rs397508609
Variant summary
Our verdict is Pathogenic. Variant got 16 ACMG points: 16P and 0B. PM1PM2PP3_StrongPP5_Very_Strong
The NM_000492.4(CFTR):c.377G>A(p.Gly126Asp) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.00000411 in 1,461,460 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 Pathogenic (★★★).
Frequency
Consequence
NM_000492.4 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Pathogenic. Variant got 16 ACMG points.
Transcripts
RefSeq
Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt |
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CFTR | NM_000492.4 | c.377G>A | p.Gly126Asp | missense_variant | Exon 4 of 27 | ENST00000003084.11 | NP_000483.3 |
Ensembl
Frequencies
GnomAD3 genomes Cov.: 32
GnomAD3 exomes AF: 0.0000120 AC: 3AN: 250898Hom.: 0 AF XY: 0.0000148 AC XY: 2AN XY: 135582
GnomAD4 exome AF: 0.00000411 AC: 6AN: 1461460Hom.: 0 Cov.: 31 AF XY: 0.00000275 AC XY: 2AN XY: 727038
GnomAD4 genome Cov.: 32
ClinVar
Submissions by phenotype
Cystic fibrosis Pathogenic:7Other:1
The p.G126D variant (also known as c.377G>A), located in coding exon 4 of the CFTR gene, results from a G to A substitution at nucleotide position 377. The glycine at codon 126 is replaced by aspartic acid, an amino acid with similar properties. This variant was originally reported in an individual with cystic fibrosis who had p.F508del on the other chromosome (Wagner K et al. Hum. Hered.;44:56-7). p.G126D was also detected in another patient with a different pathogenic mutation (Lucarelli M et al. Mol. Med., 2015 Apr;21:257-75). Furthermore, average sweat chloride in patients with this variant is 90 mEq/L, and it has significantly low chloride conductance in CFBE cell lines (The Clinical and Functional TRanslation of CFTR (CFTR2); available at http://cftr2.org. Accessed <May 20, 2019>). Based on data from gnomAD, the A allele has an overall frequency of approximately 0.001% (3/250898). 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 the majority of available evidence to date, this variant is likely to be pathogenic. -
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This variant was identified in 2 unrelated patients with a clinically confirmed diagnosis of cystic fibrosis. The variant was classified in the context of a project re-classifying variants in the German Cystic Fibrosis Registry (Muko.e.V.). Link: https://www.muko.info/angebote/qualitaetsmanagement/register/cf-einrichtungen/mukoweb. Criteria applied: PM2_SUP, PM3_STR, PM5, PP3, PP4 -
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This sequence change replaces glycine, which is neutral and non-polar, with aspartic acid, which is acidic and polar, at codon 126 of the CFTR protein (p.Gly126Asp). This variant is present in population databases (rs397508609, gnomAD 0.003%). This missense change has been observed in individuals with clinical feature of CFTR-related conditions (PMID: 8163293, 10439967, 23974870, 25042876, 27214204). ClinVar contains an entry for this variant (Variation ID: 53812). 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 CFTR protein function with a positive predictive value of 80%. For these reasons, this variant has been classified as Pathogenic. -
Variant summary: CFTR c.377G>A (p.Gly126Asp) results in a non-conservative amino acid change located in the ABC transporter type 1, transmembrane domain (IPR011527) of the encoded protein sequence. Five of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 1.2e-05 in 250898 control chromosomes. c.377G>A has been reported in the literature as presumed or confirmed compound heterozygous genotypes in individuals affected with Cystic Fibrosis and/or Pseudo Bartters syndrome as well as in cohorts from the Canadian CFTR registry (e.g. Wagner_1994, Desai_2018, Terzik_2019, Palladino_2020, AnghelDelia_2024), in addition to settings of newborn screening (example, Lucarelli_2017, Salinas_2016). 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 resulted in approximately 10% of normal chloride channel conductance relative to wild type (e.g. Bihler_2024). The following publications have been ascertained in the context of this evaluation (PMID: 39296431, 38388235, 11504857, 29944384, 28736296, 33195651, 27214204, 31523618, 8163293). ClinVar contains an entry for this variant (Variation ID: 53812). Based on the evidence outlined above, the variant was classified as pathogenic. -
