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rs373822756

Variant summary

Our verdict is Pathogenic. Variant got 14 ACMG points: 18P and 4B. PS4PP1_StrongPM1PM3BS4PM2PP3PP4PS3_Moderate

This summary comes from the ClinGen Evidence Repository: NM_000527.5(LDLR): c.662A>G (p.Asp221Gly) variant is classified as Pathogenic for Familial Hypercholesterolemia by applying evidence codes (PP1_strong, PS3_moderate, PS4, PM1, PM2, PM3, PP3, PP4 and BS4) as defined by the ClinGen Familial Hypercholesterolemia Expert Panel LDLR-specific variant curation guidelines (https://doi.org/10.1016/j.gim.2021.09.012). The supporting evidence is as follows:PP1_strong - Variant segregates with FH phenotype in 92 informative meiosis in at least 37 families from different labs (Robarts Research Institute; Laboratory of Genetics and Molecular Cardiology, University of São Paulo; Centre de Génétique Moléculaire et Chromosomique, Unité de génétique de l'Obésité et des Dyslipidémies (APHP.Sorbonne Université, Hôpital de la Pitié-Salpêtrière); Molecular Genetics Laboratory (Centre for Cardiovascular Surgery and Transplantation); Cardiovascular Research Group,Instituto Nacional de Saude Doutor Ricardo Jorge; Cardiovascular Genetics Laboratory (PathWest Laboratory Medicine WA)): 55 affected family members have the variant, 37 unaffected family members don’t have the variant.PS3_moderate - PMID:9974426 - Level 2 assay - Homozygous patients' fibroblasts, 125I-LDL assays: 8% LDLR activity; PMID:25647241 - Level 3 assay - Heterologous cells (HeLa), CLSM assay: most of mutant LDLR is in ER, LDLR activity decreased compared to WT - considered as disruptive.PS4 - Variant meets PM2. Variant identified in 48 unrelated index cases (2 cases with DLCN≥6 from Robarts Research Institute; 21 cases (13 patients with DLCN≥6, and 8 patients with possible FH (Simon Broome)) from Centre de Génétique Moléculaire et Chromosomique, Unité de génétique de l'Obésité et des Dyslipidémies (APHP.Sorbonne Université, Hôpital de la Pitié-Salpêtrière); 17 cases with possible/definite FH (Simon-Broome) from Molecular Genetics Laboratory (Centre for Cardiovascular Surgery and Transplantation); 1 case with Possible FH (Simon-Broome) from Cardiovascular Research Group,Instituto Nacional de Saude Doutor Ricardo Jorge; 5 cases with DLCN≥6 from Cardiovascular Genetics Laboratory (PathWest Laboratory Medicine WA); 2 cases with DLCN≥6 from Color Health, Inc.PM1 - Variant meets PM2 and is missense in exon 4.PM2 - PopMax MAF = 0.0001152 (0.01152%) in European (non-Finnish) exomes+genomes (gnomAD v2.1.1).PM3 - Index case from Ambry Genetics has LDL = 750 mg/dl and also LDLR c.2140+1G>T (pathogenic by these guidelines, confirmed to be in trans).PP3 - REVEL = 0.986.PP4 - Variant meets PM2. Identified in 48 FH cases from different labs (for list see PS4) with clinical Dutch Lipid Clinic Network Criteria score ≥ 6 or Simon-Broome possible/definite FH, after alternative causes of high cholesterol were excluded.BS4 - 30 nonsegregations in 12 families (Laboratory of Genetics and Molecular Cardiology, University of São Paulo).Variant has 2 Strong plus 4 Moderate plus 2 Supporting evidence codes towards Pathogenic, enough to classify as Pathogenic, and only 1 Strong evidence codes towards Benign. The Pathogenic criteria overwhelms the Benign criteria, so we are confident in classifying this variant as Pathogenic. LINK:https://erepo.genome.network/evrepo/ui/classification/CA023739/MONDO:0007750/013

Frequency

Genomes: not found (cov: 33)
Exomes 𝑓: 0.000027 ( 0 hom. )

