rs397517349
Variant summary
Our verdict is Uncertain significance. Variant got 4 ACMG points: 4P and 0B. PM3PP1PM2_Supporting
This summary comes from the ClinGen Evidence Repository: The variant c.6614C>T (NM_022124.6(CDH23):c.6614C>T (p.Pro2205Leu)) in CDH23 is a missense variant predicted to cause substitution of proline by leucine at amino acid 2205 (p.Pro2205Leu). The highest population minor allele frequency in gnomAD v4.0.0 is 0.000002920 (8/1179896 alleles) in the European (non-Finnish) population, which is lower than the ClinGen Hearing Loss VCEP threshold (<0.00007) for PM2_Supporting, meeting this criterion (PM2_Supporting). The computational predictor REVEL gives a score of 0.342, which is neither above nor below the thresholds predicting a damaging or benign impact on CDH23 function. This variant has been detected in at least 8 individuals with autosomal recessive hearing loss. All of these individuals were homozygous for the variant (1.0 pts; PMIDs: 28501645, 32747562 & LMM Internal Data (SCV000062934.5); PM3). There was a common haplotype found between five affected individuals from three families, one of which had three affected siblings, including a set of twins. Personal communication confirmed the three siblings were sequenced; however, it was not apparent whether the twins were dizygotic or monozygotic and therefore only one twin was counted toward segregation (PP1_Supporting; 28501645). In summary, this variant meets the criteria to be classified as uncertain significance for autosomal recessive Usher syndrome, based on the ACMG/AMP criteria applied, as specified by the ClinGen Hearing Loss VCEP (PM2_Supporting, PM3, PP1_Supporting; Version 2; 11/15/23). LINK:https://erepo.genome.network/evrepo/ui/classification/CA137541/MONDO:0019501/005
Frequency
Consequence
NM_022124.6 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Uncertain_significance. Variant got 4 ACMG points.
Transcripts
RefSeq
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | MANE | Protein | UniProt |
---|---|---|---|---|---|---|---|---|
CDH23 | NM_022124.6 | c.6614C>T | p.Pro2205Leu | missense_variant | 48/70 | ENST00000224721.12 | NP_071407.4 |
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | TSL | MANE | Protein | Appris | UniProt |
---|---|---|---|---|---|---|---|---|---|---|
CDH23 | ENST00000224721.12 | c.6614C>T | p.Pro2205Leu | missense_variant | 48/70 | 5 | NM_022124.6 | ENSP00000224721.9 |
Frequencies
GnomAD3 genomes AF: 0.0000131 AC: 2AN: 152188Hom.: 0 Cov.: 31
GnomAD3 exomes AF: 0.00000402 AC: 1AN: 248748Hom.: 0 AF XY: 0.00 AC XY: 0AN XY: 134958
GnomAD4 exome AF: 0.00000821 AC: 12AN: 1461514Hom.: 0 Cov.: 31 AF XY: 0.0000110 AC XY: 8AN XY: 727042
GnomAD4 genome AF: 0.0000131 AC: 2AN: 152188Hom.: 0 Cov.: 31 AF XY: 0.0000135 AC XY: 1AN XY: 74338
ClinVar
Submissions by phenotype
Usher syndrome Pathogenic:1Uncertain:1
Uncertain significance, reviewed by expert panel | curation | ClinGen Hearing Loss Variant Curation Expert Panel | Nov 15, 2023 | The variant c.6614C>T (NM_022124.6(CDH23):c.6614C>T (p.Pro2205Leu)) in CDH23 is a missense variant predicted to cause substitution of proline by leucine at amino acid 2205 (p.Pro2205Leu). The highest population minor allele frequency in gnomAD v4.0.0 is 0.000002920 (8/1179896 alleles) in the European (non-Finnish) population, which is lower than the ClinGen Hearing Loss VCEP threshold (<0.00007) for PM2_Supporting, meeting this criterion (PM2_Supporting). The computational predictor REVEL gives a score of 0.342, which is neither above nor below the thresholds predicting a damaging or benign impact on CDH23 function. This variant has been detected in at least 8 individuals with autosomal recessive hearing loss. All of these individuals were homozygous for the variant (1.0 pts; PMIDs: 28501645, 32747562 & LMM Internal Data (SCV000062934.5); PM3). There was a common haplotype found between five affected individuals from three families, one of which had three affected siblings, including a set of twins. Personal communication confirmed the three siblings were sequenced; however, it was not apparent whether the twins were dizygotic or monozygotic and therefore only one twin was counted toward segregation (PP1_Supporting; 28501645). In summary, this variant meets the criteria to be classified as uncertain significance for autosomal recessive Usher syndrome, based on the ACMG/AMP criteria applied, as specified by the ClinGen Hearing Loss VCEP (PM2_Supporting, PM3, PP1_Supporting; Version 2; 11/15/23). - |
