rs61491953

Variant summary

Our verdict is Pathogenic. The variant received 15 ACMG points: 15P and 0B. PM1PM2PM5PP2PP5_Very_Strong

The NM_006158.5(NEFL):​c.23C>T​(p.Pro8Leu) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. Variant has been reported in ClinVar as Likely pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. P8T) has been classified as Likely pathogenic.

Frequency

Genomes: not found (cov: 32)
Exomes 𝑓: 0.0 ( 0 hom. )
Failed GnomAD Quality Control

Consequence

NEFL
NM_006158.5 missense

Scores

2
5
3

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:4O:1

Conservation

PhyloP100: 2.76

Publications

22 publications found
Variant links:
Genes affected
NEFL (HGNC:7739): (neurofilament light chain) Neurofilaments are type IV intermediate filament heteropolymers composed of light, medium, and heavy chains. Neurofilaments comprise the axoskeleton and they functionally maintain the neuronal caliber. They may also play a role in intracellular transport to axons and dendrites. This gene encodes the light chain neurofilament protein. Mutations in this gene cause Charcot-Marie-Tooth disease types 1F (CMT1F) and 2E (CMT2E), disorders of the peripheral nervous system that are characterized by distinct neuropathies. A pseudogene has been identified on chromosome Y. [provided by RefSeq, Oct 2008]
NEFL Gene-Disease associations (from GenCC):
  • Charcot-Marie-Tooth disease
    Inheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
  • Charcot-Marie-Tooth disease type 2
    Inheritance: AR Classification: DEFINITIVE Submitted by: ClinGen
  • Charcot-Marie-Tooth disease type 1F
    Inheritance: AR, AD Classification: STRONG, SUPPORTIVE Submitted by: Labcorp Genetics (formerly Invitae), Orphanet
  • Charcot-Marie-Tooth disease type 2E
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • Charcot-Marie-Tooth disease type 2B5
    Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Pathogenic. The variant received 15 ACMG points.

PM1
In a region_of_interest Head (size 90) in uniprot entity NFL_HUMAN there are 10 pathogenic changes around while only 3 benign (77%) in NM_006158.5
PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chr8-24956494-G-T is described in ClinVar as Conflicting_classifications_of_pathogenicity. ClinVar VariationId is 287020.
PP2
Missense variant in the gene, where a lot of missense mutations are associated with disease in ClinVar. The gene has 19 curated pathogenic missense variants (we use a threshold of 10). The gene has 5 curated benign missense variants. Trascript score misZ: 0.63774 (below the threshold of 3.09). GenCC associations: The gene is linked to Charcot-Marie-Tooth disease type 2B5, Charcot-Marie-Tooth disease type 2, Charcot-Marie-Tooth disease type 2E, Charcot-Marie-Tooth disease, Charcot-Marie-Tooth disease type 1F.
PP5
Variant 8-24956493-G-A is Pathogenic according to our data. Variant chr8-24956493-G-A is described in ClinVar as Pathogenic/Likely_pathogenic. ClinVar VariationId is 66689.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
NEFLNM_006158.5 linkc.23C>T p.Pro8Leu missense_variant Exon 1 of 4 ENST00000610854.2 NP_006149.2 P07196

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
NEFLENST00000610854.2 linkc.23C>T p.Pro8Leu missense_variant Exon 1 of 4 1 NM_006158.5 ENSP00000482169.2 P07196
ENSG00000272157ENST00000607735.3 linkn.803G>A non_coding_transcript_exon_variant Exon 1 of 1 6
NEFLENST00000615973.1 linkn.229C>T non_coding_transcript_exon_variant Exon 1 of 1 6

Frequencies

GnomAD3 genomes
Cov.:
32
GnomAD4 exome
Data not reliable, filtered out with message: AC0
AF:
0.00
AC:
0
AN:
1447836
Hom.:
0
Cov.:
36
AF XY:
0.00
AC XY:
0
AN XY:
718908
African (AFR)
AF:
0.00
AC:
0
AN:
33242
American (AMR)
AF:
0.00
AC:
0
AN:
42414
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
25732
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39098
South Asian (SAS)
AF:
0.00
AC:
0
AN:
83728
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
51916
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5344
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
1106528
Other (OTH)
AF:
0.00
AC:
0
AN:
59834
GnomAD4 genome
Cov.:
32

