in uniprot entity NPC1_HUMAN there are 159 pathogenic changes around while only 14 benign (92%) in NM_000271.5
PM2
Very rare variant in population databases, with high coverage;
PP3
MetaRNN computational evidence supports a deleterious effect, 0.963
PP5
Variant 18-23539985-T-A is Pathogenic according to our data. Variant chr18-23539985-T-A is described in ClinVar as [Likely_pathogenic]. Clinvar id is 194810.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr18-23539985-T-A is described in Lovd as [Pathogenic]. Variant chr18-23539985-T-A is described in Lovd as [Pathogenic]. Variant chr18-23539985-T-A is described in Lovd as [Likely_pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE UniProt
NPC1NM_000271.5 linkuse as main transcriptc.2621A>T p.Asp874Val missense_variant 18/25 ENST00000269228.10

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Appris UniProt
NPC1ENST00000269228.10 linkuse as main transcriptc.2621A>T p.Asp874Val missense_variant 18/251 NM_000271.5 P1O15118-1
NPC1ENST00000591051.1 linkuse as main transcriptc.1700A>T p.Asp567Val missense_variant 11/182
NPC1ENST00000540608.5 linkuse as main transcriptn.2535A>T non_coding_transcript_exon_variant 16/162
NPC1ENST00000586718.1 linkuse as main transcriptn.412A>T non_coding_transcript_exon_variant 3/33

Frequencies

GnomAD3 genomes
AF:
0.000105
AC:
16
AN:
152152
Hom.:
0
Cov.:
33
show subpopulations
Gnomad AFR
AF:
0.0000724
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:
0.000191
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000477
AC:
12
AN:
251354
Hom.:
0
AF XY:
0.0000515
AC XY:
7
AN XY:
135872
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.0000289
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:
0.0000792
Gnomad OTH exome
AF:
0.000326
GnomAD4 exome
AF:
0.000187
AC:
274
AN:
1461782
Hom.:
0
Cov.:
34
AF XY:
0.000173
AC XY:
126
AN XY:
727204
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:
0.0000187
Gnomad4 NFE exome
AF:
0.000237
Gnomad4 OTH exome
AF:
0.000166
GnomAD4 genome
AF:
0.000105
AC:
16
AN:
152152
Hom.:
0
Cov.:
33
AF XY:
0.0000942
AC XY:
7
AN XY:
74326
show subpopulations
Gnomad4 AFR
AF:
0.0000724
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:
0.000191
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.000140
Hom.:
0
Bravo
AF:
0.000125
TwinsUK
AF:
0.000809
AC:
3
ALSPAC
AF:
0.000259
AC:
1
ESP6500AA
AF:
0.00
AC:
0
ESP6500EA
AF:
0.000116
AC:
1
ExAC
AF:
0.0000330
AC:
4
EpiCase
AF:
0.000109
EpiControl
AF:
0.000178