Pathogenic, criteria provided, single submitter | clinical testing | Women's Health and Genetics/Laboratory Corporation of America, LabCorp | Jun 05, 2023 | Variant summary: CDH23 c.6614C>T (p.Pro2205Leu) results in a non-conservative amino acid change in 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 4e-06 in 248748 control chromosomes (gnomAD v2), absent in 316 control individuals from Middle Eastern (gnomAD v3) and absent in 1309 Palestinian controls (Rayyan _2020). c.6614C>T has been reported in the literature in multiple individuals affected with Non-syndromic hearing loss, including being seen phase unknown along with a VUS missense in a sporadic case (Sloan_Heggen_2016), in homozygous state in 5 patients from 3 consanguineous pedigrees in Qatar (Alkowari_2017), and in homozygous state in 2 patients from 2 Palestinian families (Rayyan _2020). Haplotype analysis of the patients revealed a same haplotype across those patients from Qatar, which support a common ancestor in those patients or a founder effect of this variant (Alkowari_2017). These data indicate that the variant is very likely to be associated with disease. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. The following publications have been ascertained in the context of this evaluation (PMID: 28501645, 29048421, 32747562, 26969326). Five clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 among which four (including the ClinGen Hearing Loss Variant Curation Expert Panel) classified the variant as VUS, and one as likely pathogenic. Some submitters classifying the variant as uncertain significance cited the expert panel assertion and cited overlapping but not identical evidence captured in the context of this ascertainment. Based on the additional emerging evidence outlined above, the variant was classified as pathogenic. - |
not provided Pathogenic:1Uncertain:1
Likely pathogenic, criteria provided, single submitter | research | Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center | - | - - |
Uncertain significance, criteria provided, single submitter | clinical testing | GeneDx | Nov 25, 2024 | 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: 25356970, 34426522, 31860473, 34338889, 32747562, 26969326, 38844983, 38517009, 38378725, 28501645) - |
Autosomal recessive nonsyndromic hearing loss 12 Pathogenic:1Uncertain:1
Likely pathogenic, criteria provided, single submitter | research | King Laboratory, University of Washington | Aug 01, 2020 | CDH23 c.6614C>T, p.E1071K alters a highly conserved residue of CDH23. The variant is homozygous in 3 children from 2 Palestinian families with moderate pre-lingual hearing loss (Abu Rayyan 2020). It was found also in 6 Palestinian children in compound heterozygosity with CDH23 c.1675C>T. The variant is absent from 1300 Palestinian controls and from gnomAD v2.1.1. This variant was previously interpreted as a VUS by the Expert Panel due to few Arab population controls. We suggest reclassification to LP given perfect co-segregation with hearing loss in additional families (both as a homozygote and as a compound heterozygote) and its absence from 1300 ancestry-matched controls - |
Uncertain significance, criteria provided, single submitter | clinical testing | Baylor Genetics | Aug 23, 2019 | This variant was determined to be of uncertain significance according to ACMG Guidelines, 2015 [PMID:25741868]. - |
Pituitary adenoma 5, multiple types Pathogenic:1
Likely pathogenic, criteria provided, single submitter | clinical testing | Baylor Genetics | Mar 14, 2024 | - - |
Usher syndrome type 1D Pathogenic:1
Likely pathogenic, criteria provided, single submitter | clinical testing | Baylor Genetics | - | - - |
Inborn genetic diseases Uncertain:1
Uncertain significance, criteria provided, single submitter | clinical testing | Ambry Genetics | - | Overall WES conclusion for patient, including all identified alterations: Uncertain - |
Rare genetic deafness Uncertain:1
Uncertain significance, criteria provided, single submitter | clinical testing | Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine | Feb 02, 2023 | The p.Pro2205Leu variant in CDH23 has been reported in 3 individuals with hearing loss and 1 individual with Usher syndrome, 3 of whom were of Middle Eastern ancestry (Syrian, Saudi Arabian, Kuwaiti; Sloan-Heggen 2016, LMM data). Of the three individuals with hearing loss, one was homozygous, one individual was heterozygous, and one was compound heterozygous with a second CDH23 variant of uncertain significance. The individual with Usher syndrome was homozygous for a pathogenic variant in another gene that could account for the disease. This variant was absent from large population studies, though none of these studies specify frequency data for individuals of Middle Eastern ancestry. Computational prediction tools and conservation analyses suggest that this variant may impact the protein, though this information is not predictive enough to determine pathogenicity. In summary, the clinical significance of this variant is uncertain. ACMG/AMP Criteria applied: PM3_supporting. - |
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at