Consequence

LDLR
NM_000527.5 missense

Scores

12
5
1

Clinical Significance

Pathogenic reviewed by expert panel P:30O:1

Conservation

PhyloP100: 9.21
Variant links:
Genes affected
LDLR (HGNC:6547): (low density lipoprotein receptor) The low density lipoprotein receptor (LDLR) gene family consists of cell surface proteins involved in receptor-mediated endocytosis of specific ligands. The encoded protein is normally bound at the cell membrane, where it binds low density lipoprotein/cholesterol and is taken into the cell. Lysosomes release the cholesterol, which is made available for repression of microsomal enzyme 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase, the rate-limiting step in cholesterol synthesis. At the same time, a reciprocal stimulation of cholesterol ester synthesis takes place. Mutations in this gene cause the autosomal dominant disorder, familial hypercholesterolemia. Alternate splicing results in multiple transcript variants.[provided by RefSeq, May 2022]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 14 ACMG points.

PS3
PS4
PM1
PM2
PM3
PP1
PP3
PP4
BS4

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE UniProt
LDLRNM_000527.5 linkuse as main transcriptc.662A>G p.Asp221Gly missense_variant 4/18 ENST00000558518.6

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Appris UniProt
LDLRENST00000558518.6 linkuse as main transcriptc.662A>G p.Asp221Gly missense_variant 4/181 NM_000527.5 P3P01130-1

Frequencies

GnomAD3 genomes
Cov.:
33
GnomAD3 exomes
AF:
0.0000520
AC:
13
AN:
249796
Hom.:
0
AF XY:
0.0000812
AC XY:
11
AN XY:
135548
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:
0.000115
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000274
AC:
40
AN:
1459188
Hom.:
0
Cov.:
33
AF XY:
0.0000303
AC XY:
22
AN XY:
725462
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:
0.00
Gnomad4 NFE exome
AF:
0.0000351
Gnomad4 OTH exome
AF:
0.0000166
GnomAD4 genome
Cov.:
33
Alfa
AF:
0.00354
Hom.:
0
ESP6500AA
AF:
0.00
AC:
0
ESP6500EA
AF:
0.000116
AC:
1
ExAC
AF:
0.0000824
AC:
10
EpiCase
AF:
0.0000545
EpiControl
AF:
0.000415

ClinVar

Significance: Pathogenic
Submissions summary: Pathogenic:30Other:1
Revision: reviewed by expert panel
LINK: link

