rs771877780

Variant summary

Our verdict is Likely benign. The variant received -2 ACMG points: 0P and 2B. BP4BS2_Supporting

The NM_004006.3(DMD):​c.7555G>A​(p.Asp2519Asn) variant causes a missense change. The variant allele was found at a frequency of 0.0000058 in 1,207,821 control chromosomes in the GnomAD database, with no homozygous occurrence. There are 5 hemizygotes in GnomAD. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).

Frequency

Genomes: 𝑓 0.000018 ( 0 hom., 2 hem., cov: 23)
Exomes 𝑓: 0.0000046 ( 0 hom. 3 hem. )

Consequence

DMD
NM_004006.3 missense

Scores

2
6
8

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications P:3U:3B:1

Conservation

PhyloP100: 6.67

Publications

1 publications found
Variant links:
Genes affected
DMD (HGNC:2928): (dystrophin) This gene spans a genomic range of greater than 2 Mb and encodes a large protein containing an N-terminal actin-binding domain and multiple spectrin repeats. The encoded protein forms a component of the dystrophin-glycoprotein complex (DGC), which bridges the inner cytoskeleton and the extracellular matrix. Deletions, duplications, and point mutations at this gene locus may cause Duchenne muscular dystrophy (DMD), Becker muscular dystrophy (BMD), or cardiomyopathy. Alternative promoter usage and alternative splicing result in numerous distinct transcript variants and protein isoforms for this gene. [provided by RefSeq, Dec 2016]
DMD Gene-Disease associations (from GenCC):
  • Becker muscular dystrophy
    Inheritance: XL Classification: DEFINITIVE, SUPPORTIVE Submitted by: Ambry Genetics, Orphanet
  • dilated cardiomyopathy 3B
    Inheritance: XL Classification: DEFINITIVE Submitted by: Ambry Genetics
  • Duchenne and Becker muscular dystrophy
    Inheritance: XL Classification: DEFINITIVE Submitted by: Myriad Women’s Health
  • Duchenne muscular dystrophy
    Inheritance: XL Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Ambry Genetics, Labcorp Genetics (formerly Invitae), G2P, Orphanet
  • progressive muscular dystrophy
    Inheritance: XL Classification: DEFINITIVE Submitted by: ClinGen
  • familial isolated dilated cardiomyopathy
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • non-syndromic X-linked intellectual disability
    Inheritance: XL Classification: SUPPORTIVE Submitted by: Orphanet
  • symptomatic form of muscular dystrophy of Duchenne and Becker in female carriers
    Inheritance: XL Classification: SUPPORTIVE Submitted by: Orphanet

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Likely_benign. The variant received -2 ACMG points.

BP4
Computational evidence support a benign effect (MetaRNN=0.27373123).
BS2
High AC in GnomAdExome4 at 5 XL,AD gene. Variant has AC lower than other variant known as pathogenic in the gene, so the strength is limited to Supporting.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
DMDNM_004006.3 linkc.7555G>A p.Asp2519Asn missense_variant Exon 52 of 79 ENST00000357033.9 NP_003997.2

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
DMDENST00000357033.9 linkc.7555G>A p.Asp2519Asn missense_variant Exon 52 of 79 1 NM_004006.3 ENSP00000354923.3

Frequencies

GnomAD3 genomes
AF:
0.0000179
AC:
2
AN:
111885
Hom.:
0
Cov.:
23
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.000559
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
GnomAD2 exomes
AF:
0.0000272
AC:
5
AN:
183507
AF XY:
0.0000442
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.000361
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.00000456
AC:
5
AN:
1095936
Hom.:
0
Cov.:
29
AF XY:
0.00000830
AC XY:
3
AN XY:
361320
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
26363
American (AMR)
AF:
0.00
AC:
0
AN:
35202
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
19369
East Asian (EAS)
AF:
0.000166
AC:
5
AN:
30187
South Asian (SAS)
AF:
0.00
AC:
0
AN:
54100
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
40526
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
4128
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
840043
Other (OTH)
AF:
0.00
AC:
0
AN:
46018
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.450
Heterozygous variant carriers
0
0
1
1
2
2
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Exome Hom
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
AF:
0.0000179
AC:
2
AN:
111885
Hom.:
0
Cov.:
23
AF XY:
0.0000587
AC XY:
2
AN XY:
34065
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
30722
American (AMR)
AF:
0.00
AC:
0
AN:
10551
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
2653
East Asian (EAS)
AF:
0.000559
AC:
2
AN:
3575
South Asian (SAS)
AF:
0.00
AC:
0
AN:
2675
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
6065
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
237
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
53215
Other (OTH)
AF:
0.00
AC:
0
AN:
1509

Age Distribution

Genome Hom
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
Alfa
AF:
0.00
Hom.:
0
Bravo
AF:
0.0000151
ExAC
AF:
0.0000494
AC:
6

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Pathogenic:3Uncertain:3Benign:1
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

not provided Pathogenic:2Uncertain:1
May 04, 2015
GeneDx
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The D2519N missense variant has been reported previously as de novo in a male with elevated CK level, calf hypertrophy, and a clinical diagnosis of Duchenne muscular dystrophy (Wang et al., 2014). It was not observed in approximately 6,500 individuals of European and African American ancestry in the NHLBI Exome Sequencing Project, indicating it is not a common benign variant in these populations. The D2519N variant is a semi-conservative amino acid substitution, which may impact secondary protein structure as these residues differ in some properties. This substitution occurs at a position that is conserved across species. Therefore, D2519N is interpreted as a pathogenic variant. -

Jun 01, 2017
CeGaT Center for Human Genetics Tuebingen
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

