rs41364652

Variant summary

Our verdict is Likely benign. Variant got -3 ACMG points: 2P and 5B. PP3_ModerateBP6BS2

The NM_000517.6(HBA2):​c.409C>A​(p.Leu137Met) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000149 in 1,608,190 control chromosomes in the GnomAD database, including 3 homozygotes. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars). Another nucleotide change resulting in the same amino acid substitution has been previously reported as Likely benign in UniProt.

Frequency

Genomes: 𝑓 0.00011 ( 3 hom., cov: 25)
Exomes 𝑓: 0.0000055 ( 0 hom. )

Consequence

HBA2
NM_000517.6 missense

Scores

8
4
4

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications U:2B:1

Conservation

PhyloP100: 1.65
Variant links:
Genes affected
HBA2 (HGNC:4824): (hemoglobin subunit alpha 2) The human alpha globin gene cluster located on chromosome 16 spans about 30 kb and includes seven loci: 5'- zeta - pseudozeta - mu - pseudoalpha-1 - alpha-2 - alpha-1 - theta - 3'. The alpha-2 (HBA2) and alpha-1 (HBA1) coding sequences are identical. These genes differ slightly over the 5' untranslated regions and the introns, but they differ significantly over the 3' untranslated regions. Two alpha chains plus two beta chains constitute HbA, which in normal adult life comprises about 97% of the total hemoglobin; alpha chains combine with delta chains to constitute HbA-2, which with HbF (fetal hemoglobin) makes up the remaining 3% of adult hemoglobin. Alpha thalassemias result from deletions of each of the alpha genes as well as deletions of both HBA2 and HBA1; some nondeletion alpha thalassemias have also been reported. [provided by RefSeq, Jul 2008]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Likely_benign. Variant got -3 ACMG points.

PP3
MetaRNN computational evidence supports a deleterious effect, 0.861
BP6
Variant 16-173580-C-A is Benign according to our data. Variant chr16-173580-C-A is described in ClinVar as [Conflicting_classifications_of_pathogenicity]. Clinvar id is 439118.We mark this variant Likely_benign, oryginal submissions are: {Likely_benign=1, Uncertain_significance=2}.
BS2
High Homozygotes in GnomAd4 at 3 AD,AR,Digenic gene

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
HBA2NM_000517.6 linkc.409C>A p.Leu137Met missense_variant Exon 3 of 3 ENST00000251595.11 NP_000508.1 P69905D1MGQ2

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
HBA2ENST00000251595.11 linkc.409C>A p.Leu137Met missense_variant Exon 3 of 3 1 NM_000517.6 ENSP00000251595.6 P69905

Frequencies

GnomAD3 genomes
AF:
0.000107
AC:
16
AN:
149052
Hom.:
3
Cov.:
25
show subpopulations
Gnomad AFR
AF:
0.000413
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
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:
0.00
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000241
AC:
6
AN:
249166
Hom.:
1
AF XY:
0.0000222
AC XY:
3
AN XY:
134960
show subpopulations
Gnomad AFR exome
AF:
0.000325
Gnomad AMR exome
AF:
0.0000290
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:
0.00
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.00000548
AC:
8
AN:
1459138
Hom.:
0
Cov.:
33
AF XY:
0.00000276
AC XY:
2
AN XY:
725642
show subpopulations
Gnomad4 AFR exome
AF:
0.000217
Gnomad4 AMR exome
AF:
0.0000224
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:
0.00
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
AF:
0.000107
AC:
16
AN:
149052
Hom.:
3
Cov.:
25
AF XY:
0.0000825
AC XY:
6
AN XY:
72752
show subpopulations
Gnomad4 AFR
AF:
0.000413
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.00
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.0000623
Hom.:
0
Bravo
AF:
0.0000491
ESP6500AA
AF:
0.000698
AC:
3
ESP6500EA
AF:
0.00
AC:
0
ExAC
AF:
0.0000331
AC:
4

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Uncertain:2Benign:1
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

not provided Uncertain:1Benign:1
May 05, 2022
ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories
Significance: Likely benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Nov 03, 2020
Quest Diagnostics Nichols Institute San Juan Capistrano
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

not specified Uncertain:1
May 31, 2023
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Variant summary: HBA2 c.409C>A (p.Leu137Met), also known as Hb Chicago, results in a 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 4.9e-05 in 390836 control chromosomes, predominantly at a frequency of 0.00036 within the African or African-American subpopulation in the gnomAD database, including 3 homozygotes. This frequency is somewhat lower than estimated maximum expected for a pathogenic variant in HBA2 causing Alpha Thalassemia (0.0056), allowing no clear conclusions about variant significance. The variant, c.409C>A, has been reported together with the -a3.7 deletion in at least two individuals, however both of these individuals also carried HBB variants, i.e. one of them had HbSS (Molchanova_1994), while the other had HbSC (Hughes_2009), and authors of the later study noted a relatively milder phenotype than expected (Hughes_2009). In addition, the variant was also reported in heterozygous state in individuals who had HbSS (Gu_1993, Ou_1996), though no detailed hematological characterization was presented in these studies. Finally, the variant was also reported in clinically silent carriers (e.g., Bowman_1986). These reports therefore do not provide unequivocal conclusions about association of the variant with Alpha Thalassemia. Publications reported experimental evidence evaluating an impact on protein function, demonstrating that the Leu137Met variant produces a stable hemoglobin variant (e.g., Bowman_1986, Molchanova_1994). The following publications have been ascertained in the context of this evaluation (PMID: 7803274, 34272389, 3781866, 8226092, 19373463, 24200101, 8653909). Two ClinVar submitters (evaluation after 2014) have cited the variant with conflicting assessments: one submitter classified the variant as likely benign, and one submitter classified the variant as uncertain significance. Based on the evidence outlined above, the variant was classified as VUS-possibly benign. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
BayesDel_addAF
Pathogenic
0.18
D
BayesDel_noAF
Pathogenic
0.33
CADD
Benign
19
DANN
Uncertain
0.99
DEOGEN2
Benign
0.090
.;T
Eigen
Uncertain
0.29
Eigen_PC
Benign
0.13
FATHMM_MKL
Uncertain
0.77
D
M_CAP
Pathogenic
0.65
D
MetaRNN
Pathogenic
0.86
D;D
MetaSVM
Pathogenic
0.96
D
PrimateAI
Uncertain
0.64
T
PROVEAN
Benign
-1.9
N;N
REVEL
Pathogenic
0.77
Sift
Pathogenic
0.0
D;D
Sift4G
Pathogenic
0.0010
D;D
Vest4
0.69
MVP
0.96
MPC
2.5
ClinPred
0.86
D
GERP RS
2.4
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.9
gMVP
0.82

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: rs41364652; hg19: chr16-223579; API