Submissions by phenotype

Hypercholesterolemia, familial, 1 Pathogenic:19
Likely pathogenic, criteria provided, single submitterliterature onlyLDLR-LOVD, British Heart FoundationMar 25, 2016- -
Pathogenic, criteria provided, single submitterresearchCardiovascular Research Group, Instituto Nacional de Saude Doutor Ricardo JorgeMar 01, 20160/190 non-FH alleles; 0/60 healthy control individuals -
Pathogenic, no assertion criteria providedclinical testingCardiovascular Genetics Laboratory, PathWest Laboratory Medicine WA - Fiona Stanley HospitalDec 12, 2009- -
Likely pathogenic, criteria provided, single submitterclinical testingLaboratory of molecular diagnosis of dyslipidemias, Università egli studi di Napoli Federico IIMay 24, 2021- -
Likely pathogenic, criteria provided, single submitterclinical testingMolecular Genetics Laboratory, Centre for Cardiovascular Surgery and TransplantationNov 05, 2016Asp221 bind structural Ca2+. -
Pathogenic, reviewed by expert panelcurationClinGen Familial Hypercholesterolemia Variant Curation Expert PanelMay 30, 2022NM_000527.5(LDLR): c.662A>G (p.Asp221Gly) variant is classified as Pathogenic for Familial Hypercholesterolemia by applying evidence codes (PP1_strong, PS3_moderate, PS4, PM1, PM2, PM3, PP3, PP4 and BS4) as defined by the ClinGen Familial Hypercholesterolemia Expert Panel LDLR-specific variant curation guidelines (https://doi.org/10.1016/j.gim.2021.09.012). The supporting evidence is as follows: PP1_strong - Variant segregates with FH phenotype in 92 informative meiosis in at least 37 families from different labs (Robarts Research Institute; Laboratory of Genetics and Molecular Cardiology, University of São Paulo; Centre de Génétique Moléculaire et Chromosomique, Unité de génétique de l'Obésité et des Dyslipidémies (APHP.Sorbonne Université, Hôpital de la Pitié-Salpêtrière); Molecular Genetics Laboratory (Centre for Cardiovascular Surgery and Transplantation); Cardiovascular Research Group,Instituto Nacional de Saude Doutor Ricardo Jorge; Cardiovascular Genetics Laboratory (PathWest Laboratory Medicine WA)): 55 affected family members have the variant, 37 unaffected family members don’t have the variant. PS3_moderate - PMID: 9974426 - Level 2 assay - Homozygous patients' fibroblasts, 125I-LDL assays: 8% LDLR activity; PMID: 25647241 - Level 3 assay - Heterologous cells (HeLa), CLSM assay: most of mutant LDLR is in ER, LDLR activity decreased compared to WT - considered as disruptive. PS4 - Variant meets PM2. Variant identified in 48 unrelated index cases (2 cases with DLCN≥6 from Robarts Research Institute; 21 cases (13 patients with DLCN≥6, and 8 patients with possible FH (Simon Broome)) from Centre de Génétique Moléculaire et Chromosomique, Unité de génétique de l'Obésité et des Dyslipidémies (APHP.Sorbonne Université, Hôpital de la Pitié-Salpêtrière); 17 cases with possible/definite FH (Simon-Broome) from Molecular Genetics Laboratory (Centre for Cardiovascular Surgery and Transplantation); 1 case with Possible FH (Simon-Broome) from Cardiovascular Research Group,Instituto Nacional de Saude Doutor Ricardo Jorge; 5 cases with DLCN≥6 from Cardiovascular Genetics Laboratory (PathWest Laboratory Medicine WA); 2 cases with DLCN≥6 from Color Health, Inc. PM1 - Variant meets PM2 and is missense in exon 4. PM2 - PopMax MAF = 0.0001152 (0.01152%) in European (non-Finnish) exomes+genomes (gnomAD v2.1.1). PM3 - Index case from Ambry Genetics has LDL = 750 mg/dl and also LDLR c.2140+1G>T (pathogenic by these guidelines, confirmed to be in trans). PP3 - REVEL = 0.986. PP4 - Variant meets PM2. Identified in 48 FH cases from different labs (for list see PS4) with clinical Dutch Lipid Clinic Network Criteria score ≥ 6 or Simon-Broome possible/definite FH, after alternative causes of high cholesterol were excluded. BS4 - 30 nonsegregations in 12 families (Laboratory of Genetics and Molecular Cardiology, University of São Paulo). Variant has 2 Strong plus 4 Moderate plus 2 Supporting evidence codes towards Pathogenic, enough to classify as Pathogenic, and only 1 Strong evidence codes towards Benign. The Pathogenic criteria overwhelms the Benign criteria, so we are confident in classifying this variant as Pathogenic. -
Pathogenic, criteria provided, single submitterclinical testingU4M - Lille University & CHRU Lille, Université de Lille - CHRU de LilleMar 30, 2017- -
Pathogenic, criteria provided, single submitterresearchIberoamerican FH NetworkMar 01, 2016- -
Pathogenic, criteria provided, single submitterresearchBrunham Lab, Centre for Heart and Lung Innovation, University of British ColumbiaJun 04, 2019- -
Likely pathogenic, criteria provided, single submitterclinical testingRobarts Research Institute, Western University-- -
