rs74315416
Variant summary
Our verdict is Benign. Variant got -10 ACMG points: 2P and 12B. PM1BP4_StrongBS1BS2
The NM_144773.4(PROKR2):c.518T>G(p.Leu173Arg) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.00316 in 1,614,222 control chromosomes in the GnomAD database, including 18 homozygotes. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).
Frequency
Consequence
NM_144773.4 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Benign. Variant got -10 ACMG points.
Transcripts
RefSeq
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
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PROKR2 | ENST00000678254.1 | c.518T>G | p.Leu173Arg | missense_variant | Exon 3 of 3 | NM_144773.4 | ENSP00000504128.1 | |||
PROKR2 | ENST00000217270.4 | c.518T>G | p.Leu173Arg | missense_variant | Exon 3 of 3 | 1 | ENSP00000217270.3 | |||
PROKR2 | ENST00000678059.1 | c.410T>G | p.Leu137Arg | missense_variant | Exon 3 of 3 | ENSP00000503366.1 |
Frequencies
GnomAD3 genomes AF: 0.00212 AC: 322AN: 152244Hom.: 1 Cov.: 33
GnomAD3 exomes AF: 0.00230 AC: 578AN: 251442Hom.: 4 AF XY: 0.00238 AC XY: 324AN XY: 135896
GnomAD4 exome AF: 0.00326 AC: 4772AN: 1461860Hom.: 17 Cov.: 39 AF XY: 0.00320 AC XY: 2329AN XY: 727230
GnomAD4 genome AF: 0.00211 AC: 322AN: 152362Hom.: 1 Cov.: 33 AF XY: 0.00200 AC XY: 149AN XY: 74508
ClinVar
Submissions by phenotype
not provided Uncertain:3Benign:2
The PROKR2 p.Leu173Arg variant was identified in several compound heterozygous and homozygous individuals with idiopathic central hypogonadism, as well as a four heterozygous individuals with complex congenital hypopituitarism (Stefanija_2012_PMID:22773735; McCabe_2013_PMID:23386640; Dode_2006_PMID: 17054399; Cole_2008_PMID:18559922). Pathogenic variants in the PROKR2 gene have been reported to associate with the autosomal recessive form of isolated gondotropin-releasing hormone (GnRH) deficiency. In familial cases, this variant is shown to segregate with disease. However, this variant is also seen in unaffected homozygous and heterozygous individuals, which is inconsistent with the autosomal recessive form of GnRH deficiency (McCabe_2013_PMID:23386640; Dode_2006_PMID: 17054399). The variant was identified in dbSNP (ID: rs74315416), LOVD 3.0 and ClinVar (classified as likely benign by Invitae, Illumina and Division of Genomic Diagnostics, Children's Hospital of Philadelphia, as uncertain significance by GeneDx and Mendelics, and as pathogenic by Athena Diagnostics). The variant was identified in control databases in 621 of 282842 chromosomes (4 homozygous) at a frequency of 0.002196 increasing the likelihood this could be a low frequency benign variant (Genome Aggregation Database March 6, 2019, v2.1.1). The variant was observed in the following populations: Ashkenazi Jewish in 65 of 10370 chromosomes (freq: 0.006268), European (non-Finnish) in 429 of 129164 chromosomes (freq: 0.003321), Latino in 81 of 35436 chromosomes (freq: 0.002286), Other in 15 of 7222 chromosomes (freq: 0.002077), African in 21 of 24964 chromosomes (freq: 0.000841), South Asian in 9 of 30616 chromosomes (freq: 0.000294) and European (Finnish) in 1 of 25118 chromosomes (freq: 0.00004), but was not observed in the East Asian population. The p.Leu173 residue is conserved across mammals and other organisms, and computational analyses (PolyPhen-2, SIFT, AlignGVGD, BLOSUM, MutationTaster) suggest that the variant may impact the protein; however, this information is not predictive enough to assume pathogenicity. Functional studies reveal that this variant causes impaired protein activity by affecting normal protein localization to the cell surface (Libri_2014_PMID:24276467; Monnier_2009_PMID:18826963; Cole_2008_PMID:18559922). The variant occurs outside of the splicing consensus sequence and in silico or computational prediction software programs (SpliceSiteFinder, MaxEntScan, NNSPLICE, GeneSplicer) do not predict a difference in splicing. In summary, based on the above information the clinical significance of this variant cannot be determined with certainty at this time. This variant is classified as a variant of uncertain significance. -
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The best available variant frequency is higher than the disease allele frequency; however, this variant is statistically enriched in patients compared to population databases. Variant has been seen homozygously in unaffected individuals. Assessment of experimental evidence suggests this variant results in abnormal protein function. -
PROKR2: BS1, BS2 -
Reported in the heterozygous, homozygous, or compound heterozygous state in published literature in multiple unrelated patients from different ethnic backgrounds with variable phenotypes, including classic Kallman syndrome with anosmia and hypogonadism, hypogonadotropic hypogonadism, hypothalamic amenorrhea, and gonadotropin-releasing hormone (GnRH) deficiency (PMID: 17054399, 21247312, 22035731, 22773735, 23386640); Published functional studies demonstrate decreased signalling activity secondary to impaired cell-surface targeting of the PROKR2 receptor protein (PMID: 18826963); 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: 22035731, 18723471, 26733480, 28754744, 24276467, 23643382, 22466334, 23386640, 21247312, 27168972, 27899157, 29161432, 29419413, 34426522, 35207461, 35173048, 35236788, 33098107, 34231173, 33401665, Wang2022[case report], 33932486, 36531499, 30476936, 36034425, 32222824, 33988008, 36843573, 35066646, 36138264, 36920900, 25071724, 37338295, 37321569, 36694982, 18826963, 22773735, 17054399) -
Hypogonadotropic hypogonadism 3 with or without anosmia Pathogenic:1Uncertain:2Benign:1
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This variant was observed as part of a predisposition screen in an ostensibly healthy population. A literature search was performed for the gene, cDNA change, and amino acid change (where applicable). Publications were found based on this search. The evidence from the literature, in combination with allele frequency data from public databases where available, was sufficient to determine this variant is unlikely to cause disease. Therefore, this variant is classified as likely benign. -
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not specified Benign:2
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Hypogonadotropic hypogonadism Pathogenic:1
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Infertility disorder Uncertain:1
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Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at