rs57520892
Variant summary
Our verdict is Uncertain significance. The variant received 5 ACMG points: 5P and 0B. PM1PM5PP5
The NM_170707.4(LMNA):c.1580G>A(p.Arg527His) variant causes a missense change. The variant allele was found at a frequency of 0.0000257 in 1,598,282 control chromosomes in the GnomAD database, with no homozygous occurrence. 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. R527L) has been classified as Likely pathogenic.
Frequency
Consequence
NM_170707.4 missense
Scores
Clinical Significance
Conservation
Publications
- dilated cardiomyopathyInheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
- dilated cardiomyopathy 1AInheritance: AD Classification: DEFINITIVE, SUPPORTIVE Submitted by: G2P, Ambry Genetics, Orphanet
- familial partial lipodystrophy, Dunnigan typeInheritance: AD Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Orphanet, Genomics England PanelApp, G2P, Labcorp Genetics (formerly Invitae)
- Hutchinson-Gilford progeria syndromeInheritance: AD, SD Classification: DEFINITIVE, STRONG, MODERATE, SUPPORTIVE Submitted by: Orphanet, G2P, Ambry Genetics, Labcorp Genetics (formerly Invitae)
- restrictive dermopathy 2Inheritance: AR, AD Classification: DEFINITIVE, LIMITED Submitted by: G2P
- Emery-Dreifuss muscular dystrophy 2, autosomal dominantInheritance: SD, AD Classification: DEFINITIVE, STRONG Submitted by: Ambry Genetics, Labcorp Genetics (formerly Invitae), G2P
- atrioventricular blockInheritance: AD Classification: STRONG Submitted by: Genomics England PanelApp
- heart-hand syndrome, Slovenian typeInheritance: AD Classification: STRONG, MODERATE, SUPPORTIVE, LIMITED Submitted by: Labcorp Genetics (formerly Invitae), Orphanet, Ambry Genetics, G2P
- Charcot-Marie-Tooth disease type 2B1Inheritance: AR, AD Classification: STRONG, MODERATE, SUPPORTIVE, LIMITED Submitted by: G2P, Ambry Genetics, Orphanet, Labcorp Genetics (formerly Invitae)
- Emery-Dreifuss muscular dystrophy 3, autosomal recessiveInheritance: AR Classification: STRONG Submitted by: Labcorp Genetics (formerly Invitae)
- mandibuloacral dysplasia with type A lipodystrophyInheritance: AR Classification: STRONG, SUPPORTIVE Submitted by: Labcorp Genetics (formerly Invitae), Orphanet
- atrial fibrillationInheritance: AD Classification: MODERATE Submitted by: Ambry Genetics
- atypical Werner syndromeInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- autosomal dominant Emery-Dreifuss muscular dystrophyInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- congenital muscular dystrophy due to LMNA mutationInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- familial isolated dilated cardiomyopathyInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- lethal restrictive dermopathyInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- LMNA-related cardiocutaneous progeria syndromeInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- autosomal recessive Emery-Dreifuss muscular dystrophyInheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
- dilated cardiomyopathy-hypergonadotropic hypogonadism syndromeInheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
- autosomal semi-dominant severe lipodystrophic laminopathyInheritance: SD Classification: SUPPORTIVE Submitted by: Orphanet
- arrhythmogenic right ventricular cardiomyopathyInheritance: AD Classification: LIMITED Submitted by: ClinGen
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ACMG classification
Our verdict: Uncertain_significance. The variant received 5 ACMG points.
