rs752135143
Variant summary
Our verdict is Pathogenic. The variant received 11 ACMG points: 11P and 0B. PM2PP3PP5_Very_Strong
The ENST00000526567.5(ATM):c.336G>A(p.Lys112Lys) variant causes a synonymous change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.000000686 in 1,456,716 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Likely pathogenic (★★).
Frequency
Consequence
ENST00000526567.5 synonymous
Scores
Clinical Significance
Conservation
Publications
- hereditary breast carcinomaInheritance: AD Classification: DEFINITIVE Submitted by: Ambry Genetics, ClinGen
- ataxia telangiectasiaInheritance: AR Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Ambry Genetics, Genomics England PanelApp, Labcorp Genetics (formerly Invitae), G2P, ClinGen, Laboratory for Molecular Medicine, Orphanet
- hereditary nonpolyposis colon cancerInheritance: AD Classification: MODERATE, LIMITED Submitted by: ClinGen, Ambry Genetics
- prostate cancerInheritance: AD Classification: MODERATE Submitted by: Ambry Genetics
- sarcomaInheritance: AD Classification: MODERATE Submitted by: Genomics England PanelApp
- familial ovarian cancerInheritance: AD Classification: LIMITED Submitted by: ClinGen
- gastric carcinomaInheritance: AD Classification: LIMITED Submitted by: Ambry Genetics
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ACMG classification
Our verdict: Pathogenic. The variant received 11 ACMG points.
Transcripts
RefSeq
Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt |
---|---|---|---|---|---|---|---|---|
ATM | NM_000051.4 | c.331+5G>A | splice_region_variant, intron_variant | Intron 4 of 62 | ENST00000675843.1 | NP_000042.3 |
Ensembl
Frequencies
GnomAD3 genomes Cov.: 33
GnomAD2 exomes AF: 0.00000401 AC: 1AN: 249372 AF XY: 0.00 show subpopulations
GnomAD4 exome AF: 6.86e-7 AC: 1AN: 1456716Hom.: 0 Cov.: 32 AF XY: 0.00 AC XY: 0AN XY: 724808 show subpopulations
GnomAD4 genome Cov.: 33
ClinVar
Submissions by phenotype
not provided Pathogenic:6
Intronic variant directly or indirectly altering the +5 splice site in a gene for which loss of function is a known mechanism of disease, and published functional studies demonstrate this variant causes skipping of exon 4, with reduced or absent ATM protein and kinase activity (Verhagen et al., 2009; Verhagen et al., 2012; Nakamura et al., 2012; van Os et al., 2017); Observed in the homozygous or compound heterozygous state in several individuals with ataxia-telangiectasia (Verhagen et al., 2009; Verhagen et al., 2012; Nakamura et al., 2012; Chen et al., 2013; van Os et al., 2017); Observed in the heterozygous state in individuals with prostate or ovarian cancer (Lilyquist et al., 2017; Darst et al., 2021); Not observed at significant frequency in large population cohorts (gnomAD); Also reported as IVS6+5G>A using alternate intron nomenclature; This variant is associated with the following publications: (PMID: 23726790, 22006793, 19535770, 23566627, 22213089, 28126470, 19705055, 30549301, 29288088, 32853339, 29922827, 30850667, 37649078, 28888541) -
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Ataxia-telangiectasia syndrome Pathogenic:4
The c.331+5G>A variant in ATM has been reported in at least 2 homozygous and 2 compound heterozygous individuals with ataxia-telangiectasia and segregated with disease in at least 1 affected family member (Verhagen 2009 PMID: 19535770, Nakamura 2012 PMID: 22006793, Verhagen 2012 PMID: 22213089, Chen 2013 PMID: 23726790). It has also been reported in ClinVar (Variation ID 230851) but was absent from large population studies. This variant is located in the 5'/3' splice region. Computational tools do not provide strong support for a splicing impact, however, In vitro functional studies (including using patient tissue) support exon 6 (exon 5 on NM000051) skipping (introducing a frameshift) and an impact on ATM function (Verhagen 2009 PMID: 19535770, Nakamura 2012 PMID: 22006793). Loss of function of the ATM gene is an established disease mechanism in autosomal recessive ataxia telangiectasia. In summary, this variant meets criteria to be classified as pathogenic for autosomal recessive ataxia telangiectasia. ACMG/AMP Criteria applied: PM2_supporting, PVS1, PM3_Strong. -
This submission and the accompanying classification are no longer maintained by the submitter. For more information on current observations and classification, please contact variantquestions@myriad.com. -
