rs776155094
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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
NM_024426.6 frameshift
Scores
Not classified
Clinical Significance
Conservation
PhyloP100: 0.811
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 |
---|---|---|---|---|---|---|---|---|
WT1 | NM_024426.6 | c.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 |
---|---|---|---|---|---|---|---|---|---|---|
WT1 | ENST00000452863.10 | c.151del | p.Ala51ProfsTer31 | frameshift_variant | 1/10 | 1 | NM_024426.6 | ENSP00000415516 |
Frequencies
GnomAD3 genomes AF: 0.0000197 AC: 3AN: 152108Hom.: 0 Cov.: 30
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GnomAD3 exomes AF: 0.00000762 AC: 1AN: 131284Hom.: 0 AF XY: 0.00 AC XY: 0AN XY: 71976
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GnomAD4 exome AF: 0.00000217 AC: 3AN: 1380958Hom.: 0 Cov.: 44 AF XY: 0.00000294 AC XY: 2AN XY: 681070
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GnomAD4 genome AF: 0.0000197 AC: 3AN: 152108Hom.: 0 Cov.: 30 AF XY: 0.0000135 AC XY: 1AN XY: 74296
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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 submitter | clinical testing | St. Jude Molecular Pathology, St. Jude Children's Research Hospital | Mar 16, 2016 | This 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 submitter | clinical testing | Labcorp Genetics (formerly Invitae), Labcorp | Nov 02, 2023 | This 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 submitter | clinical testing | Baylor Genetics | Sep 03, 2023 | - - |
not provided Uncertain:1
Uncertain significance, criteria provided, single submitter | clinical testing | GeneDx | Jun 23, 2023 | Nonsense 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 provided | clinical testing | PreventionGenetics, part of Exact Sciences | Feb 29, 2024 | The 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. - |
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Details are displayed if max score is > 0.2
Find out detailed SpliceAI scores and Pangolin per-transcript scores at