rs41557217

Variant summary

Our verdict is Benign. The variant received -9 ACMG points: 0P and 9B. BP4_StrongBP6BS1

The NM_000179.3(MSH6):​c.663A>C​(p.Glu221Asp) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.000748 in 1,612,862 control chromosomes in the GnomAD database, including 1 homozygotes. In-silico tool predicts a benign outcome for this variant. 14/22 in silico tools predict a benign 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 ClinVar. Another variant affecting the same amino acid position, but resulting in a different missense (i.e. E221K) has been classified as Uncertain significance.

Frequency

Genomes: š‘“ 0.00063 ( 1 hom., cov: 32)
Exomes š‘“: 0.00076 ( 0 hom. )

Consequence

MSH6
NM_000179.3 missense

Scores

2
17

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications U:5B:20O:1

Conservation

PhyloP100: -0.266

Publications

33 publications found
Variant links:
Genes affected
MSH6 (HGNC:7329): (mutS homolog 6) This gene encodes a member of the DNA mismatch repair MutS family. In E. coli, the MutS protein helps in the recognition of mismatched nucleotides prior to their repair. A highly conserved region of approximately 150 aa, called the Walker-A adenine nucleotide binding motif, exists in MutS homologs. The encoded protein heterodimerizes with MSH2 to form a mismatch recognition complex that functions as a bidirectional molecular switch that exchanges ADP and ATP as DNA mismatches are bound and dissociated. Mutations in this gene may be associated with hereditary nonpolyposis colon cancer, colorectal cancer, and endometrial cancer. Transcripts variants encoding different isoforms have been described. [provided by RefSeq, Jul 2013]
FBXO11 (HGNC:13590): (F-box protein 11) This gene encodes a member of the F-box protein family which is characterized by an approximately 40 amino acid motif, the F-box. The F-box proteins constitute one of the four subunits of ubiquitin protein ligase complex called SCFs (SKP1-cullin-F-box), which function in phosphorylation-dependent ubiquitination. The F-box proteins are divided into 3 classes: Fbws containing WD-40 domains, Fbls containing leucine-rich repeats, and Fbxs containing either different protein-protein interaction modules or no recognizable motifs. The protein encoded by this gene belongs to the Fbxs class. It can function as an arginine methyltransferase that symmetrically dimethylates arginine residues, and it acts as an adaptor protein to mediate the neddylation of p53, which leads to the suppression of p53 function. This gene is known to be down-regulated in melanocytes from patients with vitiligo, a skin disorder that results in depigmentation. Polymorphisms in this gene are associated with chronic otitis media with effusion and recurrent otitis media (COME/ROM), a hearing loss disorder, and the knockout of the homologous mouse gene results in the deaf mouse mutant Jeff (Jf), a single gene model of otitis media. Alternatively spliced transcript variants encoding distinct isoforms have been identified for this gene. [provided by RefSeq, Jun 2010]
FBXO11 Gene-Disease associations (from GenCC):
  • intellectual developmental disorder with dysmorphic facies and behavioral abnormalities
    Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: Labcorp Genetics (formerly Invitae), Ambry Genetics, G2P

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Benign. The variant received -9 ACMG points.

BP4
Computational evidence support a benign effect (MetaRNN=0.031133354).
BP6
Variant 2-47798646-A-C is Benign according to our data. Variant chr2-47798646-A-C is described in ClinVar as Conflicting_classifications_of_pathogenicity. ClinVar VariationId is 89552.
BS1
Variant frequency is greater than expected in population amr. GnomAd4 allele frequency = 0.00063 (96/152354) while in subpopulation AMR AF = 0.000915 (14/15294). AF 95% confidence interval is 0.000716. There are 1 homozygotes in GnomAd4. There are 53 alleles in the male GnomAd4 subpopulation. Median coverage is 32. This position passed quality control check.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
MSH6NM_000179.3 linkc.663A>C p.Glu221Asp missense_variant Exon 4 of 10 ENST00000234420.11 NP_000170.1 P52701-1Q3SWU9

