rs41407250

Variant summary

Our verdict is Uncertain significance. Variant got 3 ACMG points: 4P and 1B. PP3_StrongBP6

The NM_000558.5(HBA1):​c.49A>G​(p.Lys17Glu) variant causes a missense change. 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. K17M) has been classified as Likely benign.

Frequency

Genomes: š‘“ 0.0 ( 0 hom., cov: 28)
Exomes š‘“: 0.0000042 ( 0 hom. )
Failed GnomAD Quality Control

Consequence

HBA1
NM_000558.5 missense

Scores

7
5
6

Clinical Significance

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

Conservation

PhyloP100: 4.90
Variant links:
Genes affected
HBA1 (HGNC:4823): (hemoglobin subunit alpha 1) 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 Uncertain_significance. Variant got 3 ACMG points.

PP3
MetaRNN computational evidence supports a deleterious effect, 0.986
BP6
Variant 16-176765-A-G is Benign according to our data. Variant chr16-176765-A-G is described in ClinVar as [Conflicting_classifications_of_pathogenicity]. Clinvar id is 15746.We mark this variant Likely_benign, oryginal submissions are: {Likely_benign=2, Uncertain_significance=1}.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
HBA1NM_000558.5 linkc.49A>G p.Lys17Glu missense_variant Exon 1 of 3 ENST00000320868.9 NP_000549.1 P69905D1MGQ2

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
HBA1ENST00000320868.9 linkc.49A>G p.Lys17Glu missense_variant Exon 1 of 3 1 NM_000558.5 ENSP00000322421.5 P69905
HBA1ENST00000472694.1 linkn.68A>G non_coding_transcript_exon_variant Exon 1 of 2 1
HBA1ENST00000487791.1 linkn.18A>G non_coding_transcript_exon_variant Exon 1 of 2 1
HBA1ENST00000397797.1 linkc.-2+3A>G splice_region_variant, intron_variant Intron 1 of 2 2 ENSP00000380899.1 G3V1N2

Frequencies

GnomAD3 genomes
AF:
0.00
AC:
0
AN:
150228
Hom.:
0
Cov.:
28
FAILED QC
Gnomad AFR
AF:
0.00
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
GnomAD4 exome
Data not reliable, filtered out with message: AS_VQSR
AF:
0.00000417
AC:
6
AN:
1437400
Hom.:
0
Cov.:
27
AF XY:
0.00000280
AC XY:
2
AN XY:
713834
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.0000238
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:
0.00000454
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
Data not reliable, filtered out with message: AC0
AF:
0.00
AC:
0
AN:
150228
Hom.:
0
Cov.:
28
AF XY:
0.00
AC XY:
0
AN XY:
73186
Gnomad4 AFR
AF:
0.00
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

ClinVar

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

Submissions by phenotype

not provided Uncertain:1Benign:1
Jan 30, 2024
Quest Diagnostics Nichols Institute San Juan Capistrano
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The HBA1 c.49A>G (p.Lys17Glu) variant has been reported in the published literature to have normal stability, with oxygen equilibrium and kinetic properties similar to wild type Hb A (HbVar (http://globin.cse.psu.edu/cgi-bin/hbvar/counter), PMID: 4444049 (1974)). Individuals who are heterozygous for this variant have a normal clinical presentation (PMIDs: 23806067 (2013), 6085353 (1984), 740406 (1978)). Co-occurrence of this variant with a beta-thalassemia pathogenic variant presented with mild hypochromic microcytic anemia (PMID: 19234704 (2009)). The frequency of this variant in the general population, 0.000006 (1/166854 chromosomes (Genome Aggregation Database, http://gnomad.broadinstitute.org)), is uninformative in the assessment of its pathogenicity. Analysis of this variant using bioinformatics tools for the prediction of the effect of amino acid changes on protein structure and function yielded conflicting predictions that this variant is deleterious or benign. Based on the available information, we are unable to determine the clinical significance of this variant. -

Jun 12, 2024
ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories
Significance: Likely benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The Hb I variant (HBA1 or HBA2: c.49A>G; p.Lys17Glu, also known as Lys16Glu when numbered from the mature protein, rs41407250, HbVar ID: 19) has been reported in the literature as a stable hemoglobin variant present in normal heterozygous individuals (Arya 2009, Lin 2013, Molchanova 1994, HbVar database and references therein) and in an individual without clinical symptoms who also carried an alpha globin deletion (Liebhaber 1984). The variant is listed in ClinVar (Variation ID: 15746) and is only observed on one allele in the Genome Aggregation Database (v2.1.1), indicating it is not a common polymorphism. Computational analyses predict the variant is deleterious (REVEL: 0.732). At least one report suggests this variant may interfere with measurements of Hb A1c in diabetic individuals (Arya 2009). Considering available information, the Hb I variant is considered to be likely benign. References: Link to HbVar database: https://globin.bx.psu.edu/hbvar/menu.html Arya V et al. Rare hemoglobin variant Hb I Philadelphia in North Indian family. Ann Hematol. 2009;88(9):927-929. PMID: 19234704. Liebhaber S et al. Hemoglobin I mutation encoded at both alpha-globin loci on the same chromosome: concerted evolution in the human genome. Science. 1984; 226(4681):1449-51. PMID: 6505702. Lin M et al. Molecular epidemiological survey of hemoglobinopathies in the Wuxi region of Jiangsu Province, eastern China. Hemoglobin. 2013;37(5):454-466. PMID: 23806067. Molchanova TP et al. The differences in quantities of alpha 2- and alpha 1-globin gene variants in heterozygotes. Br J Haematol. 1994;88(2):300-306. PMID: 7803274. -

