rs752200396
Variant summary
Our verdict is Uncertain significance. Variant got 4 ACMG points: 4P and 0B. PM1PP3PP5
The NM_000256.3(MYBPC3):c.2176C>T(p.Arg726Cys) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0000403 in 1,613,442 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).
Frequency
Consequence
NM_000256.3 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Uncertain_significance. Variant got 4 ACMG points.
Transcripts
RefSeq
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
---|---|---|---|---|---|---|---|---|---|---|
MYBPC3 | ENST00000545968.6 | c.2176C>T | p.Arg726Cys | missense_variant | Exon 23 of 35 | 5 | NM_000256.3 | ENSP00000442795.1 | ||
MYBPC3 | ENST00000399249.6 | c.2176C>T | p.Arg726Cys | missense_variant | Exon 22 of 34 | 5 | ENSP00000382193.2 | |||
MYBPC3 | ENST00000544791.1 | n.2176C>T | non_coding_transcript_exon_variant | Exon 23 of 27 | 5 | ENSP00000444259.1 |
Frequencies
GnomAD3 genomes AF: 0.000105 AC: 16AN: 152166Hom.: 0 Cov.: 32
GnomAD3 exomes AF: 0.0000606 AC: 15AN: 247584Hom.: 0 AF XY: 0.0000744 AC XY: 10AN XY: 134422
GnomAD4 exome AF: 0.0000335 AC: 49AN: 1461276Hom.: 0 Cov.: 31 AF XY: 0.0000371 AC XY: 27AN XY: 726896
GnomAD4 genome AF: 0.000105 AC: 16AN: 152166Hom.: 0 Cov.: 32 AF XY: 0.000135 AC XY: 10AN XY: 74332
ClinVar
Submissions by phenotype
not provided Pathogenic:1Uncertain:1
Identified in a patient with HCM, a patient with sudden unexplained death (SUD), in a patient from the Jackson Heart Study cohort (PMID: 32917565, 19150014, 22958901); 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: 22958901, 22765922, 20594303, 33919104, 34426522, 32917565, 28356264, 19150014, 35885957) -
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Cardiomyopathy Uncertain:2
This missense variant replaces arginine with cysteine at codon 726 of the MYBPC3 protein. Computational prediction tools indicate that this variant has a deleterious impact on protein structure and function. To our knowledge, functional studies have not been reported for this variant. This variant has been reported in two individuals affected with hypertrophic cardiomyopathy (PMID: 22765922, 27930701), in one individual affected with noncompaction cardiomyopathy (PMID: 35885957), in one individual affected with Tetralogy of Fallot and multiple congenital anomalies (PMID: 35885957), and in one individual affected with sudden cardiac death (PMID: 32917565, 33919104). It has also been reported in one asymptomatic individual (PMID: 19150014). This variant has been identified in 16/278974 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -
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Hypertrophic cardiomyopathy Uncertain:2
This missense variant replaces arginine with cysteine at codon 726 of the MYBPC3 protein. Computational prediction is inconclusive regarding the impact of this variant on protein structure and function (internally defined REVEL score threshold 0.5 < inconclusive < 0.7, PMID: 27666373). To our knowledge, functional studies have not been reported for this variant. This variant has been reported in individuals affected with hypertrophic cardiomyopathy (PMID: 22765922, 27930701), in an individual affected with noncompaction cardiomyopathy (PMID: 35885957), in an individual affected with Tetralogy of Fallot and multiple congenital anomalies (PMID: 35885957), and in an individual affected with sudden cardiac death (PMID: 32917565, 33919104). It has also been reported in an asymptomatic individual (PMID: 19150014). This variant has been identified in 16/278974 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -
This sequence change replaces arginine, which is basic and polar, with cysteine, which is neutral and slightly polar, at codon 726 of the MYBPC3 protein (p.Arg726Cys). This variant is present in population databases (rs752200396, gnomAD 0.02%). This missense change has been observed in individual(s) with hypertrophic cardiomyopathy (PMID: 19150014). ClinVar contains an entry for this variant (Variation ID: 575705). Algorithms developed to predict the effect of missense changes on protein structure and function (SIFT, PolyPhen-2, Align-GVGD) all suggest that this variant is likely to be disruptive. In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. -
