rs45517202

Variant summary

Our verdict is Uncertain significance. Variant got 3 ACMG points: 4P and 1B. PM2PM5BP4

The NM_000548.5(TSC2):​c.1796A>G​(p.Lys599Arg) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.00000137 in 1,460,946 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign 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. K599M) has been classified as Pathogenic.

Frequency

Genomes: not found (cov: 33)
Exomes 𝑓: 0.0000014 ( 0 hom. )

Consequence

TSC2
NM_000548.5 missense

Scores

8
11

Clinical Significance

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

Conservation

PhyloP100: 2.95
Variant links:
Genes affected
TSC2 (HGNC:12363): (TSC complex subunit 2) This gene is a tumor suppressor gene that encodes the growth inhibitory protein tuberin. Tuberin interacts with hamartin to form the TSC protein complex which functions in the control of cell growth. This TSC protein complex negatively regulates mammalian target of rapamycin complex 1 (mTORC1) signaling which is a major regulator of anabolic cell growth. Mutations in this gene have been associated with tuberous sclerosis and lymphangioleiomyomatosis. [provided by RefSeq, May 2022]

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ACMG classification

Classification made for transcript

Verdict is Uncertain_significance. Variant got 3 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chr16-2070535-A-T is described in Lovd as [Pathogenic].
BP4
Computational evidence support a benign effect (MetaRNN=0.31025937).

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
TSC2NM_000548.5 linkc.1796A>G p.Lys599Arg missense_variant Exon 17 of 42 ENST00000219476.9 NP_000539.2 P49815-1

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
TSC2ENST00000219476.9 linkc.1796A>G p.Lys599Arg missense_variant Exon 17 of 42 5 NM_000548.5 ENSP00000219476.3 P49815-1

Frequencies

GnomAD3 genomes
Cov.:
33
GnomAD3 exomes
AF:
0.00000399
AC:
1
AN:
250664
Hom.:
0
AF XY:
0.00
AC XY:
0
AN XY:
135824
show subpopulations
Gnomad AFR exome
AF:
0.0000618
Gnomad AMR exome
AF:
0.00
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:
0.00000137
AC:
2
AN:
1460946
Hom.:
0
Cov.:
34
AF XY:
0.00000138
AC XY:
1
AN XY:
726784
show subpopulations
Gnomad4 AFR exome
AF:
0.0000299
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
Cov.:
33
Bravo
AF:
0.00000378
ExAC
AF:
0.00000824
AC:
1

ClinVar

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

Submissions by phenotype

Tuberous sclerosis 2 Uncertain:1Benign:1
Nov 07, 2021
Genome-Nilou Lab
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Aug 31, 2022
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

not provided Uncertain:1
Oct 28, 2012
GeneDx
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

p.Lys599Arg (AAG>AGG):c.1796 A>G in exon 17 of the TSC2 gene (NM_000548.3)The Lys599Arg missense change has not been published as a mutation, nor has it been reported as a benign polymorphism to our knowledge. A different amino acid substitution at the same position, Lys599Met, was previously reported as a de novo mutation in a patient with sporadic tuberous sclerosis, and some in vitro studies suggested it may alter protein function; however, subsequent studies revealed no effect on protein function, and at this time the clinical significance of Lys599Met is unknown (Niida et al., 1999; Tee et al., 2002; Nellist et al., 2005; Hoogeveen-Westerveld et al., 2011; LOVD; an external gene datebase). The NHLBI ESP Exome Variant Project has not identified Lys599Arg in approximately 6,500 individuals of European or African American ethnicity, indicating that it is not a common benign variant in these populations. The amino acid substitution is conservative, as both Lysine and Arginine are positively charged amino acids. Lys599Arg alters a position in the tuberin protein that is not conserved. While one in silico algorithm predicts it may be damaging to protein structure/function, another model predicts it is likely benign. Therefore, based on the currently available information, it is unclear whether Lys599Arg is a disease-causing mutation or a rare benign variant. The variant is found in INFANT-EPI panel(s). -

Hereditary cancer-predisposing syndrome Uncertain:1
Dec 02, 2024
Ambry Genetics
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The p.K599R variant (also known as c.1796A>G), located in coding exon 16 of the TSC2 gene, results from an A to G substitution at nucleotide position 1796. The lysine at codon 599 is replaced by arginine, an amino acid with highly similar properties. This amino acid position is well conserved in available vertebrate species. In addition, the in silico prediction for this alteration is inconclusive. Based on the available evidence, the clinical significance of this variant remains unclear. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.071
BayesDel_addAF
Uncertain
0.023
T
BayesDel_noAF
Uncertain
-0.020
CADD
Benign
17
DANN
Uncertain
0.99
DEOGEN2
Uncertain
0.52
D;.;.;.;.;.;.;.;.;.;.;.;T;.;T
Eigen
Benign
-0.29
Eigen_PC
Benign
-0.20
FATHMM_MKL
Uncertain
0.88
D
LIST_S2
Benign
0.85
T;T;T;T;T;T;T;T;T;T;T;T;T;T;T
M_CAP
Uncertain
0.10
D
MetaRNN
Benign
0.31
T;T;T;T;T;T;T;T;T;T;T;T;T;T;T
MetaSVM
Benign
-0.36
T
MutationAssessor
Benign
1.9
L;.;.;.;L;L;.;.;.;L;.;L;.;.;.
PrimateAI
Benign
0.43
T
PROVEAN
Benign
-1.3
N;.;.;N;.;N;.;.;N;N;.;.;.;.;N
REVEL
Uncertain
0.56
Sift
Benign
0.13
T;.;.;T;.;T;.;.;T;T;.;.;.;.;T
Sift4G
Uncertain
0.041
D;.;.;D;.;D;.;.;D;D;.;.;.;.;D
Polyphen
0.85
P;.;.;.;B;B;.;.;B;B;.;.;.;.;.
Vest4
0.42
MutPred
0.52
Loss of ubiquitination at K599 (P = 0.0199);Loss of ubiquitination at K599 (P = 0.0199);Loss of ubiquitination at K599 (P = 0.0199);.;Loss of ubiquitination at K599 (P = 0.0199);Loss of ubiquitination at K599 (P = 0.0199);Loss of ubiquitination at K599 (P = 0.0199);Loss of ubiquitination at K599 (P = 0.0199);.;Loss of ubiquitination at K599 (P = 0.0199);Loss of ubiquitination at K599 (P = 0.0199);Loss of ubiquitination at K599 (P = 0.0199);Loss of ubiquitination at K599 (P = 0.0199);Loss of ubiquitination at K599 (P = 0.0199);.;
MVP
0.71
ClinPred
0.078
T
GERP RS
2.1
Varity_R
0.046
gMVP
0.31

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: rs45517202; hg19: chr16-2120536; API