Likely pathogenic, criteria provided, single submitterclinical testingCentre de Génétique Moléculaire et Chromosomique, Unité de génétique de l'Obésité et des Dyslipidémies, APHP, GH Hôpitaux Universitaires Pitié-Salpêtrière / Charles-FoixDec 16, 2016subjects mutated among 2600 FH index cases screened = 12 , family members = 7 with co-segregation / FH-Padua / Software predictions: Damaging -
Pathogenic, no assertion criteria providedresearchLaboratorium voor Moleculaire Diagnostiek Experimentele Vasculaire Geneeskunde, Academisch Medisch Centrum-- -
Pathogenic, criteria provided, single submitterclinical testingDepartment of Human Genetics, Laborarztpraxis Dres. Walther, Weindel und KollegenSep 25, 2018The mutation occurs at the protein level at position 221 (position 200 of the mature protein) to exchange the amino acid aspartate for glycine. This change has already been described in the literature as the FH Padova-1 allele, detected in patients with familial hypercholesterolemia, and associated with elevated cholesterol and LDL-C levels. It leads to an almost complete loss of LDL receptor activity. We observed this variant in a patient with TC up to 380 mg/dl and LDL-C approx 310 mg/dl. PMID: 25647241, 23375686 -
Pathogenic, criteria provided, single submitterclinical testingInstitute of Human Genetics, University of Leipzig Medical CenterMay 25, 2022_x000D_ Criteria applied: PS4, PM5_STR, PS3_MOD, PM2_SUP, PP3 -
Pathogenic, criteria provided, single submitterclinical testingRevvity Omics, RevvityMar 09, 2023- -
Pathogenic, criteria provided, single submitterclinical testingAll of Us Research Program, National Institutes of HealthFeb 05, 2024This missense variant (also known as p.Asp200Gly in the mature protein) replaces aspartic acid with glycine at codon 221 located in the fifth LDLR type A repeat of the ligand binding domain of the LDLR protein. Computational prediction suggests that this variant may have a deleterious impact on protein structure and function (internally defined REVEL score threshold >= 0.7, PMID: 27666373). A functional study has shown the mutant protein to exhibit loss of LDL uptake activity and to be defective for transport through the endoplasmic reticulum (PMID: 21865347). This variant has been identified in more than 100 individuals diagnosed with familial hypercholesterolemia from multiple European ethnicities (PMID: 1301956, 7649546, 9104431, 10208479, 10978268, 17765246, 20145306, 21310417, 32770674, 34037665, 35052492, 35626767) and is highly recurrent in the Northern Italian population (PMID: 10978268). This variant has been identified in 13/249796 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Different variants affecting the same codon, p.Asp221Asn and p.Asp221Tyr, are considered to be disease-causing (ClinVar variation ID: 226331 and 251356), suggesting that aspartic acid at this position is important for LDLR protein function. Based on the available evidence, this variant is classified as Pathogenic. -
Pathogenic, criteria provided, single submitterresearchLaboratory of Genetics and Molecular Cardiology, University of São PauloMar 01, 2016- -
Pathogenic, criteria provided, single submitternot providedInstitute of Human Genetics, University Hospital of Duesseldorf-- -
Pathogenic, criteria provided, single submitterresearchFundacion Hipercolesterolemia FamiliarMar 01, 2016- -
Familial hypercholesterolemia Pathogenic:6
Pathogenic, no assertion criteria providedclinical testingNatera, Inc.Sep 16, 2020- -
Pathogenic, criteria provided, single submitterclinical testingWomen's Health and Genetics/Laboratory Corporation of America, LabCorpFeb 16, 2018Variant summary: LDLR c.662A>G (p.Asp221Gly) results in a non-conservative amino acid change located in the Low-density lipoprotein (LDL) receptor class A repeat of the encoded protein sequence. Five of five in-silico tools predict a damaging effect of the variant on protein function. The variant was found in 13/245460 control chromosomes (0.00005296), which does not exceed the maximum expected allele frequency for a pathogenic variant in the LDLR gene (0.0013). The c.662A>G variant has been reported in the literature in numerous individuals affected with Familial Hypercholesterolemia. These data indicate that the variant is very likely to be associated with disease. At least one publication reports experimental evidence evaluating an impact on protein function. The most pronounced variant effect results in 10%-<30% of normal LDLR activity (Thormaehlen_2015). Several other variants that cause a change at Asp221 are associated with disease (e.g., D221N, D221Y, and D221V), suggesting the codon is critical for function. Eight clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 without evidence for independent evaluation. All of these laboratories classified the variant as pathogenic/likely pathogenic. Based on the evidence outlined above, the variant was classified as pathogenic. -