May 04, 2022
ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The DMD c.7555G>A; p.Asp2519Asn variant (rs771877780) is reported in the literature as occurring de novo in a male diagnosed with muscular dystrophy and in a female with an increased CK undergoing carrier screening (Han 2020, Wang 2014). This variant is reported in the ClinVar database with conflicting classifications (Variation ID: 427170). This variant is found in the East Asian population with an allele frequency of 0.04% (6/14,879 alleles, including 4 hemizygotes) in the Genome Aggregation Database. The aspartic acid at codon 2519 is highly conserved, but computational analyses are uncertain whether this variant is neutral or deleterious (REVEL: 0.254). Although the number of hemizygotes in the Genome Aggregation Database indicates this variant may be a rare benign variant, due to conflicting information, the clinical significance of the p.Asp2519Asn variant is uncertain at this time. References: Han S et al. Population-Wide Duchenne Muscular Dystrophy Carrier Detection by CK and Molecular Testing. Biomed Res Int. 2020 Sep 27;2020:8396429. PMID: 33029525. Wang Y et al. Whole dystrophin gene analysis by next-generation sequencing: a comprehensive genetic diagnosis of Duchenne and Becker muscular dystrophy. Mol Genet Genomics. 2014 Oct;289(5):1013-21. PMID: 24770780. -

Duchenne muscular dystrophy Pathogenic:1Benign:1
Aug 16, 2020
Department of Obstetrics, Zhejiang Provincial People's Hospital, Zhejiang Provincial People's Hospital
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The D2519N missense variant was not observed in 1000 Genome database, ESP 6500 and genomAD. It was a presumed de novo variant in a female with elevated CK and harboring non-DMD family history. This substitution occurs at a position that is conserved across species (SIFT and PolyPhen predicted it deleterious and probably damaging). Therefore, D2519N is interpreted as a likely pathogenic variant. -

Mar 17, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

not specified Uncertain:1
Oct 19, 2023
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: DMD c.7555G>A (p.Asp2519Asn) results in a conservative amino acid change located in the central rod domain of the encoded protein sequence. Three of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 2.9e-05 in 205897 control chromosomes, predominantly at a frequency of 0.0004 within the East Asian subpopulation in the gnomAD database, including 4 hemizygotes. The available data on variant occurrences in the general population suggest the variant could be a benign polymorphism found predominantly in individuals of East Asian ancestry, but are ultimately insufficient to allow any conclusion about variant significance. c.7555G>A has been reported in the literature as de novo in a male child affected with Duchenne Muscular Dystrophy (DMD) (Wang_2013) as well as in a female carrier with slightly elevated creatine kinase levels but no family history of DMD (Han_2020). These data do not allow any conclusion about variant significance. 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: 33029525, 24770780). Six submitters have cited clinical-significance assessments for this variant to ClinVar after 2014 with conflicting assessments. Three submitters classified the variant as pathogenic/likely pathogenic, two classified it as uncertain significance, and one submitter classified it as benign. Based on the evidence outlined above, the variant was classified as uncertain significance. -

Cardiovascular phenotype Uncertain:1
Jun 25, 2022
Ambry Genetics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The p.D2519N variant (also known as c.7555G>A), located in coding exon 52 of the DMD gene, results from a G to A substitution at nucleotide position 7555. The aspartic acid at codon 2519 is replaced by asparagine, an amino acid with highly similar properties. This variant was described as de novo in one male reported to have symptoms of Duchenne muscular dystrophy (DMD), although clinical details were limited (Wang Y et al. Mol Genet Genomics, 2014 Oct;289:1013-21). This variant was also detected in a female with elevated creatine kinase (CK) levels who had no skeletal muscular or cardiac findings, and known family history of DMD (Han S et al. Biomed Res Int, 2020 Sep;2020:8396429). Based on data from gnomAD, the A allele has an overall frequency of 0.0029%( 6/205497) total alleles studied, with 4 hemizygotes observed. The highest observed frequency was 0.0403% (6/14879) of East Asian alleles. This amino acid position is well conserved in available vertebrate species. In addition, this alteration is predicted to be tolerated by in silico analysis. 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
0.15
BayesDel_addAF
Benign
-0.38
T
BayesDel_noAF
Benign
-0.47
CADD
Uncertain
23
DANN
Pathogenic
1.0
DEOGEN2
Benign
0.33
.;T;T;.;.;T;.;.;T
FATHMM_MKL
Uncertain
0.95
D
LIST_S2
Pathogenic
0.98
D;.;.;.;D;.;D;D;.
M_CAP
Uncertain
0.16
D
MetaRNN
Benign
0.27
T;T;T;T;T;T;T;T;T
MetaSVM
Benign
-0.35
T
PhyloP100
6.7
PrimateAI
Uncertain
0.58
T
PROVEAN
Uncertain
-3.0
D;D;D;D;.;D;.;D;D
REVEL
Benign
0.25
Sift
Uncertain
0.0020
D;D;D;D;.;D;.;D;D
Sift4G
Uncertain
0.0050
D;D;D;D;D;D;D;D;D
Polyphen
1.0, 1.0, 0.99
.;D;D;D;.;D;.;.;D
Vest4
0.57, 0.52, 0.52, 0.69, 0.61, 0.53, 0.80, 0.42
MutPred
0.46
.;.;.;.;.;.;.;Loss of ubiquitination at K2514 (P = 0.0705);.;
MVP
0.71
MPC
0.070
ClinPred
0.69
D
GERP RS
5.2
gMVP
0.52
Mutation Taster
=78/22
disease causing (ClinVar)

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: rs771877780; hg19: chrX-31747853; COSMIC: COSV58901806; API