rs776155094

Variant summary

Our verdict is Likely pathogenic. Variant got 8 ACMG points: 8P and 0B. PVS1

The NM_024426.6(WT1):​c.151del​(p.Ala51ProfsTer31) variant causes a frameshift change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.00000391 in 1,533,066 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars). Variant results in nonsense mediated mRNA decay.

Frequency

Genomes: 𝑓 0.000020 ( 0 hom., cov: 30)
Exomes 𝑓: 0.0000022 ( 0 hom. )

Consequence

WT1
NM_024426.6 frameshift

Scores

Not classified

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications P:1U:4

Conservation

PhyloP100: 0.811
Variant links:
Genes affected
WT1 (HGNC:12796): (WT1 transcription factor) This gene encodes a transcription factor that contains four zinc-finger motifs at the C-terminus and a proline/glutamine-rich DNA-binding domain at the N-terminus. It has an essential role in the normal development of the urogenital system, and it is mutated in a small subset of patients with Wilms tumor. This gene exhibits complex tissue-specific and polymorphic imprinting pattern, with biallelic, and monoallelic expression from the maternal and paternal alleles in different tissues. Multiple transcript variants have been described. In several variants, there is evidence for the use of a non-AUG (CUG) translation initiation codon upstream of, and in-frame with the first AUG. Authors of PMID:7926762 also provide evidence that WT1 mRNA undergoes RNA editing in human and rat, and that this process is tissue-restricted and developmentally regulated. [provided by RefSeq, Mar 2015]

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ACMG classification

Classification made for transcript

Verdict is Likely_pathogenic. Variant got 8 ACMG points.

PVS1
Loss of function variant, product undergoes nonsense mediated mRNA decay. LoF is a known mechanism of disease.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
WT1NM_024426.6 linkuse as main transcriptc.151del p.Ala51ProfsTer31 frameshift_variant 1/10 ENST00000452863.10 NP_077744.4

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
WT1ENST00000452863.10 linkuse as main transcriptc.151del p.Ala51ProfsTer31 frameshift_variant 1/101 NM_024426.6 ENSP00000415516 P19544-7

Frequencies

GnomAD3 genomes
AF:
0.0000197
AC:
3
AN:
152108
Hom.:
0
Cov.:
30
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:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0000441
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.00000762
AC:
1
AN:
131284
Hom.:
0
AF XY:
0.00
AC XY:
0
AN XY:
71976
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000202
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.00000217
AC:
3
AN:
1380958
Hom.:
0
Cov.:
44
AF XY:
0.00000294
AC XY:
2
AN XY:
681070
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.00
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:
0.00000278
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
AF:
0.0000197
AC:
3
AN:
152108
Hom.:
0
Cov.:
30
AF XY:
0.0000135
AC XY:
1
AN XY:
74296
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.0000441
Gnomad4 OTH
AF:
0.00
Bravo
AF:
0.0000264

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Pathogenic:1Uncertain:4
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

Precursor B-cell acute lymphoblastic leukemia Pathogenic:1
Likely pathogenic, criteria provided, single submitterclinical testingSt. Jude Molecular Pathology, St. Jude Children's Research HospitalMar 16, 2016This is a frameshift variant, in which a G is deleted at coding position 136 and is predicted to change an Alanine to a Proline and shift the reading frame. -
11p partial monosomy syndrome;C0950121:Drash syndrome;C0950122:Frasier syndrome;CN033288:Wilms tumor 1 Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpNov 02, 2023This sequence change creates a premature translational stop signal (p.Ala46Profs*31) in the WT1 gene. It is unclear whether it will result in an absent or disrupted protein product because a major initiation site located at codon 69 has the potential to rescue this variant. This variant is present in population databases (rs776155094, gnomAD 0.002%). This premature translational stop signal has been observed in individual(s) with anaplastic astrocytoma (PMID: 31970404). ClinVar contains an entry for this variant (Variation ID: 265295). Downstream of the non-canonical translation start site (CTG) at codon 1, the nearest methionine codon that can be used to initiate translation of the WT1 protein lies at codon 69. This downstream in-frame ATG is known as a major initiation site (PMID: 28811308, 16987884, 8621495). The functional significance of the different WT1 protein isoforms is unknown (PMID: 8621495), however mice lacking the N-terminal 68 amino acids develop normally and are fertile (PMID: 12640141). Based on these results, the impact of this variant on WT1 protein function is uncertain. 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. -
Drash syndrome Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingBaylor GeneticsSep 03, 2023- -
not provided Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingGeneDxJun 23, 2023Nonsense variant predicted to result in protein truncation; however a downstream in-frame ATG could serve as an alternate initiator codon which may result in a smaller, yet still functional, protein (Bruenig et al., 1996; Scharnhorst et al., 1999; Yang et al., 2007).; Not observed at significant frequency in large population cohorts (gnomAD); Observed in individuals with pancreatic cancer and pediatric glioma (Skaro et al., 2019; Muskens et al., 2020); Also known as c.151del/p.(A51Pfs*31); This variant is associated with the following publications: (PMID: 26633542, 30665703, 31970404, 30716324, 8621495, 10438524, 17361230) -
WT1-related disorder Uncertain:1
Uncertain significance, no assertion criteria providedclinical testingPreventionGenetics, part of Exact SciencesFeb 29, 2024The WT1 c.136delG variant is predicted to result in a frameshift and premature protein termination (p.Ala46Profs*31). This variant has been reported in an individual with anaplastic astrocytoma (Muskens et al. 2020. PubMed ID: 31970404) and another individual with intraductal papillary mucinous neoplasms (IPMNs) at risk for developing pancreatic cancer (Skaro et al. 2019. PubMed ID: 30716324), but it has not been reported in patients with established WT-related disorders. This variant would typically be expected to cause a frameshift leading to premature termination; however there is a downstream, in-frame methionine residue (p.Met69) that has been shown to act as an alternate initiation site and potentially rescue WT1 translation (Bruening and Pelletier. 1996. PubMed ID: 8621495; Scharnhorst et al. 1999. PubMed ID: 10438524). Furthermore, significant N-terminal variation has been observed in functional WT1 isoforms (same studies), and a mouse model lacking the 68 N-terminal amino acids developed normally and remained capable of reproduction (Miles et al. 2003. PubMed ID: 12640141). This variant is reported in 0.0020% of alleles in individuals of European (Non-Finnish) descent in gnomAD. This variant is interpreted as a variant of uncertain significance by most submitters in ClinVar (https://www.ncbi.nlm.nih.gov/clinvar/variation/265295/). Taken together, the clinical significance of this variant is uncertain at this time due to the absence of conclusive functional and genetic evidence. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction

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: rs776155094; hg19: chr11-32456755; API