rs786204505

Variant summary

Our verdict is Pathogenic. Variant got 14 ACMG points: 14P and 0B. PM2PP3_StrongPP5_Very_Strong

The NM_000053.4(ATP7B):​c.3451C>T​(p.Arg1151Cys) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0000248 in 1,613,994 control chromosomes in the GnomAD database, including 1 homozygotes. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Likely pathogenic (★★).

Frequency

Genomes: 𝑓 0.000039 ( 0 hom., cov: 31)
Exomes 𝑓: 0.000023 ( 1 hom. )

Consequence

ATP7B
NM_000053.4 missense

Scores

14
4
1

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:13O:1

Conservation

PhyloP100: 7.47
Variant links:
Genes affected
ATP7B (HGNC:870): (ATPase copper transporting beta) This gene is a member of the P-type cation transport ATPase family and encodes a protein with several membrane-spanning domains, an ATPase consensus sequence, a hinge domain, a phosphorylation site, and at least 2 putative copper-binding sites. This protein is a monomer, and functions as a copper-transporting ATPase which exports copper out of the cells, such as the efflux of hepatic copper into the bile. Alternate transcriptional splice variants, encoding different isoforms with distinct cellular localizations, have been characterized. Mutations in this gene have been associated with Wilson disease which is characterized by copper accumulation. [provided by RefSeq, Dec 2019]

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ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 14 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
PP3
MetaRNN computational evidence supports a deleterious effect, 0.984
PP5
Variant 13-51941186-G-A is Pathogenic according to our data. Variant chr13-51941186-G-A is described in ClinVar as [Likely_pathogenic]. Clinvar id is 188839.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr13-51941186-G-A is described in Lovd as [Likely_pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
ATP7BNM_000053.4 linkuse as main transcriptc.3451C>T p.Arg1151Cys missense_variant 16/21 ENST00000242839.10 NP_000044.2

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
ATP7BENST00000242839.10 linkuse as main transcriptc.3451C>T p.Arg1151Cys missense_variant 16/211 NM_000053.4 ENSP00000242839 P1P35670-1

Frequencies

GnomAD3 genomes
AF:
0.0000394
AC:
6
AN:
152104
Hom.:
0
Cov.:
31
show subpopulations
Gnomad AFR
AF:
0.0000242
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.000131
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.000207
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0000294
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000561
AC:
14
AN:
249588
Hom.:
0
AF XY:
0.0000517
AC XY:
7
AN XY:
135410
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.000203
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.0000556
Gnomad SAS exome
AF:
0.000131
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000177
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000233
AC:
34
AN:
1461890
Hom.:
1
Cov.:
30
AF XY:
0.0000234
AC XY:
17
AN XY:
727246
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.000201
Gnomad4 ASJ exome
AF:
0.000153
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.0000927
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.00000989
Gnomad4 OTH exome
AF:
0.0000331
GnomAD4 genome
AF:
0.0000394
AC:
6
AN:
152104
Hom.:
0
Cov.:
31
AF XY:
0.0000539
AC XY:
4
AN XY:
74274
show subpopulations
Gnomad4 AFR
AF:
0.0000242
Gnomad4 AMR
AF:
0.000131
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.000207
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.0000294
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.0000688
Hom.:
0
Bravo
AF:
0.0000340
ExAC
AF:
0.0000414
AC:
5
EpiCase
AF:
0.00
EpiControl
AF:
0.0000593

