rs730881020

Variant summary

Our verdict is Pathogenic. Variant got 10 ACMG points: 10P and 0B. PS4PS2PP3PM2_Supporting

This summary comes from the ClinGen Evidence Repository: The c.519G>A variant in the SHOC2 gene is a missense variant predicted to cause substitution of methionine by isoleucine at amino acid 173 (p.Met173Ile). This variant is absent from gnomAD v4.1.0 (PM2_Supporting). The computational predictor REVEL gives a score of 0.768 (PP3). This variant has been identified as a de novo occurrence with confirmed parental relationships in 3 individuals and with unconfirmed parental relationships in 1 individual with RASopathy (PS2_VeryStrong; Invitae, GeneDx, Ambry, Genomic Medicine Lab; ClinVar SCV001573982.4, SCV000209055.14, SCV002641556.1, SCV001573024.1). This variant has been reported in more than 5 probands diagnosed with RASopathy (PS4; PMIDs: 25137548, 29907801; Invitae, GeneDx, UCSF Genomic Medicine Lab, LabCorp, Ambry; ClinVar SCV001573982.4, SCV000209055.14, SCV001573024.1, SCV000699327.2, SCV002641556.1). ERK phosphorylation assays showed that this variant decreases the ability of SHOC2 to accelerate ERK1/2 phosphorylation (PS3 not met, PMID:25137548). In summary, this variant meets criteria to be classified as pathogenic for autosomal dominant RASopathies based on the ACMG/AMP criteria applied, as specified by the ClinGen RASopathy Variant Curation Expert Panel: PS2_VeryStrong, PS4, PM2_Supporting, PP3 (Specification Version 2.1, 09/17/2024) LINK:https://erepo.genome.network/evrepo/ui/classification/CA199174/MONDO:0021060/038

Frequency

Genomes: not found (cov: 32)

Consequence

SHOC2
NM_007373.4 missense

Scores

5
2
12

Clinical Significance

Pathogenic reviewed by expert panel P:9U:1

Conservation

PhyloP100: 10.0
Variant links:
Genes affected
SHOC2 (HGNC:15454): (SHOC2 leucine rich repeat scaffold protein) This gene encodes a protein that consists almost entirely of leucine-rich repeats, a domain implicated in protein-protein interactions. The protein may function as a scaffold linking RAS to downstream signal transducers in the RAS/ERK MAP kinase signaling cascade. Mutations in this gene have been associated with Noonan-like syndrome with loose anagen hair. [provided by RefSeq, May 2010]

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ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 10 ACMG points.

PS2
For more information check the summary or visit ClinGen Evidence Repository.
PS4
For more information check the summary or visit ClinGen Evidence Repository.
PM2
For more information check the summary or visit ClinGen Evidence Repository.
PP3
For more information check the summary or visit ClinGen Evidence Repository.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
SHOC2NM_007373.4 linkuse as main transcriptc.519G>A p.Met173Ile missense_variant 2/9 ENST00000369452.9 NP_031399.2 Q9UQ13-1

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
SHOC2ENST00000369452.9 linkuse as main transcriptc.519G>A p.Met173Ile missense_variant 2/91 NM_007373.4 ENSP00000358464.5 Q9UQ13-1

Frequencies

GnomAD3 genomes
Cov.:
32
GnomAD4 exome
Cov.:
32
GnomAD4 genome
Cov.:
32

ClinVar

Significance: Pathogenic
Submissions summary: Pathogenic:9Uncertain:1
Revision: reviewed by expert panel
LINK: link

