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rs777250096

Variant summary

Our verdict is Uncertain significance. Variant got 2 ACMG points: 2P and 0B. PP2PP3

The NM_005120.3(MED12):c.4021C>T(p.Arg1341Trp) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000199 in 1,207,320 control chromosomes in the GnomAD database, with no homozygous occurrence. There are 7 hemizygotes in GnomAD. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Uncertain significance (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R1341Q) has been classified as Uncertain significance.

Frequency

Genomes: 𝑓 0.000018 ( 0 hom., 0 hem., cov: 24)
Exomes 𝑓: 0.000020 ( 0 hom. 7 hem. )

Consequence

MED12
NM_005120.3 missense

Scores

9
3
2

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:4

Conservation

PhyloP100: 0.839
Variant links:
Genes affected
MED12 (HGNC:11957): (mediator complex subunit 12) The initiation of transcription is controlled in part by a large protein assembly known as the preinitiation complex. A component of this preinitiation complex is a 1.2 MDa protein aggregate called Mediator. This Mediator component binds with a CDK8 subcomplex which contains the protein encoded by this gene, mediator complex subunit 12 (MED12), along with MED13, CDK8 kinase, and cyclin C. The CDK8 subcomplex modulates Mediator-polymerase II interactions and thereby regulates transcription initiation and reinitation rates. The MED12 protein is essential for activating CDK8 kinase. Defects in this gene cause X-linked Opitz-Kaveggia syndrome, also known as FG syndrome, and Lujan-Fryns syndrome. [provided by RefSeq, Aug 2009]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Uncertain_significance. Variant got 2 ACMG points.

PP2
Missense variant where missense usually causes diseases, MED12
PP3
MetaRNN computational evidence supports a deleterious effect, 0.784

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE UniProt
MED12NM_005120.3 linkuse as main transcriptc.4021C>T p.Arg1341Trp missense_variant 28/45 ENST00000374080.8

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Appris UniProt
MED12ENST00000374080.8 linkuse as main transcriptc.4021C>T p.Arg1341Trp missense_variant 28/451 NM_005120.3 P4Q93074-1

Frequencies

GnomAD3 genomes
AF:
0.0000177
AC:
2
AN:
113207
Hom.:
0
Cov.:
24
AF XY:
0.00
AC XY:
0
AN XY:
35343
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:
0.000354
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0000187
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.00000575
AC:
1
AN:
173825
Hom.:
0
AF XY:
0.0000166
AC XY:
1
AN XY:
60421
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:
0.0000129
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000201
AC:
22
AN:
1094113
Hom.:
0
Cov.:
33
AF XY:
0.0000194
AC XY:
7
AN XY:
359991
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:
0.0000562
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.0000214
Gnomad4 OTH exome
AF:
0.0000218
GnomAD4 genome
AF:
0.0000177
AC:
2
AN:
113207
Hom.:
0
Cov.:
24
AF XY:
0.00
AC XY:
0
AN XY:
35343
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:
0.000354
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.0000187
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.0000712
Hom.:
0
Bravo
AF:
0.0000189
ExAC
AF:
0.0000497
AC:
6

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:4
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

X-linked intellectual disability with marfanoid habitus Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingLaboratory of Medical Genetics, National & Kapodistrian University of AthensJul 05, 2018PP2, PP3 -
Familial thoracic aortic aneurysm and aortic dissection Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingAmbry GeneticsAug 20, 2021The p.R1341W variant (also known as c.4021C>T), located in coding exon 28 of the MED12 gene, results from a C to T substitution at nucleotide position 4021. The arginine at codon 1341 is replaced by tryptophan, an amino acid with dissimilar properties. Based on data from gnomAD, the T allele has an overall frequency of 0.0005753% (1/173825) total alleles studied, with 1 hemizygote(s) observed. The highest observed frequency was 0.001293% (1/77358) of European (non-Finnish) alleles. This amino acid position is highly conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear. -
not provided Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingGeneDxNov 28, 2017The R1341W variant of uncertain significance in the MED12 gene has not been published as a pathogenic or benign variant to our knowledge. This variant has been identified independently of additional cardiogenetic variants in one other individual referred for Marfan/TAAD genetic testing at GeneDx; however, thus far, segregation data is absent for these individuals due to the lack of clinical information provided and insufficient participation by informative family members. The R1341W variant was not observed in approximately 6,100 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 R1341W variant is a non-conservative amino acid substitution, which is likely to impact secondary protein structure as these residues differ in polarity, charge, size and/or other properties. This substitution also occurs at a position that is conserved across species. Consequently, in silico analysis predicts this variant is probably damaging to the protein structure/function. Nevertheless, no missense variants in nearby residues have been reported in the Human Gene Mutation Database in association with MED12-related disorders (Stenson et al., 2014). Therefore, based on the currently available information, it is unclear whether this variant is pathogenic or rare benign. -
FG syndrome Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingInvitaeJan 11, 2024This sequence change replaces arginine, which is basic and polar, with tryptophan, which is neutral and slightly polar, at codon 1341 of the MED12 protein (p.Arg1341Trp). The frequency data for this variant in the population databases is considered unreliable, as metrics indicate poor data quality at this position in the gnomAD database. This missense change has been observed in individual(s) with clinical features of MED12-related conditions (PMID: 34008892). ClinVar contains an entry for this variant (Variation ID: 213641). 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 MED12 protein function with a positive predictive value of 95%. 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. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.77
BayesDel_addAF
Pathogenic
0.44
D
BayesDel_noAF
Pathogenic
0.40
Cadd
Uncertain
25
Dann
Pathogenic
1.0
DEOGEN2
Benign
0.12
T;.;D
FATHMM_MKL
Uncertain
0.90
D
LIST_S2
Pathogenic
0.99
D;D;D
M_CAP
Pathogenic
0.33
D
MetaRNN
Pathogenic
0.78
D;D;D
MetaSVM
Uncertain
0.38
D
MutationTaster
Benign
1.0
D;D;D
PrimateAI
Pathogenic
0.82
D
REVEL
Uncertain
0.62
Sift4G
Pathogenic
0.0
D;D;D
Polyphen
1.0
D;D;D
Vest4
0.87
MutPred
0.36
.;Loss of disorder (P = 0.0043);Loss of disorder (P = 0.0043);
MVP
0.99
MPC
2.5
ClinPred
0.98
D
GERP RS
3.1
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.7
Varity_R
0.71
gMVP
0.78

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: rs777250096; hg19: chrX-70350038; COSMIC: COSV100376766; COSMIC: COSV100376766; API