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:13Other:1
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Wilson disease Pathogenic:10Other:1
Likely pathogenic, criteria provided, single submitterclinical testingRevvity Omics, RevvityNov 24, 2021- -
Likely pathogenic, criteria provided, single submitterclinical testingLaboratory for Molecular Medicine, Mass General Brigham Personalized MedicineNov 03, 2022The p.Arg1151Cys variant in ATP7B has been reported in more than 5 individuals with Wilson disease (at least 3 in the compound heterozygous state)(Lepori 2007 PMID: 17949296, Lee 2011 PMID:21645214, Papur 2013 PMID: 23333878, Hua 2016 PMID: 27398169, Dong 2016 PMID: 27022412). This variant has also been reported in ClinVar (Variation ID: 188839). It has also been identified in 1/4822 South Asian chromosomes by gnomAD (https://gnomad.broadinstitute.org/). Computational prediction tools and conservation analyses suggest that this variant may impact the protein, though this information is not predictive enough to determine pathogenicity. In vitro functional studies support an impact on protein function (Lee 2011 PMID: 21645214). Other variants involving this codon (including the likely pathogenic p.Arg1151His) have been identified in individuals with Wilson disease. In summary, although additional studies are required to fully establish its clinical significance, this variant meets criteria to be classified as likely pathogenic for autosomal recessive Wilson disease. ACMG/AMP Criteria applied: PM2_supporting, PP3, PM5, PS3_Supporting, PM3. -
Pathogenic, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpJan 29, 2024This sequence change replaces arginine, which is basic and polar, with cysteine, which is neutral and slightly polar, at codon 1151 of the ATP7B protein (p.Arg1151Cys). This variant is present in population databases (rs755554442, gnomAD 0.02%). This missense change has been observed in individual(s) with Wilson disease (PMID: 17949296, 21645214, 23333878, 27398169). ClinVar contains an entry for this variant (Variation ID: 188839). 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 ATP7B protein function with a positive predictive value of 80%. Experimental studies have shown that this missense change affects ATP7B function (PMID: 21645214). This variant disrupts the p.Arg1151 amino acid residue in ATP7B. Other variant(s) that disrupt this residue have been determined to be pathogenic (PMID: 10544227, 15205462, 30655162). This suggests that this residue is clinically significant, and that variants that disrupt this residue are likely to be disease-causing. For these reasons, this variant has been classified as Pathogenic. -
Likely pathogenic, criteria provided, single submitterclinical testingAll of Us Research Program, National Institutes of HealthDec 18, 2023This missense variant replaces arginine with cysteine at codon 1151 of the ATP7B protein. Computational prediction suggests that this variant may have deleterious impact on protein structure and function. This variant alters a conserved arginine residue in the ATP nucleotide-binding domain of the ATP7B protein (a.a. 1032 - 1196), a highly conserved region that is considered to be important for ATP7B protein function (PMID: 35245129; ClinVar). Experimental studies have shown that this variant results in abnormal function in yeast complementation and growth assays (PMID: 21645214). This variant has been reported in numerous individuals affected with Wilson disease (PMID: 17949296, 21645214, 22484412, 23235335, 23333878, 26215059, 27398169, 27022412, 34428338, 34620762; DOI:10.46531/sinapse/AO/210033/2021). In at least one of these affected individuals, this variant has been determined to be compound heterozygous with another pathogenic variant in the same gene, indicating that this variant contributes to Wilson disease in an autosomal recessive manner (PMID: 23333878, 26215059). This variant has been identified in 14/249588 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Based on the available evidence, this variant is classified as Likely Pathogenic. -
Likely pathogenic, criteria provided, single submitterclinical testingHadassah Hebrew University Medical CenterJun 20, 2019- -
Likely pathogenic, criteria provided, single submitterliterature onlyCounsylJun 20, 2014- -
