rs760549861

Variant summary

Our verdict is Pathogenic. Variant got 13 ACMG points: 13P and 0B. PM1PM5PP3PP5_Very_Strong

The NM_000350.3(ABCA4):​c.5318C>T​(p.Ala1773Val) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0000254 in 1,613,990 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 Likely pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. A1773?) has been classified as Pathogenic.

Frequency

Genomes: 𝑓 0.0000066 ( 0 hom., cov: 32)
Exomes 𝑓: 0.000027 ( 0 hom. )

Consequence

ABCA4
NM_000350.3 missense

Scores

9
8
2

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:12

Conservation

PhyloP100: 10.0
Variant links:
Genes affected
ABCA4 (HGNC:34): (ATP binding cassette subfamily A member 4) The membrane-associated protein encoded by this gene is a member of the superfamily of ATP-binding cassette (ABC) transporters. ABC proteins transport various molecules across extra- and intracellular membranes. ABC genes are divided into seven distinct subfamilies (ABC1, MDR/TAP, MRP, ALD, OABP, GCN20, White). This protein is a member of the ABC1 subfamily. Members of the ABC1 subfamily comprise the only major ABC subfamily found exclusively in multicellular eukaryotes. This protein is a retina-specific ABC transporter with N-retinylidene-PE as a substrate. It is expressed exclusively in retina photoreceptor cells, and the gene product mediates transport of an essental molecule, all-trans-retinal aldehyde (atRAL), across the photoreceptor cell membrane. Mutations in this gene are found in patients diagnosed with Stargardt disease, a form of juvenile-onset macular degeneration. Mutations in this gene are also associated with retinitis pigmentosa-19, cone-rod dystrophy type 3, early-onset severe retinal dystrophy, fundus flavimaculatus, and macular degeneration age-related 2. [provided by RefSeq, Sep 2019]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 13 ACMG points.

PM1
In a transmembrane_region Helical (size 20) in uniprot entity ABCA4_HUMAN there are 32 pathogenic changes around while only 0 benign (100%) in NM_000350.3
PM5
Other missense variant is known to change same aminoacid residue: Variant chr1-94014684-CGC-CT is described in Lovd as [Pathogenic].
PP3
MetaRNN computational evidence supports a deleterious effect, 0.825
PP5
Variant 1-94014685-G-A is Pathogenic according to our data. Variant chr1-94014685-G-A is described in ClinVar as [Likely_pathogenic]. Clinvar id is 236129.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr1-94014685-G-A is described in Lovd as [Pathogenic]. Variant chr1-94014685-G-A is described in Lovd as [Likely_pathogenic]. Variant chr1-94014685-G-A is described in Lovd as [Pathogenic]. Variant chr1-94014685-G-A is described in Lovd as [Likely_pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
ABCA4NM_000350.3 linkuse as main transcriptc.5318C>T p.Ala1773Val missense_variant 38/50 ENST00000370225.4 NP_000341.2
ABCA4XM_047416704.1 linkuse as main transcriptc.5096C>T p.Ala1699Val missense_variant 37/49 XP_047272660.1

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
ABCA4ENST00000370225.4 linkuse as main transcriptc.5318C>T p.Ala1773Val missense_variant 38/501 NM_000350.3 ENSP00000359245 P1

Frequencies

GnomAD3 genomes
AF:
0.00000657
AC:
1
AN:
152118
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.0000654
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.00
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000756
AC:
19
AN:
251426
Hom.:
0
AF XY:
0.0000515
AC XY:
7
AN XY:
135878
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.000463
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.0000544
Gnomad SAS exome
AF:
0.0000653
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000274
AC:
40
AN:
1461872
Hom.:
0
Cov.:
32
AF XY:
0.0000261
AC XY:
19
AN XY:
727236
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.000335
Gnomad4 ASJ exome
AF:
0.0000383
Gnomad4 EAS exome
AF:
0.0000504
Gnomad4 SAS exome
AF:
0.0000464
Gnomad4 FIN exome
AF:
0.0000187
Gnomad4 NFE exome
AF:
0.0000135
Gnomad4 OTH exome
AF:
0.0000331
GnomAD4 genome
AF:
0.00000657
AC:
1
AN:
152118
Hom.:
0
Cov.:
32
AF XY:
0.0000135
AC XY:
1
AN XY:
74312
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.0000654
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.00
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.00000961
Hom.:
0
Bravo
AF:
0.0000227
ExAC
AF:
0.000115
AC:
14

