rs397508553

Variant summary

Our verdict is Pathogenic. Variant got 11 ACMG points: 11P and 0B. PM1PM2PM5PP3_StrongPP5

The NM_000492.4(CFTR):​c.3409A>G​(p.Met1137Val) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0000416 in 1,612,462 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 Conflicting classifications of pathogenicity (no stars). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. M1137I) has been classified as Uncertain significance.

Frequency

Genomes: 𝑓 0.000046 ( 0 hom., cov: 31)
Exomes 𝑓: 0.000041 ( 0 hom. )

Consequence

CFTR
NM_000492.4 missense

Scores

6
10
3

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications P:3U:5O:1

Conservation

PhyloP100: 9.14
Variant links:
Genes affected
CFTR (HGNC:1884): (CF transmembrane conductance regulator) This gene encodes a member of the ATP-binding cassette (ABC) transporter superfamily. The encoded protein functions as a chloride channel, making it unique among members of this protein family, and controls ion and water secretion and absorption in epithelial tissues. Channel activation is mediated by cycles of regulatory domain phosphorylation, ATP-binding by the nucleotide-binding domains, and ATP hydrolysis. Mutations in this gene cause cystic fibrosis, the most common lethal genetic disorder in populations of Northern European descent. The most frequently occurring mutation in cystic fibrosis, DeltaF508, results in impaired folding and trafficking of the encoded protein. Multiple pseudogenes have been identified in the human genome. [provided by RefSeq, Aug 2017]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 11 ACMG points.

PM1
In a hotspot region, there are 5 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 0 benign, 12 uncertain in NM_000492.4
PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chr7-117614655-T-G is described in ClinVar as [Likely_pathogenic]. Clinvar id is 53735.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
PP3
MetaRNN computational evidence supports a deleterious effect, 0.958
PP5
Variant 7-117614654-A-G is Pathogenic according to our data. Variant chr7-117614654-A-G is described in ClinVar as [Conflicting_classifications_of_pathogenicity]. Clinvar id is 53733.We mark this variant Likely_pathogenic, oryginal submissions are: {not_provided=1, Likely_pathogenic=3, Uncertain_significance=4}.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE UniProt
CFTRNM_000492.4 linkuse as main transcriptc.3409A>G p.Met1137Val missense_variant 21/27 ENST00000003084.11

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Appris UniProt
CFTRENST00000003084.11 linkuse as main transcriptc.3409A>G p.Met1137Val missense_variant 21/271 NM_000492.4 P2P13569-1
ENST00000456270.1 linkuse as main transcriptn.177+1575T>C intron_variant, non_coding_transcript_variant 3

Frequencies

GnomAD3 genomes
AF:
0.0000460
AC:
7
AN:
152150
Hom.:
0
Cov.:
31
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.0000656
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:
0.0000882
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000358
AC:
9
AN:
251148
Hom.:
0
AF XY:
0.0000442
AC XY:
6
AN XY:
135720
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:
0.0000793
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000411
AC:
60
AN:
1460312
Hom.:
0
Cov.:
30
AF XY:
0.0000427
AC XY:
31
AN XY:
726498
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:
0.0000504
Gnomad4 OTH exome
AF:
0.0000663
GnomAD4 genome
AF:
0.0000460
AC:
7
AN:
152150
Hom.:
0
Cov.:
31
AF XY:
0.0000135
AC XY:
1
AN XY:
74328
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.0000656
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.0000882
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.000170
Hom.:
0
Bravo
AF:
0.0000491
TwinsUK
AF:
0.000270
AC:
1
ALSPAC
AF:
0.00
AC:
0
ExAC
AF:
0.0000165
AC:
2
EpiCase
AF:
0.000164
EpiControl
AF:
0.000178

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Pathogenic:3Uncertain:5Other:1
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