not specified Benign:1
Aug 04, 2023
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance: Likely benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Variant summary: HBA1 c.49A>G (p.Lys17Glu) results in a conservative amino acid change in the encoded protein sequence. Three of four in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 6e-06 in 166854 control chromosomes (gnomAD). The available data on variant occurrences in the general population are insufficient to allow any conclusion about variant significance. The c.49A>G variant (aka Hemoglobin I, Hb I Burlington), is a known hemoglobin variant with altered electrophoretic mobility, and was reported in several asymptomatic heterozygotes, who had no hematological abnormalities (e.g. Saito_1984, Fleming_1978, Arya_2009, Lin_2013). To our knowledge, no homozygous occurrences, or compound heterozygotes with pathogenic HBA1 (or HBA2) variants were reported. The variant was reported in combination with a pathogenic HBB variant, however this individual was only mildly anemic, with a mild hypochromia and microcytosis, which are consistent with the beta-thalassemia carrier state (Arya_2009). At least one publication reported experimental evidence evaluating an impact on protein function, and demonstrated that the oxygen equilibrium and kinetic properties of hemoglobin I were indistinguishable from those of the WT (McDonald_1974). Studies also reported that the variant might (slightly) interfere with the measurement of glycosylated hemoglobin (HbA1c) that laboratories should be aware of to avoid mismanagement of individuals carrying this variant (Arya_2009, Zechmeister_2022). The following publications have been ascertained in the context of this evaluation (PMID: 4444049, 6085353, 740406, 19234704, 23806067, 35378091, 5480848). Two submitters have provided clinical-significance assessments for this variant in ClinVar after 2014, without evidence for independent evaluation, and classified the variant as likely benign. Based on the evidence outlined above, the variant was classified as likely benign. -

HBA1-related disorder Benign:1
Sep 13, 2024
PreventionGenetics, part of Exact Sciences
Significance: Likely benign
Review Status: no assertion criteria provided
Collection Method: clinical testing

This variant is classified as likely benign based on ACMG/AMP sequence variant interpretation guidelines (Richards et al. 2015 PMID: 25741868, with internal and published modifications). -

HEMOGLOBIN I (TEXAS) Other:1
May 10, 2018
OMIM
Significance: other
Review Status: no assertion criteria provided
Collection Method: literature only

- -

HEMOGLOBIN I (SKAMANIA) Other:1
May 10, 2018
OMIM
Significance: other
Review Status: no assertion criteria provided
Collection Method: literature only

- -

HEMOGLOBIN I (BURLINGTON) Other:1
May 10, 2018
OMIM
Significance: other
Review Status: no assertion criteria provided
Collection Method: literature only

- -

HEMOGLOBIN I Other:1
May 10, 2018
OMIM
Significance: other
Review Status: no assertion criteria provided
Collection Method: literature only

- -

HEMOGLOBIN I (PHILADELPHIA) Other:1
May 10, 2018
OMIM
Significance: other
Review Status: no assertion criteria provided
Collection Method: literature only

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Uncertain
0.35
BayesDel_addAF
Pathogenic
0.25
D
BayesDel_noAF
Pathogenic
0.23
CADD
Benign
22
DANN
Benign
0.69
DEOGEN2
Benign
0.30
T
Eigen
Benign
-0.32
Eigen_PC
Benign
-0.39
FATHMM_MKL
Pathogenic
0.97
D
LIST_S2
Benign
0.82
T
M_CAP
Pathogenic
0.90
D
MetaRNN
Pathogenic
0.99
D
MetaSVM
Uncertain
0.61
D
PrimateAI
Uncertain
0.73
T
PROVEAN
Uncertain
-3.8
D
REVEL
Pathogenic
0.73
Sift
Pathogenic
0.0
D
Sift4G
Uncertain
0.0030
D
Vest4
0.75
MutPred
0.88
Loss of MoRF binding (P = 0.0034);
MVP
0.98
ClinPred
0.49
T
GERP RS
3.3
Varity_R
0.66
gMVP
0.84

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: rs41407250; hg19: chr16-226764; API