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:12
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Pathogenic:4
Pathogenic, criteria provided, single submitterclinical testingInstitute of Medical Genetics and Applied Genomics, University Hospital TübingenFeb 01, 2021- -
Pathogenic, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpJan 29, 2024This sequence change replaces alanine, which is neutral and non-polar, with valine, which is neutral and non-polar, at codon 1773 of the ABCA4 protein (p.Ala1773Val). This variant is present in population databases (rs760549861, gnomAD 0.05%). This missense change has been observed in individuals with ABCA4-related retinal disease (PMID: 18652558, 23419329, 28130426, 29422768). It is commonly reported in individuals of Mexican ancestry (PMID: 18652558, 23419329, 28130426, 29422768). ClinVar contains an entry for this variant (Variation ID: 236129). 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 expected to disrupt ABCA4 protein function with a positive predictive value of 95%. For these reasons, this variant has been classified as Pathogenic. -
Pathogenic, criteria provided, single submitterclinical testingGeneDxJun 05, 2024Reported in multiple individuals with Stargardt disease from Mexico, suggesting a founder mutation effect (PMID: 23419329, 29422768); Published functional studies demonstrate a damaging effect with significant reduction of protein function (PMID: 33375396); This variant is associated with the following publications: (PMID: 26161775, 23591405, 25082829, 25301883, 23419329, 35120629, 35260635, 31964843, 36460718, 32307445, 36729443, 36087940, 36284460, 29641573, 28118664, 28130426, 24763286, 32531858, 34315337, 25283059, 26780318, 28512305, 18652558, 28327576, 29288030, 29422768, 29925512, 31736247, 31456290, 32090030, 32845068, 31589614, 32619608, 33090715, 33301772, 33732702, 35657619, 35119454, 33375396) -
Pathogenic, criteria provided, single submitterclinical testingCeGaT Center for Human Genetics TuebingenSep 01, 2016- -
Stargardt disease Pathogenic:3
Likely pathogenic, no assertion criteria providedresearchSharon lab, Hadassah-Hebrew University Medical CenterJun 23, 2019- -
Pathogenic, criteria provided, single submitterclinical testingWomen's Health and Genetics/Laboratory Corporation of America, LabCorpJan 08, 2020Variant summary: ABCA4 c.5318C>T (p.Ala1773Val) results in a non-conservative amino acid change in 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 7.6e-05 in 251426 control chromosomes (gnomAD). This frequency is not significantly higher than expected for a pathogenic variant in ABCA4 causing Stargardt disease (7.6e-05 vs 0.0014), allowing no conclusion about variant significance. c.5318C>T has been reported in the literature in numerous individuals affected with Stargardt disease (homozygotes and heterozygotes) and may be a Mexican founder mutation (Chacon-Camacho_2013, Fujinami_2019, Lopez-Rubio_2018, Stenirri_2008). These data indicate that the variant is very likely to be associated with disease. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. Three ClinVar submitters (evaluation after 2014) cite the variant as pathogenic/likely pathogenic. Based on the evidence outlined above, the variant was classified as pathogenic. -
Pathogenic, criteria provided, single submitterclinical testingLaboratory for Molecular Medicine, Mass General Brigham Personalized MedicineMay 01, 2023The p.Ala1773Val variant in ABCA4 has been reported in >10 individuals with Stargardt disease and/or retinal degeneration, including at least 3 compound heterozygotes and 6 homozygotes, and segregated in 4 affected relatives (Stenirri 2008, Chacón-Camacho 2013, Duncker 2015, Biswas 2017, López-Rubio 2018). This variant has been reported in ClinVar (Variation ID: 236129) and has been identified in 0.05% (16/33582) of Latino chromosomes by the Genome Aggregation Database (gnomAD, http://gnomad.broadinstitute.org/; dbSNP rs760549861). Although this variant is seen in the general population, its frequency is consistent with a recessive carrier frequency. Additionally, another allele the same position (p.Ala1773Glu) has been reported with a similar phenotype (Downes 2012), suggesting that changes at this position may not be tolerated. In summary, this variant is pathogenic for Stargardt disease in an autosomal recessive manner. ACMG/AMP Criteria applied: PM3_VeryStrong; PP1_Moderate; PP3. -
Severe early-childhood-onset retinal dystrophy Pathogenic:2
Likely pathogenic, criteria provided, single submitterclinical testingJohns Hopkins Genomics, Johns Hopkins UniversityJan 21, 2020- -
Pathogenic, no assertion criteria providedresearchOphthalmo-Genetics Lab, Instituto de Oftalmologia Conde de Valenciana-- -
ABCA4-related disorder Pathogenic:1
Pathogenic, no assertion criteria providedclinical testingPreventionGenetics, part of Exact SciencesSep 17, 2024The ABCA4 c.5318C>T variant is predicted to result in the amino acid substitution p.Ala1773Val. This variant has been reported many times along with a second ABCA4 variant in individuals with retinal disease (see for examples: Chacón-Camacho et al. 2013. PubMed ID: 23419329; Duncker et al. 2015. PubMed ID: 25283059; Table S1, Karali et al. 2022. PubMed ID: 36460718; Table S1, Lin et al. 2024. PubMed ID: 38219857). This variant is reported in 0.046% of alleles in individuals of Latino descent in gnomAD. This variant is interpreted as pathogenic. -
Severe early-childhood-onset retinal dystrophy;C1858806:Cone-rod dystrophy 3;C1866422:Retinitis pigmentosa 19;C3495438:Age related macular degeneration 2 Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingFulgent Genetics, Fulgent GeneticsNov 23, 2021- -
Retinal dystrophy Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingBlueprint GeneticsAug 09, 2019- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.79
BayesDel_addAF
Pathogenic
0.17
D
BayesDel_noAF
Pathogenic
0.34
CADD
Pathogenic
31
DANN
Pathogenic
1.0
DEOGEN2
Uncertain
0.73
D;D
Eigen
Pathogenic
0.83
Eigen_PC
Pathogenic
0.74
FATHMM_MKL
Uncertain
0.95
D
LIST_S2
Pathogenic
0.98
D;D
M_CAP
Uncertain
0.12
D
MetaRNN
Pathogenic
0.82
D;D
MetaSVM
Uncertain
0.53
D
MutationAssessor
Uncertain
2.8
.;M
MutationTaster
Benign
1.0
D;D
PrimateAI
Uncertain
0.50
T
PROVEAN
Uncertain
-3.0
.;D
REVEL
Pathogenic
0.79
Sift
Benign
0.044
.;D
Sift4G
Uncertain
0.0030
D;D
Polyphen
1.0
.;D
Vest4
0.92
MVP
0.93
MPC
0.41
ClinPred
0.90
D
GERP RS
4.7
Varity_R
0.54
gMVP
0.96

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.10
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: rs760549861; hg19: chr1-94480241; COSMIC: COSV64670966; COSMIC: COSV64670966; API