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not provided Pathogenic:3
Observed multiple times with a pathogenic variant in unrelated individuals with cystic fibrosis or CBAVD in published literature, but it is not known whether the variants occurred on the same (in cis) or on different (in trans) chromosomes in all cases (PMID: 28603918, 33195651, 27214204); Not observed at significant frequency in large population cohorts (gnomAD); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; This variant is associated with the following publications: (PMID: 23974870, 15463907, 11504857, 8163293, 28603918, 33195651, 28736296, 31523618, 29944384, 10439967, 34405919, 25910067, 27214204, 25042876) -
CFTR: PM3:Very Strong, PM2, PM5, PP3 -
The CFTR c.377G>A; p.Gly126Asp variant (rs397508609) is reported in the literature in several compound heterozygous individuals affected with cystic fibrosis (see link to CF database, Desai 2018, Liechti-Gallati 1999, Lucarelli 2015, Palladino 2020, Salinas 2016, Terzic 2019, Wagner 1994). This variant is reported in ClinVar (Variation ID: 53812). This variant is only observed on three alleles in the Genome Aggregation Database, indicating it is not a common polymorphism. Computational analyses predict that this variant is deleterious (REVEL: 0.881). Based on available information, this variant is considered to be likely pathogenic. References: Link to CFTR2 database: http://cftr2.org/ Desai S et al. Clinical Characteristics and Predictors of Reduced Survival for Adult-diagnosed Cystic Fibrosis. Analysis of the Canadian CF Registry. Ann Am Thorac Soc. 2018 Oct;15(10):1177-1185. PMID: 29944384. Liechti-Gallati S et al. Two buffer PAGE system-based SSCP/HD analysis: a general protocol for rapid and sensitive mutation screening in cystic fibrosis and any other human genetic disease. Eur J Hum Genet. 1999 Jul;7(5):590-8. PMID: 10439967. Lucarelli M et al. A Genotypic-Oriented View of CFTR Genetics Highlights Specific Mutational Patterns Underlying Clinical Macrocategories of Cystic Fibrosis. Mol Med. 2015 Apr 21;21(1):257-75. PMID: 25910067. Palladino F et al. Dehydrated patient without clinically evident cause: A case report. World J Clin Cases. 2020 Oct 26;8(20):4838-4843. PMID: 33195651. Salinas DB et al. Benign and Deleterious Cystic Fibrosis Transmembrane Conductance Regulator Mutations Identified by Sequencing in Positive Cystic Fibrosis Newborn Screen Children from California. PLoS One. 2016 May 23;11(5):e0155624. PMID: 27214204. Terzic M et al. Cystic Fibrosis Mutation Spectrum in North Macedonia: A Step Toward Personalized Therapy. Balkan J Med Genet. 2019 Aug 28;22(1):35-40. PMID: 31523618. Wagner K et al. A new missense mutation G126D in exon 4 of the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Hum Hered. 1994 Jan-Feb;44(1):56-7. PMID: 8163293. -
CFTR-related disorder Pathogenic:1
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Cystic fibrosis;C0403814:Congenital bilateral aplasia of vas deferens from CFTR mutation Pathogenic:1
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Cystic fibrosis;C0238339:Hereditary pancreatitis;C0403814:Congenital bilateral aplasia of vas deferens from CFTR mutation;C2749757:Bronchiectasis with or without elevated sweat chloride 1 Pathogenic:1
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Bronchiectasis with or without elevated sweat chloride 1 Pathogenic:1
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Cystic fibrosis;C5924204:CFTR-related disorder Pathogenic:1
the variant causes a phenotype but regarding our data, we can't formally attribute it to CF, CFTR-RD or both -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at