Transcripts
RefSeq
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt |
|---|---|---|---|---|---|---|---|---|
| LMNA | NM_170707.4 | c.1580G>A | p.Arg527His | missense_variant | Exon 9 of 12 | ENST00000368300.9 | NP_733821.1 | |
| LMNA | NM_005572.4 | c.1580G>A | p.Arg527His | missense_variant | Exon 9 of 10 | ENST00000677389.1 | NP_005563.1 |
Ensembl
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
|---|---|---|---|---|---|---|---|---|---|---|
| LMNA | ENST00000368300.9 | c.1580G>A | p.Arg527His | missense_variant | Exon 9 of 12 | 1 | NM_170707.4 | ENSP00000357283.4 | ||
| LMNA | ENST00000677389.1 | c.1580G>A | p.Arg527His | missense_variant | Exon 9 of 10 | NM_005572.4 | ENSP00000503633.1 |
Frequencies
GnomAD3 genomes AF: 0.0000394 AC: 6AN: 152216Hom.: 0 Cov.: 32 show subpopulations
GnomAD2 exomes AF: 0.0000410 AC: 9AN: 219426 AF XY: 0.0000168 show subpopulations
GnomAD4 exome AF: 0.0000242 AC: 35AN: 1446066Hom.: 0 Cov.: 32 AF XY: 0.0000251 AC XY: 18AN XY: 718406 show subpopulations
Age Distribution
GnomAD4 genome AF: 0.0000394 AC: 6AN: 152216Hom.: 0 Cov.: 32 AF XY: 0.0000538 AC XY: 4AN XY: 74358 show subpopulations
Age Distribution
ClinVar
Submissions by phenotype
not provided Pathogenic:3Other:1
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Published functional studies demonstrate a damaging effect: failure to restore p16ink4A/pRB pathway signaling, increased sensitivity to ionizing radiation, and destabilization of heterochromatin-associated proteins (Filesi et al., 2005; Nitta et al., 2006; di Masi et al., 2008); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; This variant is associated with the following publications: (PMID: 23891399, 24375749, 25637381, 18604166, 12075506, 14627682, 12788894, 16046620, 19764019, 28663758, 25823658, 19084400, 17848409, 31589614, 32041611, 32376792, 34135346, 33422685, 10939567, 33038109, 15473259, 29854317, 25324471, 16809772, 10080180, 31383942) -
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Mandibuloacral dysplasia with type A lipodystrophy Pathogenic:3
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Based on the classification scheme VCGS_Germline_v1.3.4, this variant is classified as Pathogenic. Following criteria are met: 0103 - Dominant negative, loss of function and gain of function are known mechanisms of disease in this gene. Missense variants have been reported to result in gain of function and dominant negative effects, and are associated with childhood-onset disease or skeletal muscle involvement while protein truncating variants have been reported to result in loss of function and haploinsufficiency, and are associated with the adult-onset disease, cardiac disorders or myopathy (PMID: 17377071). (I) 0108 - This gene is associated with both recessive and dominant disease (OMIM). (I) 0112 - The condition associated with this gene has incomplete penetrance, mainly associated with Emery-Dreifuss muscular dystrophy and LMNA-related dilated cardiomyopathy (PMID: 20301609). (I) 0200 - Variant is predicted to result in a missense amino acid change from arginine to histidine. (I) 0251 - This variant is heterozygous. (I) 0304 - Variant is present in gnomAD <0.01 for a condition (v2: 10 heterozygotes, 0 homozygotes). (SP) 0309 - An alternative amino acid change at the same position has been observed in gnomAD (v2) (5 heterozygotes, 0 homozygotes). (I) 0502 - Missense variant with conflicting in silico predictions and uninformative conservation. (I) 0600 - Variant is located in the annotated lamin tail domain (NCBI conserved domain]. (I) 0801 - This variant has strong previous evidence of pathogenicity in unrelated individuals. This variant is a recurrent pathogenic variant associated with mandibuloacral dysplasia (MIM#248370) (MAD) and has been reported in at least ten homozygous or compound heterozygous in individuals with MAD (ClinVar; PMIDs: 14627682, 17848409, 28663758, 29557732). The association of this variant with cardiomyopathy is currently unclear (ClinVar). (SP) 1208 - Inheritance information for this variant is not currently available in this individual. (I) Legend: (SP) - Supporting pathogenic, (I) - Information, (SB) - Supporting benign -
This variant was determined to be pathogenic according to ACMG Guidelines, 2015 [PMID:25741868]. -
Mandibuloacral dysplasia Pathogenic:1Uncertain:1
