rs587779272

Variant summary

Our verdict is Likely pathogenic. The variant received 9 ACMG points: 9P and 0B. PM1PM2PP3_StrongPP5

The NM_000179.3(MSH6):​c.3563G>A​(p.Ser1188Asn) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.00000661 in 151,366 control chromosomes in the GnomAD database, with no homozygous occurrence. 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. S1188T) has been classified as Uncertain significance.

Frequency

Genomes: 𝑓 0.0000066 ( 0 hom., cov: 33)
Exomes 𝑓: 0.0 ( 0 hom. )
Failed GnomAD Quality Control

Consequence

MSH6
NM_000179.3 missense

Scores

14
4
1

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications P:4U:5

Conservation

PhyloP100: 9.36

Publications

4 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: Likely_pathogenic. The variant received 9 ACMG points.

PM1
In a hotspot region, there are 3 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 7 benign, 54 uncertain in NM_000179.3
PM2
Very rare variant in population databases, with high coverage;
PP3
MetaRNN computational evidence supports a deleterious effect, 0.986
PP5
Variant 2-47805624-G-A is Pathogenic according to our data. Variant chr2-47805624-G-A is described in ClinVar as Conflicting_classifications_of_pathogenicity. ClinVar VariationId is 89421.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
MSH6NM_000179.3 linkc.3563G>A p.Ser1188Asn missense_variant Exon 7 of 10 ENST00000234420.11 NP_000170.1

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
MSH6ENST00000234420.11 linkc.3563G>A p.Ser1188Asn missense_variant Exon 7 of 10 1 NM_000179.3 ENSP00000234420.5

Frequencies

GnomAD3 genomes
AF:
0.00000661
AC:
1
AN:
151366
Hom.:
0
Cov.:
33
show subpopulations
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:
0.0000147
Gnomad OTH
AF:
0.00
GnomAD4 exome
Data not reliable, filtered out with message: AC0
AF:
0.00
AC:
0
AN:
1451214
Hom.:
0
Cov.:
33
AF XY:
0.00
AC XY:
0
AN XY:
722506
African (AFR)
AF:
0.00
AC:
0
AN:
33278
American (AMR)
AF:
0.00
AC:
0
AN:
44664
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26024
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39630
South Asian (SAS)
AF:
0.00
AC:
0
AN:
85780
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
53400
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5712
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
1102728
Other (OTH)
AF:
0.00
AC:
0
AN:
59998
GnomAD4 genome
AF:
0.00000661
AC:
1
AN:
151366
Hom.:
0
Cov.:
33
AF XY:
0.00
AC XY:
0
AN XY:
73864
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
41176
American (AMR)
AF:
0.00
AC:
0
AN:
15188
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3466
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5186
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4808
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10386
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.0000147
AC:
1
AN:
67852
Other (OTH)
AF:
0.00
AC:
0
AN:
2078
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.625
Heterozygous variant carriers
0
0
1
1
2
2
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:
0.00
Hom.:
0

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Pathogenic:4Uncertain:5
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

not provided Pathogenic:2
Mar 04, 2021
Quest Diagnostics Nichols Institute San Juan Capistrano
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The variant has not been reported in large, multi-ethnic general populations (http://gnomad.broadinstitute.org). In the published literature, this variant has been reported in an individual with colorectal cancer (PMID: 17101317 (2006)). It has also been reported in a Lynch syndrome family where affected individuals were also positive for the MSH2 c.2768T>A (p.Val923Glu) variant (PMID: 21431882 (2011)). In addition, in vitro functional studies have shown that this variant has a deleterious effect on MSH6 protein function (PMIDs: 21431882 (2011), 31965077 (2020)). Based on the available information, this variant is predicted to be likely pathogenic. -

Sep 26, 2023
GeneDx
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Published functional studies demonstrate a damaging effect: deficient MMR activity (PMID: 21431882, 31965077); Observed in patients with Lynch-related cancers and tumor studies consistent with pathogenic variants in this gene (PMID: 21431882, 22495361); Not observed at significant frequency in large population cohorts (gnomAD); 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: 22495361, 23621914, 17101317, 21431882, 30798936, 31965077, 34445333, 17531815, 21120944) -

Lynch syndrome Pathogenic:1Uncertain:1
Aug 06, 2024
All of Us Research Program, National Institutes of Health
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This missense variant replaces serine with asparagine at codon 1188 of the MSH6 protein. Computational prediction tool suggests that this variant may have deleterious impact on protein structure and function (internally defined REVEL score threshold >=0.7, PMID: 27666373). Functional studies reported this variant causing deficient in vitro DNA repair activity (PMID: 21431882, 31965077). This variant has been reported in individuals affected with Lynch syndrome-associated disease, and some individual's colorectal cancer tumors were confirmed to display high microsatellite instability and/or loss of MSH6 protein expression via immunohistochemistry analysis (PMID: 17101317, 21431882, 22495361; ClinVar SCV000813288.6). The c.2768T>A, p.V923E variant in the MSH2 gene was also reported in the related individuals affected with colorectal cancer (PMID: 17101317, 21431882, 22495361). This variant has not been identified in the general population by the Genome Aggregation Database (gnomAD). Although there is a suspicion that this variant may be associated with disease, additional clinical studies are necessary to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -

