rs769233111

Variant summary

Our verdict is Uncertain significance. Variant got 1 ACMG points: 2P and 1B. PM2BS1_Supporting

The NM_004387.4(NKX2-5):​c.13C>T​(p.Pro5Ser) variant causes a missense change. The variant allele was found at a frequency of 0.0000137 in 1,606,956 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Uncertain significance (★★).

Frequency

Genomes: 𝑓 0.000020 ( 0 hom., cov: 30)
Exomes 𝑓: 0.000013 ( 0 hom. )

Consequence

NKX2-5
NM_004387.4 missense

Scores

3
11
5

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:4

Conservation

PhyloP100: 6.08
Variant links:
Genes affected
NKX2-5 (HGNC:2488): (NK2 homeobox 5) This gene encodes a homeobox-containing transcription factor. This transcription factor functions in heart formation and development. Mutations in this gene cause atrial septal defect with atrioventricular conduction defect, and also tetralogy of Fallot, which are both heart malformation diseases. Mutations in this gene can also cause congenital hypothyroidism non-goitrous type 5, a non-autoimmune condition. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Oct 2009]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Uncertain_significance. Variant got 1 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
BS1
Variant frequency is greater than expected in population amr. gnomad4_exome allele frequency = 0.0000131 (19/1454786) while in subpopulation AMR AF= 0.000408 (18/44088). AF 95% confidence interval is 0.000263. There are 0 homozygotes in gnomad4_exome. There are 5 alleles in male gnomad4_exome subpopulation. Median coverage is 33. This position pass quality control queck. Existence of Clinvar submissions makes me limit the strength of this signal to Supporting

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
NKX2-5NM_004387.4 linkc.13C>T p.Pro5Ser missense_variant Exon 1 of 2 ENST00000329198.5 NP_004378.1 P52952-1A0A0S2Z383
NKX2-5NM_001166176.2 linkc.13C>T p.Pro5Ser missense_variant Exon 1 of 2 NP_001159648.1 P52952-2
NKX2-5NM_001166175.2 linkc.13C>T p.Pro5Ser missense_variant Exon 1 of 2 NP_001159647.1 P52952-3A0A0S2Z3K2
NKX2-5XM_017009071.3 linkc.13C>T p.Pro5Ser missense_variant Exon 1 of 2 XP_016864560.1 E5RH49

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
NKX2-5ENST00000329198.5 linkc.13C>T p.Pro5Ser missense_variant Exon 1 of 2 1 NM_004387.4 ENSP00000327758.4 P52952-1
NKX2-5ENST00000424406.2 linkc.13C>T p.Pro5Ser missense_variant Exon 1 of 2 1 ENSP00000395378.2 P52952-3
NKX2-5ENST00000521848.1 linkc.13C>T p.Pro5Ser missense_variant Exon 1 of 2 2 ENSP00000427906.1 P52952-2
NKX2-5ENST00000517440.1 linkc.13C>T p.Pro5Ser missense_variant Exon 1 of 2 4 ENSP00000429905.1 E5RH49

Frequencies

GnomAD3 genomes
AF:
0.0000197
AC:
3
AN:
152170
Hom.:
0
Cov.:
30
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.000196
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:
0.0000674
AC:
16
AN:
237222
Hom.:
0
AF XY:
0.0000230
AC XY:
3
AN XY:
130392
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.000473
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000131
AC:
19
AN:
1454786
Hom.:
0
Cov.:
33
AF XY:
0.00000691
AC XY:
5
AN XY:
723696
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.000408
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.00
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
9.01e-7
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
AF:
0.0000197
AC:
3
AN:
152170
Hom.:
0
Cov.:
30
AF XY:
0.00
AC XY:
0
AN XY:
74334
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.000196
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
Bravo
AF:
0.0000378
ExAC
AF:
0.0000664
AC:
8

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:4
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not specified Uncertain:1
Jan 20, 2025
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Variant summary: NKX2-5 c.13C>T (p.Pro5Ser) 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 6.7e-05 in 237222 control chromosomes, predominantly at a frequency of 0.00047 within the Latino subpopulation in the gnomAD database. c.13C>T has been reported in the literature in at least an individual affected with down syndrome with normal heart and no family history of congenital heart defect (example: Alcntara-Ortigoza_2015). This report however, does not provide unequivocal conclusions about association of the variant with congenital heart disease. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. The following publication has been ascertained in the context of this evaluation (PMID: 25524324). ClinVar contains an entry for this variant (Variation ID: 578898). Based on the evidence outlined above, the variant was classified as VUS-possibly benign. -

Atrial septal defect 7 Uncertain:1
Dec 25, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This sequence change replaces proline, which is neutral and non-polar, with serine, which is neutral and polar, at codon 5 of the NKX2-5 protein (p.Pro5Ser). This variant is present in population databases (rs769233111, gnomAD 0.05%), and has an allele count higher than expected for a pathogenic variant. This variant has not been reported in the literature in individuals affected with NKX2-5-related conditions. ClinVar contains an entry for this variant (Variation ID: 578898). Invitae Evidence Modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) has been performed for this missense variant. However, the output from this modeling did not meet the statistical confidence thresholds required to predict the impact of this variant on NKX2-5 protein function. 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. -

Tetralogy of Fallot;C1857586:Conotruncal heart malformations;C2673630:Hypothyroidism, congenital, nongoitrous, 5;C3276096:Atrial septal defect 7;C3280785:Ventricular septal defect 3;C3280795:Hypoplastic left heart syndrome 2 Uncertain:1
Jan 17, 2024
Fulgent Genetics, Fulgent Genetics
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Cardiovascular phenotype Uncertain:1
Feb 04, 2025
Ambry Genetics
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The p.P5S variant (also known as c.13C>T), located in coding exon 1 of the NKX2-5 gene, results from a C to T substitution at nucleotide position 13. The proline at codon 5 is replaced by serine, an amino acid with similar properties. This amino acid position is highly conserved in available vertebrate species. In addition, the in silico prediction for this alteration is inconclusive. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.088
BayesDel_addAF
Benign
-0.13
T
BayesDel_noAF
Benign
-0.090
CADD
Uncertain
24
DANN
Uncertain
1.0
DEOGEN2
Pathogenic
0.81
D;.;.;T
Eigen
Uncertain
0.41
Eigen_PC
Uncertain
0.39
FATHMM_MKL
Pathogenic
0.98
D
LIST_S2
Benign
0.83
T;T;T;T
M_CAP
Pathogenic
0.51
D
MetaRNN
Uncertain
0.46
T;T;T;T
MetaSVM
Uncertain
0.62
D
MutationAssessor
Uncertain
2.1
M;M;M;.
PrimateAI
Uncertain
0.74
T
PROVEAN
Uncertain
-4.3
D;D;D;D
REVEL
Uncertain
0.54
Sift
Uncertain
0.0060
D;D;D;D
Sift4G
Uncertain
0.015
D;D;D;.
Polyphen
0.58
P;.;.;P
Vest4
0.32
MutPred
0.33
Loss of glycosylation at T8 (P = 0.0725);Loss of glycosylation at T8 (P = 0.0725);Loss of glycosylation at T8 (P = 0.0725);Loss of glycosylation at T8 (P = 0.0725);
MVP
0.85
MPC
1.4
ClinPred
0.45
T
GERP RS
3.9
Varity_R
0.27
gMVP
0.64

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: rs769233111; hg19: chr5-172662074; API