rs387907208

Variant summary

Our verdict is Pathogenic. The variant received 14 ACMG points: 14P and 0B. PM2PM5PP3_ModeratePP5_Very_Strong

The NM_020297.4(ABCC9):​c.3460C>T​(p.Arg1154Trp) variant causes a missense change. The variant was absent in control chromosomes in GnomAD project. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Likely pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R1154Q) has been classified as Pathogenic.

Frequency

Genomes: not found (cov: 32)
Exomes 𝑓: 0.0 ( 0 hom. )
Failed GnomAD Quality Control

Consequence

ABCC9
NM_020297.4 missense

Scores

12
6
1

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:13

Conservation

PhyloP100: 3.66

Publications

23 publications found
Variant links:
Genes affected
ABCC9 (HGNC:60): (ATP binding cassette subfamily C member 9) The protein encoded by this gene is a member of the superfamily of ATP-binding cassette (ABC) transporters. ABC proteins transport various molecules across extra- and intra-cellular membranes. ABC genes are divided into seven distinct subfamilies (ABC1, MDR/TAP, MRP, ALD, OABP, GCN20, White). This protein is a member of the MRP subfamily which is involved in multi-drug resistance. This protein is thought to form ATP-sensitive potassium channels in cardiac, skeletal, and vascular and non-vascular smooth muscle. Protein structure suggests a role as the drug-binding channel-modulating subunit of the extra-pancreatic ATP-sensitive potassium channels. Mutations in this gene are associated with cardiomyopathy dilated type 1O. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Apr 2011]
ABCC9 Gene-Disease associations (from GenCC):
  • hypertrichotic osteochondrodysplasia Cantu type
    Inheritance: AD Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Orphanet, G2P, Labcorp Genetics (formerly Invitae), Ambry Genetics
  • dilated cardiomyopathy 1O
    Inheritance: AD Classification: STRONG, MODERATE, LIMITED Submitted by: Illumina, Ambry Genetics, Labcorp Genetics (formerly Invitae)
  • intellectual disability and myopathy syndrome
    Inheritance: AR Classification: MODERATE, LIMITED Submitted by: Ambry Genetics, Labcorp Genetics (formerly Invitae)
  • acromegaloid facial appearance syndrome
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • familial isolated dilated cardiomyopathy
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • hypertrichosis-acromegaloid facial appearance syndrome
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • Brugada syndrome
    Inheritance: AD Classification: LIMITED Submitted by: Genomics England PanelApp
  • dilated cardiomyopathy
    Inheritance: AD Classification: LIMITED Submitted by: ClinGen
  • atrial fibrillation, familial, 12
    Inheritance: Unknown Classification: LIMITED Submitted by: Labcorp Genetics (formerly Invitae)

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Pathogenic. The variant received 14 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chr12-21842326-C-T is described in ClinVar as Pathogenic. ClinVar VariationId is 31947.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
PP3
MetaRNN computational evidence supports a deleterious effect, 0.904
PP5
Variant 12-21842327-G-A is Pathogenic according to our data. Variant chr12-21842327-G-A is described in ClinVar as Pathogenic/Likely_pathogenic. ClinVar VariationId is 31946.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
ABCC9NM_020297.4 linkc.3460C>T p.Arg1154Trp missense_variant Exon 29 of 40 ENST00000261200.9 NP_064693.2 O60706-2

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
ABCC9ENST00000261200.9 linkc.3460C>T p.Arg1154Trp missense_variant Exon 29 of 40 5 NM_020297.4 ENSP00000261200.4 O60706-2

Frequencies

GnomAD3 genomes
Cov.:
32
GnomAD4 exome
Data not reliable, filtered out with message: AC0
AF:
0.00
AC:
0
AN:
1461632
Hom.:
0
Cov.:
31
AF XY:
0.00
AC XY:
0
AN XY:
727112
African (AFR)
AF:
0.00
AC:
0
AN:
33466
American (AMR)
AF:
0.00
AC:
0
AN:
44722
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26132
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39646
South Asian (SAS)
AF:
0.00
AC:
0
AN:
86236
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
53410
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5768
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
1111872
Other (OTH)
AF:
0.00
AC:
0
AN:
60380
GnomAD4 genome
Cov.:
32
Alfa
AF:
0.00
Hom.:
0

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:13
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Hypertrichotic osteochondrodysplasia Cantu type Pathogenic:5
Dec 15, 2015
Scripps Translational Science Institute, Scripps Health and The Scripps Research Institute
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:research

- -

Jun 08, 2012
OMIM
Significance:Pathogenic
Review Status:no assertion criteria provided
Collection Method:literature only

- -

Feb 25, 2020
Institute of Human Genetics Munich, TUM University Hospital
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Aug 30, 2019
Illumina Laboratory Services, Illumina
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The ABCC9 c.3640C>T (p.Arg1154Trp) variant is a missense variant that is located in the second transmembrane domain of ABCC9. This variant has been reported in a heterozygous de novo state in five unrelated individuals with Cantu syndrome (van Bon et al. 2012; Harakalova et al. 2012; Afifi et al. 2016). The p.Arg1154Trp variant is not reported in the Genome Aggregation Database in a region of good sequence coverage, suggesting that it is a rare variant. Another missense change at the same residue, p.Arg1154Gln, has also been reported to be pathogenic for Cantu syndrome (van Bon et al. 2012; Harakalova et al. 2012). Based on the collective evidence and the application of the ACMG criteria, the p.Arg1154Trp variant is classified as pathogenic for Cantu syndrome. -