Feb 04, 2025
Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

PM2_SUP; PP3 (Priors 0.74); PS3 (odds path 42.358) -

Hereditary cancer-predisposing syndrome Uncertain:2
Jul 04, 2024
Ambry Genetics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The p.S1188N variant (also known as c.3563G>A), located in coding exon 7 of the MSH6 gene, results from a G to A substitution at nucleotide position 3563. The serine at codon 1188 is replaced by asparagine, an amino acid with highly similar properties. This alteration has been previously reported in a family meeting Amsterdam criteria for HNPCC/Lynch syndrome and two affected family members that tested positive for this variant had abnormal, but inconsistent immunohistochemistry (IHC) results. In their colorectal tumors, one individual showed high microsatellite instability (MSI-H), absent MSH6, and reduced MSH2 protein expression while the other showed absent MSH2 with reduced MSH6 protein expression (MSI was not determined). Additionally, the family members who carry the MSH6 p.S1188N alteration also carry a variant of uncertain significance in MSH2 (Okkels H et al. Appl. Immunohistochem. Mol. Morphol. 2012 Oct;20:470-7; Kantelinen J et al. Fam. Cancer. 2011 Sep;10:515-20; Ollila S et al. Gastroenterology. 2006 Nov;131:1408-17). In an in vitro functional assay, MSH6 p.S1188N was reported to be completely deficient in mismatch repair compared to wild type (Kantelinen J et al. Fam. Cancer. 2011 Sep;10:515-20). This amino acid position is highly conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. Based on the available evidence, the clinical significance of this variant remains unclear. -

Jul 19, 2024
Color Diagnostics, LLC DBA Color Health
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This missense variant replaces serine with asparagine at codon 1188 of the MSH6 protein. Computational prediction tool suggests that this variant may have deleterious impact on protein structure and function. Functional studies reported this variant causing deficient in vitro DNA repair activity (PMID: 21431882, 31965077). This variant has been reported in individuals affected with Lynch syndrome-associated disease (PMID: PMID: 17101317, 21431882, 22495361; ClinVar SCV000813288.6). Two of the related individuals affected with colorectal cancer also carried the c.2768T>A, p.Val923Glu variant in the MSH2 gene that could explain the observed phenotype (PMID: 17101317, 21431882, 22495361). One of these individual's tumor showed high microsatellite instability, reduced MSH2 protein expression, and loss of MSH6 protein expression according to immunohistochemistry, while the other individual's tumor showed loss of MSH2 expression and reduced MSH6 expression, with microsatellite status not determined. It was also reported that another related individual affected with colorectal cancer only carried the MSH2 variant (PMID: 17101317). However, an in vitro mismatch repair assay found that the activity of the MSH2 p.Val923Glu variant was comparable to that of the wild type (PMID: 21431882). The MSH6 p.Ser1188Asn variant has not been identified in the general population by the Genome Aggregation Database (gnomAD). Although there is a suspicion that this variant may be associated with disease, additional clinical studies are necessary to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -

Lynch syndrome 5 Pathogenic:1
Aug 24, 2023
Myriad Genetics, Inc.
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant is considered likely pathogenic. Functional studies indicate this variant impacts protein function [PMID: 21431882, 31965077]. This variant is expected to disrupt protein structure [Myriad internal data]. -

Hereditary nonpolyposis colorectal neoplasms Uncertain:1
Sep 09, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence change replaces serine, which is neutral and polar, with asparagine, which is neutral and polar, at codon 1188 of the MSH6 protein (p.Ser1188Asn). This variant is not present in population databases (gnomAD no frequency). This missense change has been observed in individual(s) with colorectal cancer (PMID: 21431882, 22495361; internal data). ClinVar contains an entry for this variant (Variation ID: 89421). An algorithm developed specifically for the MSH6 gene suggests that this missense change is likely to be deleterious (PMID: 23621914). Experimental studies have shown that this missense change affects MSH6 function (PMID: 21431882, 31965077). In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. -

Endometrial carcinoma Uncertain:1
Nov 28, 2023
Baylor Genetics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.99
BayesDel_addAF
Pathogenic
0.29
D
BayesDel_noAF
Pathogenic
0.18
CADD
Pathogenic
27
DANN
Uncertain
1.0
DEOGEN2
Uncertain
0.64
.;.;D;D;.
Eigen
Pathogenic
1.1
Eigen_PC
Pathogenic
0.96
FATHMM_MKL
Pathogenic
0.98
D
LIST_S2
Uncertain
0.94
.;D;D;D;D
M_CAP
Pathogenic
0.51
D
MetaRNN
Pathogenic
0.99
D;D;D;D;D
MetaSVM
Pathogenic
1.1
D
MutationAssessor
Pathogenic
4.9
.;.;.;H;.
PhyloP100
9.4
PrimateAI
Pathogenic
0.81
D
PROVEAN
Uncertain
-2.9
.;D;.;D;D
REVEL
Pathogenic
0.89
Sift
Pathogenic
0.0
.;D;.;D;D
Sift4G
Pathogenic
0.0
D;D;D;D;D
Polyphen
1.0
.;.;.;D;.
Vest4
0.98
MutPred
0.97
.;.;.;Loss of catalytic residue at S1188 (P = 0.0658);.;
MVP
0.99
ClinPred
1.0
D
GERP RS
5.0
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.1
Varity_R
0.99
gMVP
0.98
Mutation Taster
=21/79
disease causing

Splicing

Name
Calibrated prediction
Score
Prediction
Splicevardb
1.0
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: rs587779272; hg19: chr2-48032763; API