Submissions by phenotype

Noonan syndrome-like disorder with loose anagen hair 1 Pathogenic:3
Likely pathogenic, criteria provided, single submitterclinical testingClinical Genomics Laboratory, Washington University in St. LouisFeb 08, 2024The SHOC2 c.519G>A (p.Met173Ile) variant has been reported in the literature in at least three individuals affected with a RASopathy. One publication described the variant occurring de novo in an affected individual and another publication described the variant in a reportedly affected father and daughter (Hannig V et al., PMID: 25137548; Motta M et al., PMID: 35348676). Additionally, this variant has been reported in the ClinVar database as a germline likely pathogenic variant by five sources and a variant of uncertain significance by three sources. Although the ClinGen RASopathy Variant Curation Expert Panel classifies this variant as a variant of uncertain significance, the classification is nearly seven years old and does not reference more current evidence. In at least one of the ClinVar entries, the submitter references internal data showing detection of the variant de novo and detection of the variant in multiple affected individuals. This variant is absent from the general population (gnomAD v.2.1.1), indicating it is not a common variant. Computational predictors indicate that the variant is damaging, evidence that correlates with impact to SHOC2 function. In support of this prediction, functional studies in transgenic zebrafish show the variant causes enhanced SHOC2 binding to both MRAS and PPP1CB, and the variant protein promotes increased EGF-stimulated MAPK signaling (Motta M et al., PMID: 35348676). Based on available information and the ACMG/AMP guidelines for variant interpretation and the RASopathy Variant Curation Expert Panel guidelines (Gelb BD et al., PMID: 29493581; Richards S et al., PMID: 25741868), this variant is classified as likely pathogenic. -
Pathogenic, no assertion criteria providedclinical testingGenetic Testing Lab, University of Kentucky College of MedicineAug 15, 2013- -
Pathogenic, no assertion criteria providedliterature onlyOMIMNov 01, 2014- -
RASopathy Pathogenic:2
Pathogenic, reviewed by expert panelcurationClinGen RASopathy Variant Curation Expert PanelSep 17, 2024The c.519G>A variant in the SHOC2 gene is a missense variant predicted to cause substitution of methionine by isoleucine at amino acid 173 (p.Met173Ile). This variant is absent from gnomAD v4.1.0 (PM2_Supporting). The computational predictor REVEL gives a score of 0.768 (PP3). This variant has been identified as a de novo occurrence with confirmed parental relationships in 3 individuals and with unconfirmed parental relationships in 1 individual with RASopathy (PS2_VeryStrong; Invitae, GeneDx, Ambry, Genomic Medicine Lab; ClinVar SCV001573982.4, SCV000209055.14, SCV002641556.1, SCV001573024.1). This variant has been reported in more than 5 probands diagnosed with RASopathy (PS4; PMIDs: 25137548, 29907801; Invitae, GeneDx, UCSF Genomic Medicine Lab, LabCorp, Ambry; ClinVar SCV001573982.4, SCV000209055.14, SCV001573024.1, SCV000699327.2, SCV002641556.1). ERK phosphorylation assays showed that this variant decreases the ability of SHOC2 to accelerate ERK1/2 phosphorylation (PS3 not met, PMID: 25137548). In summary, this variant meets criteria to be classified as pathogenic for autosomal dominant RASopathies based on the ACMG/AMP criteria applied, as specified by the ClinGen RASopathy Variant Curation Expert Panel: PS2_VeryStrong, PS4, PM2_Supporting, PP3 (Specification Version 2.1, 09/17/2024) -
Pathogenic, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpAug 10, 2023For these reasons, this variant has been classified as Pathogenic. Experimental studies are conflicting or provide insufficient evidence to determine the effect of this variant on SHOC2 function (PMID: 25137548, 30348783). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is not expected to disrupt SHOC2 protein function. ClinVar contains an entry for this variant (Variation ID: 181528). This missense change has been observed in individual(s) with clinical features of SHOC2-related conditions (PMID: 22670144, 25137548, 29907801; Invitae). In at least one individual the variant was observed to be de novo. This variant is not present in population databases (gnomAD no frequency). This sequence change replaces methionine, which is neutral and non-polar, with isoleucine, which is neutral and non-polar, at codon 173 of the SHOC2 protein (p.Met173Ile). -
See cases Pathogenic:1
Likely pathogenic, criteria provided, single submitterclinical testingCenter for Personalized Medicine, Children's Hospital Los AngelesDec 21, 2022- -
not provided Pathogenic:1
Likely pathogenic, criteria provided, single submitterclinical testingGeneDxOct 04, 2021Published as paternally inherited in an individual with some features suggestive of a RASopathy, whose father was reported to have intellectual disability, a high arched palate, sparse hair, and clubbed nails, but no additional findings suggestive of a RASopathy (Hannig et al., 2014); Not observed in large population cohorts (Lek et al., 2016); Published functional studies demonstrate conflicting data regarding the variant's effect, with some data suggesting a gain of protein function and some data suggesting a loss of protein function (Hannig et al., 2014; Young et al., 2018). Of note, the only well-defined pathogenic variant in the SHOC2 gene known to cause a RASopathy is c.4 A>G (p.Ser2Gly), which results in altered protein localization rather than function (Cordeddu et al., 2009; Lee et al., 2011).; In silico analysis, which includes protein predictors and evolutionary conservation, supports that this variant does not alter protein structure/function; Classified as a variant of uncertain signficance by the ClinGen RASopathy Expert Panel (SCV000616431.1; Gelb et al., 2018); This variant is associated with the following publications: (PMID: 25137548, 29907801, 30417923, 27574535, 30050098, 33106373, 30348783) -