-
Suma Genomics
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

not provided Pathogenic:5
Jun 27, 2022
GeneDx
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Not observed at significant frequency in large population cohorts (gnomAD); In silico analysis, which includes protein predictors and evolutionary conservation, supports a deleterious effect; This variant is associated with the following publications: (PMID: 26656175, 28690487, 27316244, 29275331, 31030551, 31828977, 34056838, 32065455, 25790160, 26871653, 22610116, 22608503) -

-
Joint Genome Diagnostic Labs from Nijmegen and Maastricht, Radboudumc and MUMC+
Significance:Pathogenic
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Feb 01, 2023
Revvity Omics, Revvity
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

May 27, 2022
Clinical Genetics Laboratory, Skane University Hospital Lund
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

-
Genome Diagnostics Laboratory, University Medical Center Utrecht
Significance:Pathogenic
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Dilated cardiomyopathy 1O Pathogenic:1
Feb 11, 2023
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This missense change has been observed in individual(s) with clinical features of Cantu syndrome (PMID: 22608503, 22610116, 25790160, 26656175, 26871653). In at least one individual the variant was observed to be de novo. This variant is not present in population databases (gnomAD no frequency). This sequence change replaces arginine, which is basic and polar, with tryptophan, which is neutral and slightly polar, at codon 1154 of the ABCC9 protein (p.Arg1154Trp). ClinVar contains an entry for this variant (Variation ID: 31946). For these reasons, this variant has been classified as Pathogenic. This variant disrupts the p.Arg1154 amino acid residue in ABCC9. Other variant(s) that disrupt this residue have been determined to be pathogenic (PMID: 22608503, 22610116, 23307537). This suggests that this residue is clinically significant, and that variants that disrupt this residue are likely to be disease-causing. Algorithms developed to predict the effect of sequence changes on RNA splicing suggest that this variant may disrupt the consensus splice site. 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 ABCC9 protein function. -

ABCC9-related disorder Pathogenic:1
-
Rady Children's Institute for Genomic Medicine, Rady Children's Hospital San Diego
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant has been previously reported as a heterozygous change in patients with Cantu syndrome (PMID: 22608503, 22610116, 25790160, 26871653, 26656175, 28690487, 31828977, 32065455, 34453476). The c.3460C>T (p.Arg1154Trp) variant is located in a mutational hotspot for pathogenic variations associated with Cantu syndrome (PMID: 22608503). Different amino acid changes at the same residue (p.R1154G and p.R1154Q) have been previously reported in individuals with Cantu syndrome (PMID: 31828977, 32065455, 32371413, 32622958, 23307537). Experimental studies showed that this change caused abnormal potassium channel function (PMID: 22610116). The c.3460C>T (p.Arg1154Trp) variant is absent from the gnomAD population database and thus is presumed to be rare. The c.3460C>T (p.Arg1154Trp) variant affects a moderately conserved amino acid and is predicted by multiple in silico tools to have a deleterious effect on protein function. Based on the available evidence, the c.3460C>T (p.Arg1154Trp) variant is classified as Pathogenic. -

Patent ductus arteriosus;C0025990:Micrognathia;C0149721:Left ventricular hypertrophy;C0240543:Bulbous nose;C0424503:Abnormal facial shape;C0426870:Large hands;C0426886:Tapered finger;C0678230:Epicanthus;C1836542:Depressed nasal bridge;C1842366:Low anterior hairline;C1844820:Joint hypermobility;C1845847:Coarse facial features;C1846423:Thick upper lip vermilion;C2243051:Macrocephaly;C4025871:Abnormality of the face Pathogenic:1
Jun 04, 2018
Knight Diagnostic Laboratories, Oregon Health and Sciences University
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.88
BayesDel_addAF
Pathogenic
0.41
D
BayesDel_noAF
Pathogenic
0.35
CADD
Pathogenic
33
DANN
Uncertain
1.0
DEOGEN2
Pathogenic
0.92
.;.;D
Eigen
Uncertain
0.51
Eigen_PC
Uncertain
0.41
FATHMM_MKL
Pathogenic
0.98
D
LIST_S2
Pathogenic
1.0
D;D;D
M_CAP
Pathogenic
0.40
D
MetaRNN
Pathogenic
0.90
D;D;D
MetaSVM
Pathogenic
0.91
D
MutationAssessor
Pathogenic
3.2
M;.;M
PhyloP100
3.7
PrimateAI
Pathogenic
0.86
D
PROVEAN
Uncertain
-3.8
D;D;D
REVEL
Pathogenic
0.89
Sift
Uncertain
0.022
D;D;D
Sift4G
Uncertain
0.021
D;D;D
Polyphen
1.0
D;.;D
Vest4
0.79
MutPred
0.76
Loss of disorder (P = 0.0359);.;Loss of disorder (P = 0.0359);
MVP
0.96
MPC
1.7
ClinPred
0.99
D
GERP RS
4.1
Varity_R
0.90
gMVP
0.96
Mutation Taster
=2/98
disease causing (ClinVar)

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.31
Details are displayed if max score is > 0.2
DS_DL_spliceai
0.31
Position offset: -13

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Publications

Other links and lift over

dbSNP: rs387907208; hg19: chr12-21995261; COSMIC: COSV53963892; API