The p.Arg527His variant in LMNA has been reported in the homozygous or compound heterozygous state in 10 individuals with mandiculoacral dysplasia (MAD) and segregated with disease in 5 affected individuals from 4 families (Novelli 2002, Shen 2003, Simha 2003, Garavelli 2009). It has also been identified in 6/31826 Latino chromosomes by gnomAD (http://gnomad.broadinstitute.org), however, this frequency is low enough to be consistent with a recessive carrier frequency. This variant has also been reported in ClinVar (Variation ID: 14499). In vitro functional studies support an impact on protein function (Novelli 2002, Amati 2004, Filesi 2005, Nitta 2006, Lombardi 2007, Meaburn 2007, di Masi 2008, Evangelisti 2015). Three additional variants involving this codon (p.Arg527) have been identified in individuals with MAD (Stenson 2017). In summary, this variant meets criteria to be classified as pathogenic for autosomal recessive MAD. ACMG/AMP Criteria applied: PM3_VeryStrong, PS4, PM5_Strong, PP1_Strong, PS3_Moderate, BP4. -
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Charcot-Marie-Tooth disease Pathogenic:1
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Mandibuloacral dysplasia with type A lipodystrophy, atypical Pathogenic:1
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Charcot-Marie-Tooth disease type 2 Pathogenic:1
This sequence change replaces arginine, which is basic and polar, with histidine, which is basic and polar, at codon 527 of the LMNA protein (p.Arg527His). This variant is present in population databases (rs57520892, gnomAD 0.02%). This missense change has been observed in individuals with autosomal recessive mandibuloacral dysplasia (PMID: 12075506, 14627682). It has also been observed to segregate with disease in related individuals. ClinVar contains an entry for this variant (Variation ID: 14499). Invitae Evidence Modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) indicates that this missense variant is expected to disrupt LMNA protein function with a positive predictive value of 95%. Experimental studies have shown that this missense change affects LMNA function (PMID: 12075506, 18604166, 25324471, 25823658). For these reasons, this variant has been classified as Pathogenic. -
Hutchinson-Gilford syndrome;C0410190:Emery-Dreifuss muscular dystrophy 2, autosomal dominant;C0796031:Dilated cardiomyopathy-hypergonadotropic hypogonadism syndrome;C1720860:Familial partial lipodystrophy, Dunnigan type;C1854154:Charcot-Marie-Tooth disease type 2B1;C1857829:Heart-hand syndrome, Slovenian type;C2750035:Emery-Dreifuss muscular dystrophy 3, autosomal recessive;C2750785:Congenital muscular dystrophy due to LMNA mutation;C5399785:Mandibuloacral dysplasia with type A lipodystrophy;C5676942:Restrictive dermopathy 2;C5979868:Dilated cardiomyopathy 1A Pathogenic:1
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Cardiomyopathy Uncertain:1
This missense variant replaces arginine with histidine at codon 527 of the lamin A/C proteins. Computational prediction suggests that this variant may have deleterious impact on protein structure and function (internally defined REVEL score threshold >= 0.7, PMID: 27666373). In a transgenic mouse model, this variant has been associated with phenotypes relevant for mandibuloacral dysplasia type A syndrome while muscle phenotypes are normal (PMID: 33458588). Fibroblast cell cultures from the transgenic mice displayed nuclear envelope aberrations, accumulation of the lamin A precursor protein, proliferation, and senescence rate defects (PMID: 33458588). Another functional study has shown that cells from a homozygous carrier show abnormal nuclear morphology, while cells from a heterozygous carrier show normal nuclear morphology (PMID: 12075506). Other functional studies have suggested that this variant may increase sensitivity to ionizing radiation (PMID:18604166), affect DNA synthesis (PMID 25324471) and fail to downregulate TGFbeta-2 secretion (PMID: 25823658). This variant has been associated with autosomal recessive mandibuloacral dysplasia and Charcot-Marie-Tooth disease in several families and has been reported in the homozygous or compound heterozygous states in multiple affected individuals (PMID: 12075506, 14627682, 25286833, 32376792, 33038109, 33422685, 34680903, Xu et al. 2019 doi: 10.3969/j.issn.1000-3606.2019.09.010). Most affected carriers showed no signs of cardiac involvement except for one individual who was also affected with dilated cardiomyopathy (PMID: 33422685). Heterozygous parents were reported to be healthy. This variant has also been identified in 10/250812 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Based on the available evidence, this variant is classified as a Variant of Uncertain Significance for autosomal dominant cardiomyopathy, although it is known to cause autosomal recessive mandibuloacral dysplasia and Charcot-Marie-Tooth disease (ClinVar variation ID: 14499). -