Cardiovascular phenotype Pathogenic:1
Likely pathogenic, criteria provided, single submitterclinical testingAmbry GeneticsNov 29, 2021The c.519G>A (p.M173I) alteration is located in exon 2 (coding exon 1) of the SHOC2 gene. This alteration results from a G to A substitution at nucleotide position 519, causing the methionine (M) at amino acid position 173 to be replaced by an isoleucine (I). This variant was not reported in population-based cohorts in the Genome Aggregation Database (gnomAD). This alteration has been reported in multiple individuals with symptoms of Noonan-like disorder (Hannig, 2014; Ambry internal data, GeneDx pers comm, Invitae pers comm). The patient reported in Hannig, et al. (2014) had right optic nerve hypoplasia, macrocephaly, nystagmus and ptosis, speech delay, hyperactive behavior, sparse slow-growing hair, wide-spaced nipples, clubbed nails, and nonspecific findings on a brain MRI. Her height was normal. Her father was also heterozygous for this alteration and had intellectual disability, tall stature, high-arched palate, sparse hair, and clubbed nails. This amino acid position is highly conserved in available vertebrate species. Functional studies showed that the p.M173I mutant protein leads to dysregulation of the ERK1/2 pathway due to impaired capacity to interact with the catalytic subunit of protein phosphatase 1c and insufficient activation of RAF-1 kinase, suggesting loss-of-function as the mechanism of disease (Hannig, 2014). However, Young et al. (2018) found that p.M173I behaves as a gain-of-function mutant that has enhanced interaction with MRAS and PP1 and rescues ERK activation in SHOC2-deficient cells. This alteration is predicted to be tolerated by in silico analysis. Based on the available evidence, this alteration is classified as likely pathogenic. -
Non-immune hydrops fetalis Pathogenic:1
Likely pathogenic, criteria provided, single submitterclinical testingGenomic Medicine Lab, University of California San FranciscoJan 09, 2020- -
not specified Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingWomen's Health and Genetics/Laboratory Corporation of America, LabCorpApr 02, 2020Variant Summary : SHOC2 c.519G>A (p.Met173Ile) results in a conservative amino acid change located in the Leucine-rich repeat (IPR001611) of the encoded protein sequence. Four of five in-silico tools predict a benign effect of the variant on protein function. The variant was absent in 250232 control chromosomes (gnomAD). c.519G>A has been reported in the literature in a father and daughter who did not have classic symptoms of NS, CFC or NS/LAH, but displayed features overlapping all three conditions, with mild clinical manifestations (Hannig_2014). The variant was also reported by a ClinVar submitter in a proband with clinical features of a RASopathy (SCV000616431.3). A different variant affecting the same amino acid (c.517A>G, p.M173V) was confirmed as de novo occurrence in one individual with Noonan-like syndrome with loose anagen hair (NS/LAH) (PMID 22670144). These data indicate that the variant may be associated with disease. Functional studies have provided somewhat contradictory conclusions regarding the mechanism of action of this variant. Hannig et al (2014) in their study demonstrated the variant protein has impaired capacity to interact with protein phosphatase 1c (PP1c), leading to insufficient activation of RAF-1 kinase and is thus unable to fully rescue ERK1/2 activity in cells depleted of endogenous SHOC2. The authors concluded that the variant causes loss of function in the ERK1/2 pathway. A more recent study (Young_2018), concluded that M173I behaves as a gain-of-function mutant that has enhanced interaction with MRAS and PP1 and rescues ERK activation by upregulating the ERK pathway in SHOC2-deficient cells. The authors describe the variant as being only weakly activating, which could perhaps correlate with presence of mild symptoms in reported patients (e.g. Hannig_2014). Two ClinVar submitters including an expert panel (ClinGen RASopathy Variant Curation Expert Panel) (evaluation after 2014) cite the variant as uncertain significance. Based on the insufficient clinical and contradictory functional evidence outlined above, the variant was classified as uncertain significance. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.83
BayesDel_addAF
Benign
-0.0022
T
BayesDel_noAF
Benign
-0.24
CADD
Uncertain
23
DANN
Benign
0.93
DEOGEN2
Benign
0.11
T;.;T
Eigen
Benign
-0.42
Eigen_PC
Benign
-0.18
FATHMM_MKL
Pathogenic
0.99
D
LIST_S2
Uncertain
0.97
D;D;D
M_CAP
Pathogenic
0.80
D
MetaRNN
Uncertain
0.48
T;T;T
MetaSVM
Benign
-1.1
T
MutationAssessor
Benign
-0.12
N;N;.
PrimateAI
Pathogenic
0.87
D
PROVEAN
Benign
0.27
N;N;N
REVEL
Pathogenic
0.77
Sift
Benign
0.075
T;T;T
Sift4G
Benign
0.24
T;T;T
Polyphen
0.0040
B;B;.
Vest4
0.80
MutPred
0.32
Loss of catalytic residue at M173 (P = 0.0094);Loss of catalytic residue at M173 (P = 0.0094);.;
MVP
0.45
MPC
0.56
ClinPred
0.84
D
GERP RS
4.9
Varity_R
0.21
gMVP
0.58

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

LitVar

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs730881020; hg19: chr10-112724635; API