Pathogenic, criteria provided, single submitterclinical testingInvitaeJan 24, 2024This sequence change replaces aspartic acid, which is acidic and polar, with glycine, which is neutral and non-polar, at codon 221 of the LDLR protein (p.Asp221Gly). This variant is present in population databases (rs373822756, gnomAD 0.01%). This missense change has been observed in individual(s) with familial hypercholesterolemia (PMID: 15523646, 23375686). In at least one individual the data is consistent with being in trans (on the opposite chromosome) from a pathogenic variant. It is commonly reported in individuals of Italian ancestry (PMID: 2698793, 11196104, 15241806, 20236128, 25461735). This variant is also known as p.Asp200Gly. ClinVar contains an entry for this variant (Variation ID: 183092). 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 LDLR protein function with a positive predictive value of 95%. Experimental studies have shown that this missense change affects LDLR function (PMID: 25647241). For these reasons, this variant has been classified as Pathogenic. -
Pathogenic, criteria provided, single submitterclinical testingNational Institute of Allergy and Infectious Diseases - Centralized Sequencing Program, National Institutes of HealthAug 06, 2021- -
Pathogenic, criteria provided, single submitterclinical testingHuman Genome Sequencing Center Clinical Lab, Baylor College of MedicineMar 01, 2019The c.662A>G (p.Asp221Gly) variant in the LDLR gene has been reported in multiple unrelated individuals affected with familial hypercholesterolemia (PMID 1301956, 11196104, 15241806, 20145306,23375686) and has also been reported in multiple myocardial infarction cases while absent from healthy controls (PMID 25487149). Independent functional studies demonstrated deleterious effect of the p.Asp221Gly variant (PMID 1301956, 25647241). Multiple algorithms predicted this change to be damaging. Therefore, this c.662A>G (p.Asp221Gly) variant in the LDLR gene is classified as pathogenic. -
Pathogenic, criteria provided, single submitterclinical testingColor Diagnostics, LLC DBA Color HealthMar 28, 2023This missense variant (also known as p.Asp200Gly in the mature protein) replaces aspartic acid with glycine at codon 221 located in the fifth LDLR type A repeat of the ligand binding domain of the LDLR protein. Computational prediction suggests that this variant may have a deleterious impact on protein structure and function (internally defined REVEL score threshold >= 0.7, PMID: 27666373). A functional study has shown the mutant protein to exhibit loss of LDL uptake activity and to be defective for transport through the endoplasmic reticulum (PMID: 21865347). This variant has been identified in more than 100 individuals diagnosed with familial hypercholesterolemia from multiple European ethnicities (PMID: 1301956, 7649546, 9104431, 10208479, 10978268, 17765246, 20145306, 21310417, 32770674, 34037665, 35052492, 35626767) and is highly recurrent in the Northern Italian population (PMID: 10978268). This variant has been identified in 13/249796 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Different variants affecting the same codon, p.Asp221Asn and p.Asp221Tyr, are considered to be disease-causing (ClinVar variation ID: 226331 and 251356), suggesting that aspartic acid at this position is important for LDLR protein function. Based on the available evidence, this variant is classified as Pathogenic. -
not provided Pathogenic:3Other:1
not provided, no classification providedin vitroDept. of Genetics and Pharmacogenomics, Merck Research Labs-- -
Pathogenic, criteria provided, single submitterclinical testingGeneDxMay 03, 2023Not observed at significant frequency in large population cohorts (gnomAD); Published in vitro over-expression and complementation studies suggest D221G is disruptive to LDLR activity (Thormaehlen et al., 2015); A different missense change at this residue (p.(D221N)) has been reported as pathogenic/likely pathogenic in association with FH at GeneDx and by other clinical laboratories (ClinVar Variant ID# 226331; ClinVar); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; Also known as p.D200G and FH Padua and FH Padova 1; This variant is associated with the following publications: (PMID: 15523646, 25487149, 1301956, 24529145, 11196104, 15241806, 25461735, 7649546, 9259195, 10206683, 11506462, 17142622, 17347910, 9104431, 10208479, 10978268, 32041611, 34182004, 33087929, 32977124, 28126585, 33740630, 34037665, 31447099, 32770674, 35177841, 34456049, 30710474, 35753512, 35971028, 9974426, 11939787, 25647241, 7682459, 28965616, 33303402, 35339733, 33955087, 35913489, 23375686) -