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
MSH6ENST00000234420.11 linkc.663A>C p.Glu221Asp missense_variant Exon 4 of 10 1 NM_000179.3 ENSP00000234420.5 P52701-1

Frequencies

GnomAD3 genomes
AF:
0.000631
AC:
96
AN:
152236
Hom.:
1
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.000313
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.000917
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.000192
Gnomad SAS
AF:
0.000621
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00633
Gnomad NFE
AF:
0.000897
Gnomad OTH
AF:
0.000955
GnomAD2 exomes
AF:
0.000706
AC:
176
AN:
249320
AF XY:
0.000801
show subpopulations
Gnomad AFR exome
AF:
0.000247
Gnomad AMR exome
AF:
0.000376
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.0000491
Gnomad NFE exome
AF:
0.00107
Gnomad OTH exome
AF:
0.000491
GnomAD4 exome
AF:
0.000760
AC:
1110
AN:
1460508
Hom.:
0
Cov.:
34
AF XY:
0.000801
AC XY:
582
AN XY:
726568
show subpopulations
African (AFR)
AF:
0.0000597
AC:
2
AN:
33480
American (AMR)
AF:
0.000470
AC:
21
AN:
44722
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26132
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39700
South Asian (SAS)
AF:
0.00123
AC:
106
AN:
86248
European-Finnish (FIN)
AF:
0.0000576
AC:
3
AN:
52124
Middle Eastern (MID)
AF:
0.000696
AC:
4
AN:
5750
European-Non Finnish (NFE)
AF:
0.000846
AC:
941
AN:
1111972
Other (OTH)
AF:
0.000547
AC:
33
AN:
60380
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.483
Heterozygous variant carriers
0
61
122
183
244
305
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Variant carriers
0
34
68
102
136
170
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
GnomAD4 genome
AF:
0.000630
AC:
96
AN:
152354
Hom.:
1
Cov.:
32
AF XY:
0.000711
AC XY:
53
AN XY:
74510
show subpopulations
African (AFR)
AF:
0.000313
AC:
13
AN:
41596
American (AMR)
AF:
0.000915
AC:
14
AN:
15294
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3472
East Asian (EAS)
AF:
0.000193
AC:
1
AN:
5190
South Asian (SAS)
AF:
0.000621
AC:
3
AN:
4828
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10624
Middle Eastern (MID)
AF:
0.00680
AC:
2
AN:
294
European-Non Finnish (NFE)
AF:
0.000897
AC:
61
AN:
68028
Other (OTH)
AF:
0.000945
AC:
2
AN:
2116
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.513
Heterozygous variant carriers
0
5
10
14
19
24
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Genome Het
Variant carriers
0
2
4
6
8
10
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
Alfa
AF:
0.000739
Hom.:
1
Bravo
AF:
0.000646
TwinsUK
AF:
0.000270
AC:
1
ALSPAC
AF:
0.000778
AC:
3
ESP6500AA
AF:
0.00
AC:
0
ESP6500EA
AF:
0.00128
AC:
11
ExAC
AF:
0.000618
AC:
75
Asia WGS
AF:
0.000289
AC:
1
AN:
3478
EpiCase
AF:
0.00131
EpiControl
AF:
0.000830

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Uncertain:5Benign:20Other:1
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

not provided Uncertain:1Benign:6
Nov 03, 2021
Institute for Clinical Genetics, University Hospital TU Dresden, University Hospital TU Dresden
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

May 01, 2024
CeGaT Center for Human Genetics Tuebingen
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

MSH6: BP1, BP4, BP5 -

Apr 16, 2021
GeneDx
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant is associated with the following publications: (PMID: 27153395, 28767289, 17453009, 18269114, 24728327, 23621914, 26300997, 22290698, 21153778, 23047549, 26898890, 26333163, 17344846, 28531214, 28481244, 28874130, 29575718, 18301448, 31159747, 32854451) -

