rs532711949

Variant summary

Our verdict is Benign. The variant received -9 ACMG points: 0P and 9B. BP4_StrongBS1_SupportingBS2

The NM_003924.4(PHOX2B):​c.227G>C​(p.Ser76Thr) variant causes a missense change. The variant allele was found at a frequency of 0.0000527 in 1,614,194 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. S76I) has been classified as Uncertain significance.

Frequency

Genomes: 𝑓 0.00018 ( 0 hom., cov: 32)
Exomes 𝑓: 0.000040 ( 0 hom. )

Consequence

PHOX2B
NM_003924.4 missense

Scores

2
2
14

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications U:6B:1

Conservation

PhyloP100: 5.97

Publications

1 publications found
Variant links:
Genes affected
PHOX2B (HGNC:9143): (paired like homeobox 2B) The DNA-associated protein encoded by this gene is a member of the paired family of homeobox proteins localized to the nucleus. The protein functions as a transcription factor involved in the development of several major noradrenergic neuron populations and the determination of neurotransmitter phenotype. The gene product is linked to enhancement of second messenger-mediated activation of the dopamine beta-hydroylase, c-fos promoters and several enhancers, including cyclic amp-response element and serum-response element. Expansion of a 20 amino acid polyalanine tract in this protein by 5-13 aa has been associated with congenital central hypoventilation syndrome. [provided by RefSeq, Jul 2016]
PHOX2B-AS1 (HGNC:40457): (PHOX2B antisense RNA 1)

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=0.037306696).
BS1
Variant frequency is greater than expected in population amr. GnomAd4 allele frequency = 0.000177 (27/152340) while in subpopulation AMR AF = 0.00176 (27/15310). AF 95% confidence interval is 0.00124. There are 0 homozygotes in GnomAd4. There are 14 alleles in the male GnomAd4 subpopulation. Median coverage is 32. This position passed quality control check. Existence of Clinvar submissions makes me limit the strength of this signal to Supporting
BS2
High AC in GnomAd4 at 27 AD gene.

Variant Effect in Transcripts

ACMG analysis was done for transcript: NM_003924.4. You can select a different transcript below to see updated ACMG assignments.

RefSeq Transcripts

Selected
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
PHOX2B
NM_003924.4
MANE Select
c.227G>Cp.Ser76Thr
missense
Exon 1 of 3NP_003915.2
PHOX2B-AS1
NR_187403.1
n.36C>G
non_coding_transcript_exon
Exon 1 of 4

Ensembl Transcripts

Selected
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
PHOX2B
ENST00000226382.4
TSL:1 MANE Select
c.227G>Cp.Ser76Thr
missense
Exon 1 of 3ENSP00000226382.2
PHOX2B-AS1
ENST00000508038.2
TSL:5
n.92C>G
non_coding_transcript_exon
Exon 1 of 5
PHOX2B-AS1
ENST00000819353.1
n.39C>G
non_coding_transcript_exon
Exon 1 of 5

Frequencies

GnomAD3 genomes
AF:
0.000177
AC:
27
AN:
152222
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00177
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
GnomAD2 exomes
AF:
0.0000400
AC:
10
AN:
250100
AF XY:
0.0000443
show subpopulations
Gnomad AFR exome
AF:
0.0000617
Gnomad AMR exome
AF:
0.000173
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00000889
Gnomad OTH exome
AF:
0.000326
GnomAD4 exome
AF:
0.0000397
AC:
58
AN:
1461854
Hom.:
0
Cov.:
31
AF XY:
0.0000495
AC XY:
36
AN XY:
727224
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
33476
American (AMR)
AF:
0.000291
AC:
13
AN:
44722
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26136
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39700
South Asian (SAS)
AF:
0.00
AC:
0
AN:
86256
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
53418
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5756
European-Non Finnish (NFE)
AF:
0.0000315
AC:
35
AN:
1111996
Other (OTH)
AF:
0.000166
AC:
10
AN:
60394
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.475
Heterozygous variant carriers
0
4
8
11
15
19
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Variant carriers
0
4
8
12
16
20
<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:
0.000177
AC:
27
AN:
152340
Hom.:
0
Cov.:
32
AF XY:
0.000188
AC XY:
14
AN XY:
74486
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
41588
American (AMR)
AF:
0.00176
AC:
27
AN:
15310
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3466
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5176
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4826
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10618
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
294
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
68034
Other (OTH)
AF:
0.00
AC:
0
AN:
2116
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.473
Heterozygous variant carriers
0
2
4
5
7
9
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:
0.0000712
Hom.:
0
Bravo
AF:
0.000427
ExAC
AF:
0.0000247
AC:
3
EpiCase
AF:
0.00
EpiControl
AF:
0.0000593

ClinVar

ClinVar submissions as Germline

Significance:Conflicting classifications of pathogenicity
Revision:criteria provided, conflicting classifications
View on ClinVar
Pathogenic
VUS
Benign
Condition
-
1
1
Hereditary cancer-predisposing syndrome (2)
-
1
-
Congenital central hypoventilation;C2751682:Neuroblastoma, susceptibility to, 2 (1)
-
1
-
Haddad syndrome (1)
-
1
-
Neuroblastoma, susceptibility to, 2 (1)
-
1
-
not provided (1)
-
1
-
PHOX2B-related disorder (1)

Computational scores

Source: dbNSFP v4.9

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.15
BayesDel_addAF
Benign
-0.12
T
BayesDel_noAF
Benign
-0.15
CADD
Uncertain
24
DANN
Uncertain
0.98
DEOGEN2
Benign
0.29
T
Eigen
Benign
-0.071
Eigen_PC
Benign
0.17
FATHMM_MKL
Pathogenic
0.99
D
LIST_S2
Benign
0.79
T
M_CAP
Benign
0.060
D
MetaRNN
Benign
0.037
T
MetaSVM
Benign
-0.35
T
MutationAssessor
Benign
0.55
N
PhyloP100
6.0
PrimateAI
Pathogenic
0.80
D
PROVEAN
Benign
-0.77
N
REVEL
Uncertain
0.33
Sift
Benign
0.35
T
Sift4G
Benign
0.67
T
Polyphen
0.025
B
Vest4
0.28
MVP
0.68
MPC
1.3
ClinPred
0.038
T
GERP RS
5.6
PromoterAI
0.010
Neutral
Varity_R
0.34
gMVP
0.94
Mutation Taster
=35/65
disease causing

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: rs532711949; hg19: chr4-41750401; COSMIC: COSV56929697; COSMIC: COSV56929697; API