Our verdict is Uncertain significance. Variant got 3 ACMG points: 3P and 0B. PM2PP3
The NM_000548.5(TSC2):c.1258G>A(p.Glu420Lys) variant causes a missense, splice region change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.00000137 in 1,456,188 control chromosomes in the GnomAD database, with no homozygous occurrence. 2/3 splice prediction tools predicting alterations to normal splicing. Variant has been reported in ClinVar as Uncertain significance (★). Synonymous variant affecting the same amino acid position (i.e. E420E) has been classified as Benign.
TSC2 (HGNC:12363): (TSC complex subunit 2) This gene is a tumor suppressor gene that encodes the growth inhibitory protein tuberin. Tuberin interacts with hamartin to form the TSC protein complex which functions in the control of cell growth. This TSC protein complex negatively regulates mammalian target of rapamycin complex 1 (mTORC1) signaling which is a major regulator of anabolic cell growth. Mutations in this gene have been associated with tuberous sclerosis and lymphangioleiomyomatosis. [provided by RefSeq, May 2022]
Review Status: criteria provided, single submitter
Collection Method: clinical testing
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. Algorithms developed to predict the effect of sequence changes on RNA splicing suggest that this variant may create or strengthen a splice site. An algorithm developed to predict the effect of missense changes on protein structure and function (PolyPhen-2) suggests that this variant is likely to be tolerated. ClinVar contains an entry for this variant (Variation ID: 467856). This variant has not been reported in the literature in individuals affected with TSC2-related conditions. This variant is not present in population databases (gnomAD no frequency). This sequence change replaces glutamic acid, which is acidic and polar, with lysine, which is basic and polar, at codon 420 of the TSC2 protein (p.Glu420Lys). -
Gain of catalytic residue at E420 (P = 0.0115);Gain of catalytic residue at E420 (P = 0.0115);Gain of catalytic residue at E420 (P = 0.0115);.;Gain of catalytic residue at E420 (P = 0.0115);Gain of catalytic residue at E420 (P = 0.0115);Gain of catalytic residue at E420 (P = 0.0115);Gain of catalytic residue at E420 (P = 0.0115);.;Gain of catalytic residue at E420 (P = 0.0115);Gain of catalytic residue at E420 (P = 0.0115);Gain of catalytic residue at E420 (P = 0.0115);Gain of catalytic residue at E420 (P = 0.0115);Gain of catalytic residue at E420 (P = 0.0115);.;