rs771533553

Variant summary

Our verdict is Likely benign. The variant received -4 ACMG points: 0P and 4B. BS2

The NM_004387.4(NKX2-5):​c.608A>G​(p.Glu203Gly) variant causes a missense change. The variant allele was found at a frequency of 0.0000062 in 1,452,522 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Uncertain significance (★★). Synonymous variant affecting the same amino acid position (i.e. E203E) has been classified as Likely benign.

Frequency

Genomes: not found (cov: 32)
Exomes 𝑓: 0.0000062 ( 0 hom. )

Consequence

NKX2-5
NM_004387.4 missense

Scores

8
8
3

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:3

Conservation

PhyloP100: 5.11

Publications

4 publications found
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]
NKX2-5 Gene-Disease associations (from GenCC):
  • atrial septal defect 7
    Inheritance: AD Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Genomics England PanelApp, G2P, Ambry Genetics, Labcorp Genetics (formerly Invitae), Laboratory for Molecular Medicine, Orphanet
  • hypothyroidism, congenital, nongoitrous, 5
    Inheritance: AD, Unknown Classification: DEFINITIVE, MODERATE, LIMITED Submitted by: G2P, Labcorp Genetics (formerly Invitae), Ambry Genetics
  • NKX2.5-related congenital, conduction and myopathic heart disease
    Inheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
  • tetralogy of fallot
    Inheritance: AD Classification: DEFINITIVE Submitted by: G2P
  • conotruncal heart malformations
    Inheritance: SD, AD Classification: DEFINITIVE, STRONG Submitted by: Ambry Genetics, Labcorp Genetics (formerly Invitae)
  • athyreosis
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • familial atrial fibrillation
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • familial bicuspid aortic valve
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • familial isolated congenital asplenia
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • dilated cardiomyopathy
    Inheritance: AD Classification: LIMITED Submitted by: ClinGen

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Likely_benign. The variant received -4 ACMG points.

BS2
High AC in GnomAdExome4 at 9 AD,Unknown,SD gene.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
NKX2-5NM_004387.4 linkc.608A>G p.Glu203Gly missense_variant Exon 2 of 2 ENST00000329198.5 NP_004378.1 P52952-1A0A0S2Z383
NKX2-5NM_001166176.2 linkc.*407A>G 3_prime_UTR_variant Exon 2 of 2 NP_001159648.1 P52952-2
NKX2-5NM_001166175.2 linkc.*561A>G 3_prime_UTR_variant Exon 2 of 2 NP_001159647.1 P52952-3A0A0S2Z3K2

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
NKX2-5ENST00000329198.5 linkc.608A>G p.Glu203Gly missense_variant Exon 2 of 2 1 NM_004387.4 ENSP00000327758.4 P52952-1
NKX2-5ENST00000424406.2 linkc.*561A>G 3_prime_UTR_variant Exon 2 of 2 1 ENSP00000395378.2 P52952-3
NKX2-5ENST00000521848.1 linkc.*407A>G 3_prime_UTR_variant Exon 2 of 2 2 ENSP00000427906.1 P52952-2

Frequencies

GnomAD3 genomes
Cov.:
32
GnomAD2 exomes
AF:
0.0000308
AC:
7
AN:
227236
AF XY:
0.0000160
show subpopulations
Gnomad AFR exome
AF:
0.0000752
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.000297
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000100
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.00000620
AC:
9
AN:
1452522
Hom.:
0
Cov.:
35
AF XY:
0.00000554
AC XY:
4
AN XY:
722180
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
33358
American (AMR)
AF:
0.00
AC:
0
AN:
43164
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
25964
East Asian (EAS)
AF:
0.0000764
AC:
3
AN:
39278
South Asian (SAS)
AF:
0.00
AC:
0
AN:
85686
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
51034
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5632
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
1108472
Other (OTH)
AF:
0.000100
AC:
6
AN:
59934
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.464
Heterozygous variant carriers
0
1
2
3
4
5
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Variant carriers
0
2
4
6
8
10
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
GnomAD4 genome
Cov.:
32
Alfa
AF:
0.00
Hom.:
0
Bravo
AF:
0.0000189
ExAC
AF:
0.0000333
AC:
4

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:3
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

NKX2-5-related disorder Uncertain:1
Jul 03, 2024
PreventionGenetics, part of Exact Sciences
Significance:Uncertain significance
Review Status:no assertion criteria provided
Collection Method:clinical testing

The NKX2-5 c.608A>G variant is predicted to result in the amino acid substitution p.Glu203Gly. This variant has been reported in an individual with ventricular septal defect (Dinesh et al. 2010. PubMed ID: 21091212) and reported in individuals with atrial septal defects (Hamanoue et al. 2009. PubMed ID: 19678963). This variant is reported in 0.030% of alleles in individuals of East Asian descent in gnomAD. At this time, the clinical significance of this variant is uncertain due to the absence of conclusive functional and genetic evidence. -

Atrial septal defect 7 Uncertain:1
Sep 06, 2023
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

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. This sequence change replaces glutamic acid, which is acidic and polar, with glycine, which is neutral and non-polar, at codon 203 of the NKX2-5 protein (p.Glu203Gly). This variant is present in population databases (rs771533553, gnomAD 0.03%). This missense change has been observed in individual(s) with congenital heart defects (PMID: 19678963, 21091212). ClinVar contains an entry for this variant (Variation ID: 519328). 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) has been performed at Invitae 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. -

Cardiovascular phenotype Uncertain:1
Sep 19, 2016
Ambry Genetics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The p.E203G variant (also known as c.608A>G), located in coding exon 2 of the NKX2-5 gene, results from an A to G substitution at nucleotide position 608. The glutamic acid at codon 203 is replaced by glycine, an amino acid with some similar properties. This alteration has been previously reported in subjects with congenital heart disease (Hamanoue H et al. Cardiol Young, 2009 Sep;19:482-5; Dinesh SM et al. Genet Test Mol Biomarkers, 2010 Dec;14:873-9). Based on data from ExAC, the G allele has an overall frequency of <0.01% (4/71849). 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
Pathogenic
0.82
BayesDel_addAF
Benign
-0.015
T
BayesDel_noAF
Uncertain
0.040
CADD
Pathogenic
28
DANN
Uncertain
1.0
DEOGEN2
Pathogenic
0.82
D
Eigen
Uncertain
0.51
Eigen_PC
Uncertain
0.49
FATHMM_MKL
Pathogenic
0.97
D
LIST_S2
Benign
0.76
T
M_CAP
Pathogenic
0.55
D
MetaRNN
Uncertain
0.60
D
MetaSVM
Uncertain
0.72
D
MutationAssessor
Uncertain
2.9
M
PhyloP100
5.1
PrimateAI
Uncertain
0.77
T
PROVEAN
Pathogenic
-6.4
D
REVEL
Pathogenic
0.67
Sift
Pathogenic
0.0
D
Sift4G
Pathogenic
0.0
D
Polyphen
0.86
P
Vest4
0.53
MutPred
0.19
Loss of stability (P = 0.059);
MVP
0.86
MPC
0.96
ClinPred
0.83
D
GERP RS
4.6
Varity_R
0.86
gMVP
0.78
Mutation Taster
=35/65
disease causing

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

Other links and lift over

dbSNP: rs771533553; hg19: chr5-172659939; API