Oct 28, 2016
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Variant summary: The MSH6 c.663A>C (p.Glu221Asp) variant causes a missense change involving a non-conserved nucleotide with 5/5 in silico tools predict a benign outcome, although these predictions have yet to be functionally assessed. The variant of interest was observed in the large, broad control population, ExAC, with an allele frequency of 75/119664 (1/1595), which is approximately 4 times the estimated maximal expected allele frequency for a pathogenic MSH6 variant of 1/7037 (0.0001421), suggesting this variant is likely a benign polymorphism. The variant of interest has been reported in multiple affected individuals via publications. In addition, multiple clinical diagnostic laboratories/databases cite the variant as "likely benign/benign." Therefore, taking all available lines of evidence into consideration, the variant of interest has been classified as Benign. -

Oct 12, 2017
PreventionGenetics, part of Exact Sciences
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Jul 08, 2024
ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Dec 28, 2022
Quest Diagnostics Nichols Institute San Juan Capistrano
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Hereditary cancer-predisposing syndrome Benign:6
Aug 01, 2018
GeneKor MSA
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Aug 30, 2017
True Health Diagnostics
Significance:Likely benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Jul 01, 2014
Ambry Genetics
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This alteration is classified as benign based on a combination of the following: seen in unaffected individuals, population frequency, intact protein function, lack of segregation with disease, co-occurrence, RNA analysis, in silico models, amino acid conservation, lack of disease association in case-control studies, and/or the mechanism of disease or impacted region is inconsistent with a known cause of pathogenicity. -

Jun 24, 2021
Sema4, Sema4
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:curation

- -

Nov 20, 2024
Institute for Biomarker Research, Medical Diagnostic Laboratories, L.L.C.
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The p.Glu221Asp variant is not predicted to introduce a novel splice site by any splice site algorithm. The p.Glu221Asp missense variant is predicted to be tolerated by both SIFT or PolyPhen2. The aspartic acid residue at codon 221 of MSH6 is present in Prairie vole and 2 other mammalian species. The nucleotide c.663 in MSH6 is not conserved according to a GERP++ and PhyloP analysis of 100 vertebrates. For these reasons, this variant has been classified as Benign. -

Oct 09, 2024
Color Diagnostics, LLC DBA Color Health
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

not specified Uncertain:1Benign:3Other:1
-
Mayo Clinic Laboratories, Mayo Clinic
Significance:Uncertain significance
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Jan 15, 2021
Genetic Services Laboratory, University of Chicago
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Feb 16, 2025
Laboratory of Genetics, Children's Clinical University Hospital Latvia
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Sep 19, 2013
ITMI
Significance:not provided
Review Status:no classification provided
Collection Method:reference population

- -

Mar 04, 2025
Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Lynch syndrome 5 Uncertain:2Benign:1
May 01, 2019
Illumina Laboratory Services, Illumina
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed as part of a predisposition screen in an ostensibly healthy population. A literature search was performed for the gene, cDNA change, and amino acid change (where applicable). Publications were found based on this search. However, the evidence from the literature, in combination with allele frequency data from public databases where available, was not sufficient to rule this variant in or out of causing disease. Therefore, this variant is classified as a variant of unknown significance. -

Dec 19, 2024
Myriad Genetics, Inc.
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant is considered benign. This variant has been observed in trans with a known pathogenic variant in one or more individuals lacking clinical features consistent with gene-specific recessive disease. This variant has been observed at a population frequency that is significantly greater than expected given the associated disease prevalence and penetrance. -

Nov 01, 2016
Center for Human Genetics, Inc, Center for Human Genetics, Inc
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Abnormality of the ovary Uncertain:1
Aug 16, 2021
Medical Genetics Laboratory, Umraniye Training and Research Hospital, University of Health Sciences
Significance:Uncertain significance
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Carcinoma of colon Benign:1
-
Department of Pathology and Laboratory Medicine, Sinai Health System
Significance:Likely benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