The variant is observed at an extremely low frequency in the gnomAD v2.1.1 dataset (total allele frequency: <0.001%). Splice variant predicted to produce a truncated protein by alternate splicing. Functional studies provide strong evidence of the variant having a damaging effect on the gene or gene product (PMID: 19535770). In silico tools predict the variant to alter splicing and produce an abnormal transcript (SpliceAI: 0.98). The variant has been reported to be in trans with a pathogenic variant as either compound heterozygous or homozygous in at least one similarly affected unrelated individual (PMID: 19535770, 22213089, 23726790). The variant has been reported to co-segregate with the disease in at least one similarly affected relative/individual in the same family or similarly affected unrelated family (PMID: 23726790). The variant has been reported at least twice as pathogenic with clinical assertions and evidence for the classification (ClinVar ID: VCV000230851 / 3billion dataset). Therefore, this variant is classified as Pathogenic according to the recommendation of ACMG/AMP guideline. -
This sequence change falls in intron 4 of the ATM gene. It does not directly change the encoded amino acid sequence of the ATM protein. RNA analysis indicates that this variant induces altered splicing and may result in an absent or altered protein product. This variant is present in population databases (rs752135143, gnomAD 0.0009%). This variant has been observed in individuals with ataxia-telangiectasia (PMID: 19535770, 22006793, 22213089, 23726790). It has also been observed to segregate with disease in related individuals. ClinVar contains an entry for this variant (Variation ID: 230851). Algorithms developed to predict the effect of variants on gene product structure and function are not available or were not evaluated for this variant. Experimental studies have shown that this variant affects ATM function (PMID: 19535770). Variants that disrupt the consensus splice site are a relatively common cause of aberrant splicing (PMID: 17576681, 9536098). Studies have shown that this variant results in skipping of exon 4, and produces a non-functional protein and/or introduces a premature termination codon (internal data). For these reasons, this variant has been classified as Pathogenic. -
Familial cancer of breast Pathogenic:3
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This variant is considered likely pathogenic. mRNA analysis has demonstrated abnormal mRNA splicing occurs [Myriad internal data, PMID: 17726045]. This variant has been reported in multiple individuals with clinical features of gene-specific disease [PMID: 19535770, 22213089, 23726790]. -
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Hereditary cancer-predisposing syndrome Pathogenic:2
The c.331+5G>A intronic pathogenic mutation results from a G to A substitution 5 nucleotides after coding exon 3 in the ATM gene. In one study, this alteration was detected as homozygous in two related individuals diagnosed with ataxia-telangiectasia (A-T) and was correlated with decreased ATM protein levels and kinase activity (Verhagen MM et al, Neurology 2009 Aug; 73(6):430-7). This alteration has also been identified in several individuals with A-T as a compound heterozygous state (Morio T et al. Int. J. Hematol., 2009 Nov;90:455-462; Nakamura K et al. Hum. Mutat., 2012 Jan;33:198-208; Verhagen MM et al. Hum. Mutat., 2012 Mar;33:561-71; Chen Z et al. Neurobiol Aging, 2013 Oct;34:2442.e11-7). This nucleotide position is highly conserved in available vertebrate species. In silico splice site analysis predicts that this alteration will weaken the native splice donor site. RNA studies have demonstrated that this alteration results in abnormal splicing in the set of samples tested (Ambry internal data). This variant is considered to be rare based on population cohorts in the Genome Aggregation Database (gnomAD). Based on the supporting evidence, this alteration is interpreted as a disease-causing mutation. -
This variant causes a G>A nucleotide substitution at the +5 position of intron 4 of ATM. Splice site prediction tools suggest that this variant may have a significant impact on RNA splicing. This variant has been reported to impact RNA splicing by external laboratories (ClinVar Accession: SCV000274529.8, SCV001219332.5, SCV004932145.1). This variant has been observed with a second pathogenic variant in trans in multiple individuals affected with ataxia-telangiectasia (PMID: 19535770, 19705055, 22006793, 22213089, 23726790). Patient derived samples showed decreased ATM protein levels and kinase activity (PMID: 19535770, 22213089). This variant has also been identified in 1/249372 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Loss of ATM function is a known mechanism of disease. Based on the available evidence, this variant is classified as Pathogenic. -
Ataxia-telangiectasia syndrome;C0346153:Familial cancer of breast Pathogenic:1
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Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at