rs771266745
Variant summary
Our verdict is Pathogenic. Variant got 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong
The NM_000022.4(ADA):c.956_960delAAGAG(p.Glu319GlyfsTer3) variant causes a frameshift change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.000183 in 1,614,088 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Pathogenic (★★). Variant results in nonsense mediated mRNA decay.
Frequency
Consequence
NM_000022.4 frameshift
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Pathogenic. Variant got 18 ACMG points.
Transcripts
RefSeq
Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt |
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ADA | NM_000022.4 | c.956_960delAAGAG | p.Glu319GlyfsTer3 | frameshift_variant | Exon 10 of 12 | ENST00000372874.9 | NP_000013.2 | |
ADA | NM_001322051.2 | c.884_888delAAGAG | p.Glu295GlyfsTer3 | frameshift_variant | Exon 9 of 11 | NP_001308980.1 | ||
ADA | NM_001322050.2 | c.551_555delAAGAG | p.Glu184GlyfsTer3 | frameshift_variant | Exon 9 of 11 | NP_001308979.1 | ||
ADA | NR_136160.2 | n.983_987delAAGAG | non_coding_transcript_exon_variant | Exon 9 of 11 |
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
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ADA | ENST00000372874.9 | c.956_960delAAGAG | p.Glu319GlyfsTer3 | frameshift_variant | Exon 10 of 12 | 1 | NM_000022.4 | ENSP00000361965.4 | ||
ADA | ENST00000695995.1 | c.566_570delAAGAG | p.Glu189GlyfsTer3 | frameshift_variant | Exon 7 of 9 | ENSP00000512318.1 | ||||
ADA | ENST00000695991.1 | c.494_498delAAGAG | p.Glu165GlyfsTer3 | frameshift_variant | Exon 6 of 8 | ENSP00000512314.1 | ||||
ADA | ENST00000695956.1 | c.110_114delAAGAG | p.Glu37fs | frameshift_variant | Exon 1 of 3 | ENSP00000512285.1 | ||||
ADA | ENST00000696038.1 | n.*713_*717delAAGAG | non_coding_transcript_exon_variant | Exon 8 of 9 | ENSP00000512344.1 | |||||
ADA | ENST00000696038.1 | n.*713_*717delAAGAG | 3_prime_UTR_variant | Exon 8 of 9 | ENSP00000512344.1 |
Frequencies
GnomAD3 genomes AF: 0.0000920 AC: 14AN: 152126Hom.: 0 Cov.: 32
GnomAD3 exomes AF: 0.000119 AC: 30AN: 251496Hom.: 0 AF XY: 0.000147 AC XY: 20AN XY: 135922
GnomAD4 exome AF: 0.000192 AC: 281AN: 1461844Hom.: 0 AF XY: 0.000191 AC XY: 139AN XY: 727226
GnomAD4 genome AF: 0.0000920 AC: 14AN: 152244Hom.: 0 Cov.: 32 AF XY: 0.0000940 AC XY: 7AN XY: 74432
ClinVar
Submissions by phenotype
Severe combined immunodeficiency, autosomal recessive, T cell-negative, B cell-negative, NK cell-negative, due to adenosine deaminase deficiency Pathogenic:10
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Variant summary: The ADA c.956_960delAAGAG (p.Glu319Glyfs) variant results in a premature termination codon, predicted to cause a truncated or absent ADA protein due to nonsense mediated decay, which are commonly known mechanisms for disease. One in silico tool predicts a damaging outcome for this variant. This variant was found in 16/121412 control chromosomes at a frequency of 0.0001318, which does not exceed the estimated maximal expected allele frequency of a pathogenic ADA variant (0.001633). This variant has been reported in multiple SCID patients in homozgyous or compound heterozygous state. In addition, multiple clinical diagnostic laboratories/reputable databases classified this variant as pathogenic. Taken together, this variant is classified as pathogenic. -
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This heterozygous p.Glu319GlyfsTer3 variant in ADA was identified by our study in an individual with severe combined immunodeficiency due to adenosine deaminase deficiency in the compound heterozygous state along with a likely pathogenic structural variant. The variant has been reported in at least 9 individuals with severe combined immunodeficiency due to adenosine deaminase deficiency ( PMID: 26376800, 23260757, 26255240) and with 0.02% (30/129198) of European (non-Finnish) chromosomes by the Genome Aggregation Database (gnomAD, http://gnomad.broadinstitute.org; dbSNP rs771266745). Although this variant has been seen in the general population in a heterozygous state, its frequency is not high enough to rule out a pathogenic role. The variant has also been reported in ClinVar as pathogenic by Integrated Genetics/Laboratory Corporation of America, EGL Genetic Diagnostics,Eurofins Clinical Diagnostics, and GeneDx and as likely pathogenic by Counsyl (Variation ID#: 193544). This variant is predicted to cause a frameshift, which alters the protein’s amino acid sequence beginning at position 319 and leads to a premature termination codon 3 amino acids downstream. This alteration is then predicted to lead to a truncated or absent protein. Loss of function of the ADA gene is an established disease mechanism in autosomal recessive severe combined immunodeficiency. The presence of this variant in at least 2 affected homozygotes and in combination with a likely pathogenic variant, and in 3 individuals with severe combined immunodeficiency increases the likelihood that p.Glu319GlyfsTer3 is pathogenic (PMID:26376800). In summary, this variant meets criteria to be classified as pathogenic for autosomal recessive severe combined immunodeficiency. ACMG/AMP Criteria applied: PVS1, PM3_strong (Richards 2015). -
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This sequence change creates a premature translational stop signal (p.Glu319Glyfs*3) in the ADA gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in ADA are known to be pathogenic (PMID: 26255240, 26376800). This variant is present in population databases (rs771266745, gnomAD 0.02%). This premature translational stop signal has been observed in individuals with severe combined immunodeficiency (PMID: 8401541, 27484032). This variant is also known as del nt1050-54. ClinVar contains an entry for this variant (Variation ID: 193544). For these reasons, this variant has been classified as Pathogenic. -
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not provided Pathogenic:4
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DNA sequence analysis of the ADA gene demonstrated a 5 base pair deletion in exon 10, c.956_960del. This pathogenic sequence change results in an amino acid frameshift and creates a premature stop codon 2 amino acids downstream of the mutation, p.Glu319Glyfs*3. This pathogenic sequence change is predicted to result in an abnormal transcript, which may be degraded, or may lead to the production of a truncated ADA protein with potentially abnormal function. The p.Glu319Glyfs*3 change has been reported in the gnomAD database with a frequency of 0.023% in the European sub-population (dbSNP rs912804754). This pathogenic sequence change has previously been described in the homozygous or compound heterozygous state in patients with ADA-related severe combined immunodeficiency (SCID) (PMIDs: 26255240, 8401541, 29744787). -
ADA: PVS1, PM2, PP4 -
Frameshift variant predicted to result in protein truncation or nonsense mediated decay in a gene for which loss-of-function is a known mechanism of disease; This variant is associated with the following publications: (PMID: 23260757, 29744787, 32888943, 26022996, 23280131, 8401541, 27484032, 8227344, 28487086, 8242080, 31858364, 32307643, 27129325, 31589614, 26255240) -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at