Our verdict is Pathogenic. Variant got 12 ACMG points: 12P and 0B. PVS1PM2PP5_Moderate
The NM_000501.4(ELN):c.1113dupA(p.Ala372SerfsTer4) variant causes a frameshift 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 Pathogenic (★). Variant results in nonsense mediated mRNA decay.
ELN (HGNC:3327): (elastin) This gene encodes a protein that is one of the two components of elastic fibers. Elastic fibers comprise part of the extracellular matrix and confer elasticity to organs and tissues including the heart, skin, lungs, ligaments, and blood vessels. The encoded protein is rich in hydrophobic amino acids such as glycine and proline, which form mobile hydrophobic regions bounded by crosslinks between lysine residues. Degradation products of the encoded protein, known as elastin-derived peptides or elastokines, bind the elastin receptor complex and other receptors and stimulate migration and proliferation of monocytes and skin fibroblasts. Elastokines can also contribute to cancer progression. Deletions and mutations in this gene are associated with supravalvular aortic stenosis (SVAS) and autosomal dominant cutis laxa. [provided by RefSeq, Aug 2017]
Verdict is Pathogenic. Variant got 12 ACMG points.
PVS1
Loss of function variant, product undergoes nonsense mediated mRNA decay. LoF is a known mechanism of disease.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 7-74054730-G-GA is Pathogenic according to our data. Variant chr7-74054730-G-GA is described in ClinVar as [Pathogenic]. Clinvar id is 179271.Status of the report is criteria_provided_single_submitter, 1 stars.
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing
The Ala372fs variant in ELN has not been previously reported in individuals with SVAS. This frameshift variant is predicted to alter the protein?s amino acid se quence beginning at position 372 and lead to a premature termination codon 4 ami no acids downstream. This alteration is then predicted to lead to a truncated or absent protein. Truncating variants in ELN are an established cause of SVAS (Hu man Gene Mutation Database, HGMD). In summary, the Ala372fs variant meets our cr iteria for pathogenicity (http://pcpgm.partners.org/lmm) based on the predicted impact of the variant. -