Primary dilated cardiomyopathy Uncertain:1
This missense variant replaces arginine with histidine at codon 527 of the lamin A/C proteins. Computational prediction suggests that this variant may have deleterious impact on protein structure and function (internally defined REVEL score threshold >= 0.7, PMID: 27666373). In a transgenic mouse model, this variant has been associated with phenotypes relevant for mandibuloacral dysplasia type A syndrome while muscle phenotypes are normal (PMID: 33458588). Fibroblast cell cultures from the transgenic mice displayed nuclear envelope aberrations, accumulation of the lamin A precursor protein, proliferation, and senescence rate defects (PMID: 33458588). Another functional study has shown that cells from a homozygous carrier show abnormal nuclear morphology, while cells from a heterozygous carrier show normal nuclear morphology (PMID: 12075506). Other functional studies have suggested that this variant may increase sensitivity to ionizing radiation (PMID:18604166), affect DNA synthesis (PMID 25324471) and fail to downregulate TGFbeta-2 secretion (PMID: 25823658). This variant has been associated with autosomal recessive mandibuloacral dysplasia and Charcot-Marie-Tooth disease in several families and has been reported in the homozygous or compound heterozygous states in multiple affected individuals (PMID: 12075506, 14627682, 25286833, 32376792, 33038109, 33422685, 34680903, Xu et al. 2019 doi: 10.3969/j.issn.1000-3606.2019.09.010). Most affected carriers showed no signs of cardiac involvement except for one individual who was also affected with dilated cardiomyopathy (PMID: 33422685). Heterozygous parents were reported to be healthy. This variant has also been identified in 10/250812 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Based on the available evidence, this variant is classified as a Variant of Uncertain Significance for autosomal dominant cardiomyopathy, although it is known to cause autosomal recessive mandibuloacral dysplasia and Charcot-Marie-Tooth disease (ClinVar variation ID: 14499). -
Cardiovascular phenotype Uncertain:1
The p.R527H variant (also known as c.1580G>A), located in coding exon 9 of the LMNA gene, results from a G to A substitution at nucleotide position 1580. The arginine at codon 527 is replaced by histidine, an amino acid with highly similar properties. This alteration has been reported in several homozygous or compound heterozygous individuals with autosomal recessive mandibuloacral dysplasia (MAD), and individuals with MAD plus overlapping laminopathy features and atypical myopathies (Shen JJ et al. J. Med. Genet., 2003 Nov;40:854-7; Lombardi F et al. J. Clin. Endocrinol. Metab., 2007 Nov;92:4467-71; Garavelli L et al. Am. J. Med. Genet. A, 2009 Oct;149A:2258-64; Sakka et al. Eur J Med Genet, 2021 Feb;64:104138; Jéru I et al. Genes (Basel), 2021 Sep;12; Turkyilmaz A et al. Clin Dysmorphol. 2021 Jan;30(1):10-16). Heterozygous carrier family members and healthy population cohort participants have been reported to be unaffected with MAD or other laminopathy-related phenotypes (Dron JS et al. BMC Med Genomics, 2020 02;13:23; Lacaze P et al. NPJ Genom Med, 2021 Jun;6:51; Sakka et al. Eur J Med Genet, 2021 Feb;64:104138). In assays testing LMNA function, this variant showed a functionally abnormal result (Novelli G et al. Am. J. Hum. Genet., 2002 Aug;71:426-31; Evangelisti C et al. Oncotarget, 2015 Apr;6:7424-37; di Masi A et al. Cell Cycle, 2008 Jul;7:2030-7). This amino acid position is well conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. Based on the supporting evidence, this variant is expected to be causative of mandibuloacral dysplasia (MAD) when present along with a second pathogenic variant on the other allele; however, its clinical significance for autosomal dominant laminopathy-related phenotypes is unclear. -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at