not provided, no classification providedphenotyping onlyGenomeConnect, ClinGen-Variant interpreted as Likely pathogenic and reported on 04-18-2019 by Lab or GTR ID 507240. GenomeConnect assertions are reported exactly as they appear on the patient-provided report from the testing laboratory. GenomeConnect staff make no attempt to reinterpret the clinical significance of the variant. -
Likely pathogenic, criteria provided, single submitterclinical testingFulgent Genetics, Fulgent GeneticsFeb 04, 2022- -
Likely pathogenic, no assertion criteria providedclinical testingNatera, Inc.Mar 23, 2020- -
Pathogenic, criteria provided, single submitterclinical testingInstitute of Human Genetics, University of Leipzig Medical CenterDec 06, 2022This variant was identified with NM_000053.4:c.1285+5G>T, phase is unknown. Both variants were reported as secondary findings in a patient without Wilson associated symptoms Criteria applied: PM3_STR, PS3_MOD, PM5, PM2_SUP, PP3 -
Likely pathogenic, criteria provided, single submitterclinical testingBaylor GeneticsMar 21, 2024- -
not provided Pathogenic:2
Likely pathogenic, criteria provided, single submitterclinical testingGeneDxMar 14, 2023Published functional studies demonstrate a damaging effect (Lee et al., 2011); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; This variant is associated with the following publications: (PMID: 24253677, 22692182, 17949296, 26215059, 22484412, 21645214, 23333878, 32231684, 30275481, 23089210, 15147237, 27022412, 23235335, 34470610, 34620762, Rosa[article]2021) -
Likely pathogenic, criteria provided, single submitterclinical testingMayo Clinic Laboratories, Mayo ClinicJul 16, 2021- -
ATP7B-related disorder Pathogenic:1
Likely pathogenic, criteria provided, single submitterclinical testingPreventionGenetics, part of Exact SciencesOct 11, 2023The ATP7B c.3451C>T variant is predicted to result in the amino acid substitution p.Arg1151Cys. This variant was reported in multiple individuals with Wilson disease (Lepori et al. 2007. PubMed ID: 17949296, Lee et al. 2011. PubMed ID: 21645214, Hua et al. 2016. PubMed ID: 27398169). It is unclear based on the literature if these variants were seen in the homozygous or compound heterozygous state. However, it was reported with a second pathogenic variant in one patient with clinical and biochemical features consistent with Wilson disease (Simsek Papur et al. 2013. PubMed ID: 23333878). In vitro functional characterization suggests that this variant is deleterious (Lee et al. 2011. PubMed ID: 21645214). Of note, two additional missense variants affecting this residue have been reported in association with Wilson disease with unclear evidence of pathogenicity (p.Arg1151His and p.Arg1151Gly; Morgan et al. 2004. PubMed ID: 15205462, Loudianos et al. 1999. PubMed ID: 10544227, Dong et al. 2016. PubMed ID: 27022412). This variant is located in exon 16, where a large number of ATP7B variants have been associated with disease (Li. 2021. PubMed ID: 34470610). This variant is reported in 0.020% of alleles in individuals of Latino descent in gnomAD (http://gnomad.broadinstitute.org/variant/13-52515322-G-A). Of note, this variant was also detected in a patient who carried two additional likely pathogenic/pathogenic variants in this gene. Overall, the collective evidence suggests that this variant is likely pathogenic. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Uncertain
0.40
BayesDel_addAF
Pathogenic
0.34
D
BayesDel_noAF
Pathogenic
0.54
CADD
Pathogenic
27
DANN
Pathogenic
1.0
DEOGEN2
Pathogenic
0.92
D;D;.;.;.;.;.
Eigen
Pathogenic
0.91
Eigen_PC
Pathogenic
0.84
FATHMM_MKL
Uncertain
0.97
D
LIST_S2
Pathogenic
1.0
D;D;D;D;D;D;D
M_CAP
Pathogenic
0.71
D
MetaRNN
Pathogenic
0.98
D;D;D;D;D;D;D
MetaSVM
Pathogenic
1.1
D
MutationAssessor
Uncertain
2.6
M;.;.;.;.;.;.
MutationTaster
Benign
1.0
D;D;D;D;D;D;D
PrimateAI
Uncertain
0.73
T
PROVEAN
Pathogenic
-7.1
D;D;D;D;D;.;D
REVEL
Pathogenic
0.97
Sift
Pathogenic
0.0
D;D;D;D;D;.;D
Sift4G
Pathogenic
0.0
D;D;D;D;D;D;D
Polyphen
1.0
D;D;D;D;D;D;D
Vest4
0.86
MutPred
0.89
Loss of MoRF binding (P = 0.0101);.;.;.;.;.;.;
MVP
0.99
MPC
0.43
ClinPred
0.95
D
GERP RS
5.0
Varity_R
0.91
gMVP
0.82

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.020
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: rs755554442; hg19: chr13-52515322; COSMIC: COSV54438170; COSMIC: COSV54438170; API