Left ventricular noncompaction 10 Pathogenic:1
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not specified Uncertain:1
Variant summary: MYBPC3 c.2176C>T (p.Arg726Cys) results in a non-conservative amino acid change located in the immunoglobulin subtype 2 domain (IPR003598) of the encoded protein sequence. Five of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 6.1e-05 in 247584 control chromosomes. This frequency is not significantly higher than estimated for a pathogenic variant in MYBPC3 causing Cardiomyopathy (6.1e-05 vs 0.001), allowing no conclusion about variant significance. c.2176C>T has been reported in the literature in the heterozygous state in an individual affected with hypertrophic cardiomyopathy who was subsequently cited by others (Garcia-Castro_2009, Coto_2012, Gomez_2017), in two cases of sudden unexplained death, one of which was likely attributed to dilated cardiomyopathy (Sanchez_2016) and the other with no conclusive cardiac-related cause (Iglesias_2021), and in two unrelated individuals undergoing genetic testing for congenital abnormalities, one with noncompaction cardiomyopathy and one with multiple congenital abnormalities including Tetralogy of Fallot, both of whom inherited the variant from a presumably unaffected parent (Delea_2022). These reports do not provide unequivocal conclusions about association of the variant with Cardiomyopathy. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. The following publications have been ascertained in the context of this evaluation (PMID: 22765922, 35885957, 19150014, 28356264, 33919104, 35629155, 27930701). Six submitters have cited clinical-significance assessments for this variant to ClinVar after 2014 and classified the variant as VUS (n=5) or likely pathogenic (n=1). Based on the evidence outlined above, the variant was classified as uncertain significance. -
Hypertrophic cardiomyopathy 4;C3715165:Left ventricular noncompaction 10 Uncertain:1
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Hypertrophic cardiomyopathy 4 Uncertain:1
The missense variant c.2176C>Tp.Arg726Cys in MYBPC3 gene has been reported in individuals affected with hypertrophic cardiomyopathy Sanchez et. al., 2016; Coto et. al., 2012, as well as in an asymptomatic individual García-Castro et. al., 2009. This variant has been reported in one case with sudden cardiac death Ripoll-Vera et. al., 2021. The p.Arg726Cys variant is novel not in any individuals in 1000 Genomes and has allele frequency of 0.006% in gnomAD exomes database. This variant has been reported to the ClinVar database as Likely Pathogenic / Uncertain Significance. The amino acid change p.Arg726Cys in MYBPC3 is predicted as conserved by GERP++ and PhyloP across 100 vertebrates. The amino acid Arg at position 726 is changed to a Cys changing protein sequence and it might alter its composition and physico-chemical properties. Functional studies will be required to confirm the pathogenicity of the variant. For these reasons, this variant has been classified as Uncertain Significance VUS. -
Cardiovascular phenotype Uncertain:1
The p.R726C variant (also known as c.2176C>T), located in coding exon 23 of the MYBPC3 gene, results from a C to T substitution at nucleotide position 2176. The arginine at codon 726 is replaced by cysteine, an amino acid with highly dissimilar properties. This variant has been detected in individuals with varying phenotypes including hypertrophic cardiomyopathy, dilated cardiomyopathy, sudden unexplained death, congenital heart disease, and noncompaction cardiomyopathy (Coto E et al. J Transl Med, 2010 Jul;8:64; Sanchez O et al. PLoS One, 2016 Dec;11:e0167358; Iglesias M et al. J Clin Med, 2021 Apr;10; Delea M et al. Genes (Basel), 2022 Jun;13). This amino acid position is not well conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear. -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at