The MSH6 p.Glu221Asp variant was identified in 7 of 1567 proband chromosomes (frequency: 0.004) from individuals or families with colorectal cancer (Devlin 2008, Steinke 2008, Bodian 2014, Liccardo 2017, Overbeek 2007, Simbolo 2015). The variant was also identified in dbSNP (ID: rs41557217) as "With Uncertain significance, other allele ", ClinVar (classified as benign by Invitae, Ambry Genetics and one clinical laboratory; as likely benign by GeneDx and four clinical laboratories; as uncertain significance by tree submitters), COGR, Cosmic (1x in Haematopoietic and lymphoid tissue), MutDB, UMD-LSDB (3x as unclassified variant), Mismatch Repair Genes Variant Database (1x), and in Insight Hereditary Tumors Database (2x VUS). The variant was not identified in Zhejiang University Database. The variant was identified in control databases in 189 of 275098 chromosomes at a frequency of 0.0007 increasing the likelihood this could be a low frequency benign variant (Genome Aggregation Database Feb 27, 2017). The variant was observed in the following populations: African in 6 of 23956 chromosomes (freq: 0.0003), Other in 3 of 6442 chromosomes (freq: 0.0005), Latino in 12 of 34380 chromosomes (freq: 0.0003), European in 133 of 126092 chromosomes (freq: 0.001), East Asian in 1 of 18824 chromosomes (freq: 0.00005), Finnish in 1 of 24524 chromosomes (freq: 0.00004), and South Asian in 33 of 30752 chromosomes (freq: 0.001), while the variant was not observed in the Ashkenazi Jewish population. The p.Glu221 residue is conserved in mammals but not in more distantly related organisms however computational analyses (PolyPhen-2, SIFT, AlignGVGD, BLOSUM, MutationTaster) do not suggest a high likelihood of impact to the protein; this information is not predictive enough to rule out pathogenicity. In addition, in functional assay using oligonucleotide-directed mutagenesis screen the variant was not identified as MMR abrogating; the variant was found in patients who also harbored a second, known pathogenic mutation in one of the DNA MMR genes that was likely causative for the LS phenotype (Houlleberghs 2017). The p.Glu221Asp was also detected in a second patient who was 83 years old and did not have a family history suspicious for LS. The observation of this variant with a co-occurring pathogenic variant (MLH1, EXON05-8, c.381-?_677del+?) by our laboratory increases the likelihood this variant does not have clinical significance. In summary, based on the above information the clinical significance of this variant cannot be determined with certainty at this time although we would lean towards a more benign role for this variant. This variant is classified as likely benign. -

Breast and/or ovarian cancer Benign:1
May 17, 2023
CHEO Genetics Diagnostic Laboratory, Children's Hospital of Eastern Ontario
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Hereditary nonpolyposis colorectal neoplasms Benign:1
Feb 03, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Hereditary cancer Benign:1
Jan 23, 2024
Mendelics
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.081
BayesDel_addAF
Benign
-0.29
T
BayesDel_noAF
Benign
-0.23
CADD
Benign
9.7
DANN
Uncertain
0.98
DEOGEN2
Benign
0.28
.;T;T;T
Eigen
Benign
-0.50
Eigen_PC
Benign
-0.50
FATHMM_MKL
Benign
0.74
D
LIST_S2
Benign
0.64
T;T;T;T
M_CAP
Benign
0.023
T
MetaRNN
Benign
0.031
T;T;T;T
MetaSVM
Benign
-0.56
T
MutationAssessor
Benign
1.6
.;L;.;.
PhyloP100
-0.27
PrimateAI
Benign
0.41
T
PROVEAN
Benign
-0.87
N;N;.;N
REVEL
Uncertain
0.32
Sift
Benign
0.16
T;T;.;T
Sift4G
Benign
0.42
T;T;T;D
Polyphen
0.0030
.;B;.;.
Vest4
0.17
MutPred
0.092
.;Gain of relative solvent accessibility (P = 0.09);.;.;
MVP
0.84
ClinPred
0.0068
T
GERP RS
-0.72
RBP_binding_hub_radar
0.97
RBP_regulation_power_radar
3.2
Varity_R
0.032
gMVP
0.073
Mutation Taster
=90/10
polymorphism

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

Other links and lift over

dbSNP: rs41557217; hg19: chr2-48025785; COSMIC: COSV52286342; COSMIC: COSV52286342; API