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:16
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Niemann-Pick disease, type C1 Pathogenic:9
Likely pathogenic, criteria provided, single submitterclinical testingGenetic Services Laboratory, University of ChicagoSep 21, 2016- -
Likely pathogenic, no assertion criteria providedclinical testingCounsylJan 02, 2014- -
Pathogenic, criteria provided, single submitterclinical testingIllumina Laboratory Services, IlluminaAug 22, 2018The NPC1 c.2621A>T (p.Asp874Val) variant has been identified in seven studies in individuals with Niemann-Pick disease, including in a homozygous state in one proband, in a compound heterozygous state in 12 probands, in four additional proband alleles, and in one unaffected heterozygous individual (Sun et al. 2001; Bauer et al. 2002; Kaminski et al. 2002; Park et al. 2003; Bauer et al. 2013; Imrie et al. 2015; Davies-Thompson et al. 2016). The p.Asp874Val variant was absent from 341 controls and is reported at a frequency of 0.000111 in the European (non-Finnish) population of the Genome Aggregation Database. Dardis et al. (2016) demonstrated TAR DNA binding protein 43 localized to the cytoplasm in Purkinje cells versus localization in both cytoplasm and nucleus in Purkinje cells from a healthy individual. Based on the evidence, the p.Asp874Val variant is classified as pathogenic for Niemann-Pick disease type C. This variant was observed by ICSL as part of a predisposition screen in an ostensibly healthy population. -
Pathogenic, criteria provided, single submitterclinical testingFulgent Genetics, Fulgent GeneticsOct 31, 2018- -
Pathogenic, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpJan 31, 2024This sequence change replaces aspartic acid, which is acidic and polar, with valine, which is neutral and non-polar, at codon 874 of the NPC1 protein (p.Asp874Val). This variant is present in population databases (rs372030650, gnomAD 0.01%). This missense change has been observed in individual(s) with Niemann-Pick Type C (PMID: 11333381, 11349231, 11754101, 12408188, 17160617, 23773996, 26666848). ClinVar contains an entry for this variant (Variation ID: 194810). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is expected to disrupt NPC1 protein function with a positive predictive value of 95%. For these reasons, this variant has been classified as Pathogenic. -
Pathogenic, criteria provided, single submitterclinical testingRevvity Omics, RevvityJun 20, 2023- -
Pathogenic, no assertion criteria providedclinical testingNatera, Inc.Sep 16, 2020- -
Pathogenic, criteria provided, single submitterclinical testingBaylor Genetics-- -
Pathogenic, no assertion criteria providedclinical testingGenomics England Pilot Project, Genomics England-- -
not provided Pathogenic:3
Pathogenic, criteria provided, single submitterclinical testingEurofins Ntd Llc (ga)May 05, 2017- -
Pathogenic, criteria provided, single submitterclinical testingGeneDxJun 29, 2022Published functional studies found D874V is associated with impaired NPC1 protein localization (Shammas et al., 2019); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; Not observed at significant frequency in large population cohorts (gnomAD); This variant is associated with the following publications: (PMID: 27544496, 23773996, 12408188, 11349231, 11333381, 23891399, 26666848, 30609409, 30690666, 31509197, 27193329, 12955717, 34113546, 30923329, 32204338) -
Pathogenic, criteria provided, single submitterclinical testingAiLife Diagnostics, AiLife DiagnosticsMar 29, 2022- -
Niemann-Pick disease, type C Pathogenic:2
Pathogenic, criteria provided, single submitterclinical testingLaboratory for Molecular Medicine, Mass General Brigham Personalized MedicineJun 20, 2016The p.Asp874Val variant in NPC1 has been reported in at least 6 compound heteroz ygous and 1 homozygous individuals with classic Niemann-Pick disease C (Millat 2 001, Sun 2001, Kaminski 2002, Bauer 2013, Dardis 2016). This variant has also be en identified in 4/120,928 of chromosomes by the Exome Aggregation Consortium (E xAC, http://exac.broadinstitute.org; dbSNP rs372030650). Although this variant h as been seen in the general population, its frequency is low enough to be consis tent with a recessive carrier frequency. In summary, the p.Asp874Val variant mee ts our criteria to be classified as pathogenic based on occurrence in trans with pathogenic variants in patients and low frequency in controls. -
Pathogenic, criteria provided, single submitterclinical testingWomen's Health and Genetics/Laboratory Corporation of America, LabCorpFeb 13, 2023Variant summary: NPC1 c.2621A>T (p.Asp874Val) results in a non-conservative amino acid change in the encoded protein sequence. Four of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 4.8e-05 in 251354 control chromosomes. This frequency is not significantly higher than estimated for a pathogenic variant in NPC1 causing Niemann-Pick Disease Type C (4.8e-05 vs 0.0027), allowing no conclusion about variant significance. c.2621A>T has been reported in the literature in individuals affected with Niemann-Pick Disease Type C. These data indicate that the variant may be associated with disease. Ten clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 without evidence for independent evaluation. All laboratories classified the variant as pathogenic/likely pathogenic. Based on the evidence outlined above, the variant was classified as pathogenic. -
Inborn genetic diseases Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingAmbry GeneticsFeb 26, 2021The c.2621A>T (p.D874V) alteration is located in exon 18 (coding exon 18) of the NPC1 gene. This alteration results from an A to T substitution at nucleotide position 2621, causing the aspartic acid (D) at amino acid position 874 to be replaced by a valine (V). Based on data from the Genome Aggregation Database (gnomAD) database, the NPC1 c.2621A>T alteration was observed in 0.01% (15/282742) of total alleles studied. This mutation has been identified in the compound heterozygous state in several individuals with Niemann-Pick disease (Millat, 2001; Bauer, 2013; Imrie, 2015). This alteration is predicted to be deleterious by in silico analysis. Based on the available evidence, this alteration is classified as pathogenic. -
NPC1-related disorder Pathogenic:1
Pathogenic, no assertion criteria providedclinical testingPreventionGenetics, part of Exact SciencesFeb 07, 2024The NPC1 c.2621A>T variant is predicted to result in the amino acid substitution p.Asp874Val. This variant has been reported to be causative for Niemann-Pick disease (Millat et al. 2001. PubMed ID: 11333381; Bauer et al. 2013. PubMed ID: 23773996; Imrie et al. 2015. PubMed ID: 26666848). This variant is reported in 0.0093% of alleles in individuals of European (Non-Finnish) descent in gnomAD. This variant is interpreted as pathogenic. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.15
BayesDel_addAF
Pathogenic
0.35
D
BayesDel_noAF
Pathogenic
0.47
CADD
Uncertain
24
DANN
Uncertain
0.98
DEOGEN2
Pathogenic
0.81
D
Eigen
Uncertain
0.35
Eigen_PC
Uncertain
0.33
FATHMM_MKL
Pathogenic
0.98
D
LIST_S2
Uncertain
0.93
D
M_CAP
Pathogenic
0.39
D
MetaRNN
Pathogenic
0.96
D
MetaSVM
Pathogenic
0.92
D
MutationAssessor
Pathogenic
3.5
M
MutationTaster
Benign
1.0
D;D
PrimateAI
Benign
0.42
T
PROVEAN
Pathogenic
-5.5
D
REVEL
Pathogenic
0.86
Sift
Uncertain
0.011
D
Sift4G
Benign
0.071
T
Polyphen
0.43
B
Vest4
0.75
MVP
0.96
MPC
0.38
ClinPred
0.79
D
GERP RS
5.7
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.7
Varity_R
0.67
gMVP
0.81

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: rs372030650; hg19: chr18-21119949; API