Cystic fibrosis Pathogenic:1Uncertain:2Other:1
Uncertain significance, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpJul 27, 2022This sequence change replaces methionine, which is neutral and non-polar, with valine, which is neutral and non-polar, at codon 1137 of the CFTR protein (p.Met1137Val). This variant is present in population databases (rs397508553, gnomAD 0.005%). This missense change has been observed in individual(s) with cystic fibrosis, bronchiectasis, congenital bilateral absence of vas deferens and hypertrypsinaemia (PMID: 7543317, 9921909, 11303517, 12454843, 22678879, 25910067, 26436105). ClinVar contains an entry for this variant (Variation ID: 53733). Algorithms developed to predict the effect of missense changes on protein structure and function (SIFT, PolyPhen-2, Align-GVGD) all suggest that this variant is likely to be tolerated. Experimental studies have shown that this missense change affects CFTR function (PMID: 26436105). 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. -
not provided, no classification providedliterature onlyClinVar Staff, National Center for Biotechnology Information (NCBI)-- -
Uncertain significance, criteria provided, single submitterclinical testingGenome-Nilou LabJul 14, 2021- -
Likely pathogenic, criteria provided, single submitterclinical testingAmbry GeneticsMay 28, 2024The p.M1137V variant (also known as c.3409A>G), located in coding exon 21 of the CFTR gene, results from an A to G substitution at nucleotide position 3409. The methionine at codon 1137 is replaced by valine, an amino acid with highly similar properties. This variant has been detected in individuals with cystic fibrosis or congenital bilateral absence of the vas deferens who carried an additional pathogenic/likely pathogenic variant (Iuliano L et al. Am J Clin Nutr, 2009 Sep;90:477-84; El-Seedy A et al. Hum Mutat, 2012 Nov;33:1557-65; Jabr S et al. Prostaglandins Leukot Essent Fatty Acids, 2013 Aug;89:121-6; Clarke LA et al. Hum Mutat, 2019 Mar;40:326-334). However, it has also been detected in trans with p.F508del in a neonate who had elevated immunoreactive trypsinogen concentration, but normal sweat chloride level (Castellani C et al. J Med Genet, 2001 Mar;38:202-5). Based on internal structural analysis, M1137V is more disruptive than several internally pathogenic variants within the same transmembrane domain (Fiedorczuk K et al. Cell, 2022 Jan;185:158-168.e11). In a functional study, M1137V did not affect protein maturation, but significantly reduced cAMP-activated whole cell chloride currents (Vankeerberghen A et al. FEBS Lett., 1998 Oct;437:1-4). This amino acid position is highly conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. Based on available evidence to date, this variant is unlikely to be causative of classic cystic fibrosis; however, it likely contributes to the development of a CFTR-related disorder. Based on the majority of available evidence to date, this variant is likely to be pathogenic. -
not specified Pathogenic:1Uncertain:1
Likely pathogenic, criteria provided, single submitterclinical testingAl Jalila Children’s Genomics Center, Al Jalila Childrens Speciality HospitalFeb 23, 2020- -
Uncertain significance, criteria provided, single submitterclinical testingWomen's Health and Genetics/Laboratory Corporation of America, LabCorpApr 10, 2024Variant summary: CFTR c.3409A>G (p.Met1137Val) results in a conservative amino acid change located in the transmembrane domain (IPR011527) of 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 3.6e-05 in 252866 control chromosomes (gnomAD v2.1, and publication data). c.3409A>G has been reported in the literature in compound heterozygous individuals affected with cystic fibrosis (CF) who carried a pathogenic variant in trans (e.g. Clarke_2018, Iuliano_2009), but was also reported in an individual with neonatal hypertrypsinaemia, but normal sweat test, who was compound heterozygous for the variant and the delta508 allele (Castellani_2001). The variant was also found in a patient diagnosed with congenital bilateral absence of the vas deferens (CBAVD), who was a compound heterozygote with a complex allele classified as pathogenic for CFTR-related disorders by our lab (El-Seedy_2012). In addition, the variant was reported in individuals affected with CF-related- or unspecified phenotypes (e.g. Durno_2002, El-Seedy_2012, Green_2010, Bombieri_1998, Trujillano_2015, Castellani_2001, Eski_2019 [No PMID]), however without strong evidence for causality (i.e. lack of second CFTR variant and co-segregation evidence). These data indicate that the variant may be associated with disease. At least one publication reported experimental evidence evaluating an impact on protein function, and demonstrated decreased channel activity, but no visible effect on protein maturation (Vankeerberghen_1998). The following publications have been ascertained in the context of this evaluation (PMID: 7543317, 9921909, 8644755, 9804160, 22678879, 11303517, 20932301, 25910067, 12454843, 19587087, 26436105, 11845002, 30488522). ClinVar contains an entry for this variant (Variation ID: 53733). Based on the evidence outlined above, the variant was classified as VUS-possibly pathogenic. -
Bronchiectasis with or without elevated sweat chloride 1 Pathogenic:1
Likely pathogenic, criteria provided, single submitterclinical testingBaylor GeneticsMar 27, 2024- -
Infertility disorder Uncertain:1
Uncertain significance, no assertion criteria providedprovider interpretationMAGI's Lab - Research, MAGI Group-- -
not provided Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingAiLife Diagnostics, AiLife DiagnosticsMar 03, 2022- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Uncertain
0.50
BayesDel_addAF
Pathogenic
0.32
D
BayesDel_noAF
Pathogenic
0.36
CADD
Uncertain
24
DANN
Uncertain
0.99
DEOGEN2
Uncertain
0.64
D;.;.;T;.
Eigen
Uncertain
0.58
Eigen_PC
Uncertain
0.66
FATHMM_MKL
Pathogenic
0.99
D
LIST_S2
Uncertain
0.88
D;D;D;D;D
M_CAP
Pathogenic
0.41
D
MetaRNN
Pathogenic
0.96
D;D;D;D;D
MetaSVM
Uncertain
0.51
D
MutationAssessor
Benign
1.8
L;.;.;.;.
MutationTaster
Benign
1.0
D;D
PrimateAI
Uncertain
0.68
T
PROVEAN
Benign
-1.5
N;.;.;N;.
REVEL
Pathogenic
0.76
Sift
Uncertain
0.0050
D;.;.;D;.
Sift4G
Uncertain
0.013
D;.;.;D;.
Polyphen
0.61
P;.;.;.;.
Vest4
0.94
MutPred
0.91
Gain of helix (P = 0.2294);.;.;.;.;
MVP
1.0
MPC
0.0055
ClinPred
0.33
T
GERP RS
5.9
Varity_R
0.78
gMVP
0.92

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: rs397508553; hg19: chr7-117254708; API