Pathogenic, criteria provided, single submitterclinical testingQuest Diagnostics Nichols Institute San Juan CapistranoMar 21, 2019This variant has been reported in individuals with familial hypercholesterolemia (PMID: 25461735 (2015), 20145306 (2010), 15241806 (2004), 11196104 (2000)). Assessment of experimental analysis yielded damaging results regarding the impact of this variant on protein function (PMID: 25647241 (2015), 1301956 (1992)). Therefore, we predict that this variant is pathogenic. -
Pathogenic, criteria provided, single submitterclinical testingCeGaT Center for Human Genetics TuebingenJun 01, 2021- -
Homozygous familial hypercholesterolemia Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingLaboratory for Molecular Medicine, Mass General Brigham Personalized MedicineMar 03, 2019The p.Asp221Gly variant in LDLR has been reported in >75 individuals with familial hypercholesterolemia (FH), including in 4 homozygotes who presented with more severe disease (Hobbs 1992, Chmara 2010, Bertolini 2013). However, not all individuals carrying this variant presented with high cholesterol levels (Bertolini 2013, Thormaehlen 2015). This variant has also been reported by other clinical laboratories in ClinVar (Variation ID 183092) and has been identified in 13/111132 European chromosomes by the Genome Aggregation Database (gnomAD, http://gnomad.broadinstitute.org; dbSNP rs373822756). Please note that this frequency is low enough to be consistent with the frequency of FH in the general population. In vitro functional studies provide some evidence that the p.Asp221Gly variant may impact protein function (Thormaehlen 2015). In summary, this variant meets criteria to be classified as pathogenic for familial hypercholesterolemia in an autosomal dominant manner based upon presence in affected individuals, low frequency in the general population, computational and functional evidence. The ACMG/AMP Criteria applied: PS4, PM3_Strong, PP3, PS3_Supporting. -
Cardiovascular phenotype Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingAmbry GeneticsMay 24, 2022The p.D221G pathogenic mutation (also known as c.662A>G), located in coding exon 4 of the LDLR gene, results from an A to G substitution at nucleotide position 662. The aspartic acid at codon 221 is replaced by glycine, an amino acid with similar properties. This mutation (referred to as D200G) was originally described in the compound heterozygous state in an Italian American with familial hypercholesterolemia (FH) in conjunction with another pathogenic allele. This patient's LDLR receptor activity was less than 2% of wild-type activity (Hobbs HH et al. Hum Mutat. 1992;1(6):445-66). In addition, this variant was further observed in 79 families and 165 individuals with clinically diagnosed heterozygous FH, which accounted for approximately 7.5% of unrelated individuals in the study (Bertolini S et al. Atherosclerosis. 2013; 227(2):342-8), and has subsequently been detected in additional FH studies (Santos RD et al. J Clin Lipidol. 2017;11(1):160-166; Pirillo A et al. Atheroscler Suppl. 2017;29:17-24). In vitro studies indicate significantly reduced amount of mature protein remaining in the endoplasmic reticulum, and reduced LDLR activity compared to wild type (Li et al. Biochemistry. 2002;41(15):4921-8; Thormaehlen AS et al. PLoS Genet. 2015;11(2):e1004855). Other alterations in the same codon (e.g., p.D221N and p.D221Y) have also been associated with FH. Based on the supporting evidence, this alteration is interpreted as a disease-causing mutation. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.99
BayesDel_addAF
Pathogenic
0.42
D
BayesDel_noAF
Pathogenic
0.60
CADD
Uncertain
26
DANN
Uncertain
1.0
DEOGEN2
Pathogenic
0.95
D;.;.;.
Eigen
Pathogenic
0.98
Eigen_PC
Pathogenic
0.85
FATHMM_MKL
Pathogenic
1.0
D
LIST_S2
Uncertain
0.97
D;D;D;D
M_CAP
Pathogenic
0.90
D
MetaRNN
Pathogenic
0.97
D;D;D;D
MetaSVM
Pathogenic
1.0
D
MutationAssessor
Pathogenic
4.3
H;.;.;H
MutationTaster
Benign
1.0
D;D;D;D;D;D;D
PrimateAI
Uncertain
0.50
T
PROVEAN
Pathogenic
-6.4
D;D;D;D
Sift
Uncertain
0.0010
D;D;D;D
Sift4G
Uncertain
0.0040
D;D;D;D
Polyphen
1.0
D;.;.;.
Vest4
0.81
MVP
1.0
MPC
0.93
ClinPred
0.99
D
GERP RS
5.6
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.7
Varity_R
0.99
gMVP
0.99

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: rs373822756; hg19: chr19-11216244; API