rs375737188

Variant summary

Our verdict is Uncertain significance. The variant received 2 ACMG points: 4P and 2B. PM2PM5BP4_Moderate

The NM_005592.4(MUSK):​c.374G>A​(p.Arg125His) variant causes a missense change. The variant allele was found at a frequency of 0.0000489 in 1,514,038 control chromosomes in the GnomAD database, including 1 homozygotes. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Uncertain significance (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R125L) has been classified as Likely pathogenic.

Frequency

Genomes: 𝑓 0.000046 ( 1 hom., cov: 33)
Exomes 𝑓: 0.000049 ( 0 hom. )

Consequence

MUSK
NM_005592.4 missense

Scores

3
7
9

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:3

Conservation

PhyloP100: 6.91

Publications

2 publications found
Variant links:
Genes affected
MUSK (HGNC:7525): (muscle associated receptor tyrosine kinase) This gene encodes a muscle-specific tyrosine kinase receptor. The encoded protein may play a role in clustering of the acetylcholine receptor in the postsynaptic neuromuscular junction. Mutations in this gene have been associated with congenital myasthenic syndrome. Alternatively spliced transcript variants have been described.[provided by RefSeq, Oct 2009]
MUSK Gene-Disease associations (from GenCC):
  • congenital myasthenic syndrome 9
    Inheritance: AR Classification: STRONG Submitted by: Genomics England PanelApp, Labcorp Genetics (formerly Invitae), PanelApp Australia
  • fetal akinesia deformation sequence 1
    Inheritance: AR Classification: STRONG, SUPPORTIVE Submitted by: Orphanet, Labcorp Genetics (formerly Invitae)
  • postsynaptic congenital myasthenic syndrome
    Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Uncertain_significance. The variant received 2 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chr9-110695418-G-T is described in ClinVar as Conflicting_classifications_of_pathogenicity. ClinVar VariationId is 211541.
BP4
Computational evidence support a benign effect (MetaRNN=0.2501967).

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
MUSKNM_005592.4 linkc.374G>A p.Arg125His missense_variant Exon 4 of 15 ENST00000374448.9 NP_005583.1

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
MUSKENST00000374448.9 linkc.374G>A p.Arg125His missense_variant Exon 4 of 15 5 NM_005592.4 ENSP00000363571.4
MUSKENST00000416899.7 linkc.374G>A p.Arg125His missense_variant Exon 4 of 14 5 ENSP00000393608.3
MUSKENST00000189978.10 linkc.374G>A p.Arg125His missense_variant Exon 4 of 14 5 ENSP00000189978.6
MUSKENST00000374439.1 linkc.68G>A p.Arg23His missense_variant Exon 2 of 4 5 ENSP00000363562.2

Frequencies

GnomAD3 genomes
AF:
0.0000461
AC:
7
AN:
151964
Hom.:
1
Cov.:
33
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
Gnomad ASJ
AF:
0.000865
Gnomad EAS
AF:
0.000193
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0000441
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.0000854
AC:
14
AN:
163840
AF XY:
0.0000461
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.0000896
Gnomad ASJ exome
AF:
0.000718
Gnomad EAS exome
AF:
0.000167
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000434
Gnomad OTH exome
AF:
0.000226
GnomAD4 exome
AF:
0.0000492
AC:
67
AN:
1362074
Hom.:
0
Cov.:
26
AF XY:
0.0000445
AC XY:
30
AN XY:
673552
show subpopulations
African (AFR)
AF:
0.0000323
AC:
1
AN:
30942
American (AMR)
AF:
0.0000593
AC:
2
AN:
33754
Ashkenazi Jewish (ASJ)
AF:
0.000526
AC:
13
AN:
24714
East Asian (EAS)
AF:
0.00
AC:
0
AN:
36648
South Asian (SAS)
AF:
0.0000817
AC:
6
AN:
73454
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
50244
Middle Eastern (MID)
AF:
0.000357
AC:
2
AN:
5596
European-Non Finnish (NFE)
AF:
0.0000381
AC:
40
AN:
1049724
Other (OTH)
AF:
0.0000526
AC:
3
AN:
56998
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.448
Heterozygous variant carriers
0
3
6
9
12
15
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Variant carriers
0
2
4
6
8
10
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
GnomAD4 genome
AF:
0.0000461
AC:
7
AN:
151964
Hom.:
1
Cov.:
33
AF XY:
0.0000674
AC XY:
5
AN XY:
74208
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
41376
American (AMR)
AF:
0.00
AC:
0
AN:
15254
Ashkenazi Jewish (ASJ)
AF:
0.000865
AC:
3
AN:
3468
East Asian (EAS)
AF:
0.000193
AC:
1
AN:
5178
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4814
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10566
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.0000441
AC:
3
AN:
67994
Other (OTH)
AF:
0.00
AC:
0
AN:
2088
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.515
Heterozygous variant carriers
0
1
1
2
2
3
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Genome Het
Genome Hom
Variant carriers
0
2
4
6
8
10
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
Alfa
AF:
0.0000131
Hom.:
0
Bravo
AF:
0.0000491
ExAC
AF:
0.0000253
AC:
3