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:4Other:1
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Charcot-Marie-Tooth disease type 2E Pathogenic:2
Dec 29, 2021
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence change replaces proline, which is neutral and non-polar, with leucine, which is neutral and non-polar, at codon 8 of the NEFL protein (p.Pro8Leu). This variant is not present in population databases (gnomAD no frequency). This missense change has been observed in individual(s) with Charcot-Marie-Tooth disease (PMID: 12566280, 19158810). In at least one individual the variant was observed to be de novo. ClinVar contains an entry for this variant (Variation ID: 66689). This variant disrupts the p.Pro8 amino acid residue in NEFL. Other variant(s) that disrupt this residue have been determined to be pathogenic (PMID: 12393795, 12566280, 17620486). This suggests that this residue is clinically significant, and that variants that disrupt this residue are likely to be disease-causing. For these reasons, this variant has been classified as Pathogenic. -

May 26, 2025
Clinical Genetics Laboratory, Skane University Hospital Lund
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

PS2 moderat, PS3 supporting, PS4 moderate, PM2 and PM5 -

not provided Pathogenic:1Other:1
Jun 14, 2024
GeneDx
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Published functional studies demonstrate that this variant results in the accumulation of mutant proteins and defective targeting of neurofilaments (PMID: 15282209); Not observed at significant frequency in large population cohorts (gnomAD); This variant is associated with the following publications: (PMID: 38578900, 12566280, 35771920, 17620486, 12393795, 19123978, 33359733, 14586770, 38401181, 19539727, 35044100, 19158810, 15282209) -

-
Epithelial Biology; Institute of Medical Biology, Singapore
Significance:not provided
Review Status:no classification provided
Collection Method:literature only

- -

Inborn genetic diseases Pathogenic:1
Apr 11, 2023
Ambry Genetics
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The c.23C>T (p.P8L) alteration is located in exon 1 (coding exon 1) of the NEFL gene. This alteration results from a C to T substitution at nucleotide position 23, causing the proline (P) at amino acid position 8 to be replaced by a leucine (L). This variant is expected to be causative of autosomal dominant NEFL-related Charcot-Marie-Tooth; however, its clinical significance for autosomal recessive NEFL-related Charcot-Marie-Tooth disease is unclear. This variant was not reported in population-based cohorts in the Genome Aggregation Database (gnomAD). This alteration has been detected in the heterozygous state in multiple individuals with clinical features of autosomal dominant NEFL-related Charcot-Marie-Tooth disease (Kim, 2022; Jordanova, 2003; Abe, 2020). This amino acid position is not well conserved in available vertebrate species. Based on internal structural analysis, P8L is deleterious. The variant has an important role in aggregate formation and 14-3-3 protein association. In addition, there is another pathogenic variant (P8R) at the same position (Zhou, 2022; Miao, 2020; Perez-Olle, 2004). Functional studies show aberrant neurofilament formation in vitro compared to controls (Miao, 2020; Perez-Olle, 2004). The in silico prediction for this alteration is inconclusive. Based on the available evidence, this alteration is classified as pathogenic. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.62
BayesDel_addAF
Pathogenic
0.17
D
BayesDel_noAF
Uncertain
0.0
CADD
Pathogenic
27
DANN
Benign
0.97
DEOGEN2
Uncertain
0.52
D;.;T
FATHMM_MKL
Uncertain
0.87
D
LIST_S2
Benign
0.85
D;D;D
MetaRNN
Uncertain
0.47
T;T;T
PhyloP100
2.8
PrimateAI
Uncertain
0.66
T
Sift4G
Benign
0.73
T;.;T
Polyphen
1.0
D;.;.
Vest4
0.34
MVP
0.78
GERP RS
5.6
PromoterAI
-0.027
Neutral
Varity_R
0.60
gMVP
0.80

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: rs61491953; hg19: chr8-24814007; API