rs775412266
Variant summary
Our verdict is Likely pathogenic. The variant received 6 ACMG points: 6P and 0B. PM2PP2PP3_ModeratePP5
The NM_000448.3(RAG1):c.2981A>G(p.His994Arg) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0000062 in 1,613,932 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 Conflicting classifications of pathogenicity (no stars).
Frequency
Consequence
NM_000448.3 missense
Scores
Clinical Significance
Conservation
Publications
- Omenn syndromeInheritance: AR Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Genomics England PanelApp, G2P, Orphanet
- recombinase activating gene 2 deficiencyInheritance: AR Classification: DEFINITIVE Submitted by: ClinGen
- severe combined immunodeficiency, autosomal recessive, T cell-negative, B cell-negative, NK cell-positiveInheritance: AR Classification: STRONG, SUPPORTIVE Submitted by: Labcorp Genetics (formerly Invitae), Orphanet
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ACMG classification
Our verdict: Likely_pathogenic. The variant received 6 ACMG points.
Transcripts
RefSeq
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt |
|---|---|---|---|---|---|---|---|---|
| RAG1 | NM_000448.3 | c.2981A>G | p.His994Arg | missense_variant | Exon 2 of 2 | ENST00000299440.6 | NP_000439.2 |
Ensembl
Frequencies
GnomAD3 genomes AF: 0.0000131 AC: 2AN: 152142Hom.: 0 Cov.: 33 show subpopulations
GnomAD2 exomes AF: 0.00000799 AC: 2AN: 250180 AF XY: 0.00000739 show subpopulations
GnomAD4 exome AF: 0.00000547 AC: 8AN: 1461790Hom.: 0 Cov.: 33 AF XY: 0.00000275 AC XY: 2AN XY: 727194 show subpopulations
Age Distribution
GnomAD4 genome AF: 0.0000131 AC: 2AN: 152142Hom.: 0 Cov.: 33 AF XY: 0.00 AC XY: 0AN XY: 74320 show subpopulations ⚠️ The allele balance in gnomAD version 4 Genomes is significantly skewed from the expected value of 0.5.
ClinVar
Submissions by phenotype
Severe combined immunodeficiency, autosomal recessive, T cell-negative, B cell-negative, NK cell-positive;C1835931:Combined immunodeficiency due to partial RAG1 deficiency;C2673536:Combined immunodeficiency with skin granulomas;C2700553:Histiocytic medullary reticulosis Pathogenic:1
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not provided Pathogenic:1
The H994Rvariant in the RAG1 gene has not been published as a pathogenic variant, nor has it been reported as a benignpolymorphism to our knowledge. The H994R variant was not observed in approximately 6,500 individualsof European and African American ancestry in the NHLBI Exome Sequencing Project, indicating it is nota common benign variant in these populations. The H994R variant is a conservative amino acidsubstitution, which occurs at a position that is well conserved across species. In silico analysis predicts thisvariant is probably damaging to the protein structure/function. Missense variants in a nearby residue(K992E and K992R) have been reported in the Human Gene Mutation Database in association withOmenn syndrome (Stenson et al., 2014), supporting the functional importance of this region of the protein.The H994R variant is a good candidate for a pathogenic variant, however the possibility it may be arare benign variant cannot be excluded. -
Severe combined immunodeficiency, autosomal recessive, T cell-negative, B cell-negative, NK cell-positive;C2673536:Combined immunodeficiency with skin granulomas Pathogenic:1
For these reasons, this variant has been classified as Pathogenic. 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 RAG1 protein function. ClinVar contains an entry for this variant (Variation ID: 372489). This missense change has been observed in individual(s) with clinical features of RAG1-related conditions (PMID: 33193364; Invitae). In at least one individual the data is consistent with being in trans (on the opposite chromosome) from a pathogenic variant. This variant is present in population databases (rs775412266, gnomAD 0.002%). This sequence change replaces histidine, which is basic and polar, with arginine, which is basic and polar, at codon 994 of the RAG1 protein (p.His994Arg). -
not specified Uncertain:1
Variant summary: RAG1 c.2981A>G (p.His994Arg) results in a non-conservative amino acid change in the encoded protein sequence. Algorithms developed to predict the effect of missense changes on protein structure and function all suggest that this variant is likely to be disruptive. The variant allele was found at a frequency of 8e-06 in 250180 control chromosomes. The available data on variant occurrences in the general population are insufficient to allow any conclusion about variant significance. c.2981A>G has been observed in trans with a pathogenic variant in at least 1 individual(s) affected with Severe Combined Immunodeficiency (example, Labcorp Genetics (formerly Invitae)), as well as in the presumed compound heterozygous state in 1 individual with severe multisystemic vasculitis. 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: 38240953, 30877075, 35902638, 33193364, 37475856, 39720732). ClinVar contains an entry for this variant (Variation ID: 372489). Based on the evidence outlined above, the variant was classified as uncertain significance. -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at