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:3
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Inborn genetic diseases Uncertain:1
Sep 29, 2023
Ambry Genetics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The c.374G>A (p.R125H) alteration is located in exon 4 (coding exon 4) of the MUSK gene. This alteration results from a G to A substitution at nucleotide position 374, causing the arginine (R) at amino acid position 125 to be replaced by a histidine (H). Based on insufficient or conflicting evidence, the clinical significance of this alteration remains unclear. -

Fetal akinesia deformation sequence 1;C4225368:Congenital myasthenic syndrome 9 Uncertain:1
Aug 24, 2022
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence change replaces arginine, which is basic and polar, with histidine, which is basic and polar, at codon 125 of the MUSK protein (p.Arg125His). The frequency data for this variant in the population databases is considered unreliable, as metrics indicate poor data quality at this position in the gnomAD database. This variant has not been reported in the literature in individuals affected with MUSK-related conditions. ClinVar contains an entry for this variant (Variation ID: 542747). 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 MUSK protein function. 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. -

Congenital myasthenic syndrome 9 Uncertain:1
Jan 12, 2018
Illumina Laboratory Services, Illumina
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score, this variant could not be ruled out of causing disease and therefore its association with disease required further investigation. A literature search was performed for the gene, cDNA change, and amino acid change (if applicable). No publications were found based on this search. This variant was therefore classified as a variant of unknown significance for this disease. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Uncertain
0.38
BayesDel_addAF
Uncertain
0.085
D
BayesDel_noAF
Benign
-0.12
CADD
Pathogenic
33
DANN
Pathogenic
1.0
DEOGEN2
Benign
0.15
T;.;.;.;.
Eigen
Pathogenic
0.71
Eigen_PC
Pathogenic
0.76
FATHMM_MKL
Uncertain
0.97
D
LIST_S2
Uncertain
0.97
D;D;D;D;D
M_CAP
Benign
0.073
D
MetaRNN
Benign
0.25
T;T;T;T;T
MetaSVM
Benign
-0.34
T
MutationAssessor
Benign
1.6
L;.;L;.;.
PhyloP100
6.9
PrimateAI
Uncertain
0.60
T
PROVEAN
Benign
-1.7
N;N;N;.;.
REVEL
Uncertain
0.32
Sift
Uncertain
0.0020
D;D;D;.;.
Sift4G
Benign
0.097
T;T;T;T;T
Polyphen
1.0
D;.;.;.;.
Vest4
0.60
MVP
0.78
MPC
0.77
ClinPred
0.29
T
GERP RS
6.0
Varity_R
0.37
gMVP
0.64
Mutation Taster
=65/35
polymorphism

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

Other links and lift over

dbSNP: rs375737188; hg19: chr9-113457698; COSMIC: COSV51885774; API