rs886039544

Variant summary

Our verdict is Likely pathogenic. Variant got 6 ACMG points: 6P and 0B. PP4_ModeratePP3PM2_SupportingPM1_SupportingPM5_Supporting

This summary comes from the ClinGen Evidence Repository: The c.779C>A variant in the HNF1 homeobox A gene, HNF1A, causes an amino acid change of threonine to lysine at codon 260 (p.(Thr260Lys)) of NM_000545.8. This variant is predicted to be deleterious by computational evidence, with a REVEL score of 0.925, which is greater than the MDEP VCEP threshold of 0.70 (PP3). This variant is located within a conserved region of the DNA binding domain (codons 107-174 and 201-280) of HNF1A, which is defined as critical for the protein’s function by the ClinGen MDEP (PM1_Supporting). This variant is absent from gnomAD v2.1.1 (PM2_Supporting). This variant was identified in two unrelated individuals with non-autoimmune and non-absolute/near-absolute insulin-deficient diabetes; however, PS4_Moderate cannot be applied because this number is below the ClinGen MDEP threshold (internal lab contributors). One of these individuals had a clinical history highly specific for HNF1A-monogenic diabetes (MODY probability calculator result nearly 50%, negative genetic testing for HNF4A, and negative antibodies). While the MODY probability score was slightly below 50%, the patient was on insulin with a C-peptide in the normal range and thus the score was likely an underestimate, and clinical judgment was used to apply PP4_Moderate (internal lab contributors). Another missense variant, c.779C>T p.Thr260Met, has been classified as pathogenic by the ClinGen MDEP but has a greater Grantham distance than p.Thr260Lys (PM5_Supporting). In summary, c.779C>A meets the criteria to be classified as likely pathogenic for monogenic diabetes. ACMG/AMP criteria applied, as specified by the ClinGen MDEP (specification version 2.1.0, approved 8/11/2023): PP4_Moderate, PP3, PM1_Supporting, PM2_Supporting, PM5_Supporting. LINK:https://erepo.genome.network/evrepo/ui/classification/CA386966081/MONDO:0015967/085

Frequency

Genomes: not found (cov: 32)

Consequence

HNF1A
NM_000545.8 missense

Scores

13
4
1

Clinical Significance

Likely pathogenic reviewed by expert panel P:1

Conservation

PhyloP100: 7.49
Variant links:
Genes affected
HNF1A (HGNC:11621): (HNF1 homeobox A) The protein encoded by this gene is a transcription factor required for the expression of several liver-specific genes. The encoded protein functions as a homodimer and binds to the inverted palindrome 5'-GTTAATNATTAAC-3'. Defects in this gene are a cause of maturity onset diabetes of the young type 3 (MODY3) and also can result in the appearance of hepatic adenomas. Alternative splicing results in multiple transcript variants encoding different isoforms. [provided by RefSeq, Apr 2015]

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ACMG classification

Classification made for transcript

Verdict is Likely_pathogenic. Variant got 6 ACMG points.

PM1
For more information check the summary or visit ClinGen Evidence Repository.
PM2
For more information check the summary or visit ClinGen Evidence Repository.
PM5
For more information check the summary or visit ClinGen Evidence Repository.
PP3
For more information check the summary or visit ClinGen Evidence Repository.
PP4
For more information check the summary or visit ClinGen Evidence Repository.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
HNF1ANM_000545.8 linkc.779C>A p.Thr260Lys missense_variant Exon 4 of 10 ENST00000257555.11 NP_000536.6 P20823E0YMI7
HNF1ANM_001306179.2 linkc.779C>A p.Thr260Lys missense_variant Exon 4 of 10 NP_001293108.2 P20823E0YMI7
HNF1ANM_001406915.1 linkc.779C>A p.Thr260Lys missense_variant Exon 4 of 9 NP_001393844.1
HNF1AXM_024449168.2 linkc.779C>A p.Thr260Lys missense_variant Exon 4 of 9 XP_024304936.1

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
HNF1AENST00000257555.11 linkc.779C>A p.Thr260Lys missense_variant Exon 4 of 10 1 NM_000545.8 ENSP00000257555.5 A0A0A0MQU7

Frequencies

GnomAD3 genomes
Cov.:
32
GnomAD4 exome
Cov.:
33
GnomAD4 genome
Cov.:
32

ClinVar

Significance: Likely pathogenic
Submissions summary: Pathogenic:1
Revision: reviewed by expert panel
LINK: link

Submissions by phenotype

Monogenic diabetes Pathogenic:1
Sep 19, 2023
ClinGen Monogenic Diabetes Variant Curation Expert Panel
Significance: Likely pathogenic
Review Status: reviewed by expert panel
Collection Method: curation

The c.779C>A variant in the HNF1 homeobox A gene, HNF1A, causes an amino acid change of threonine to lysine at codon 260 (p.(Thr260Lys)) of NM_000545.8. This variant is predicted to be deleterious by computational evidence, with a REVEL score of 0.925, which is greater than the MDEP VCEP threshold of 0.70 (PP3). This variant is located within a conserved region of the DNA binding domain (codons 107-174 and 201-280) of HNF1A, which is defined as critical for the protein’s function by the ClinGen MDEP (PM1_Supporting). This variant is absent from gnomAD v2.1.1 (PM2_Supporting). This variant was identified in two unrelated individuals with non-autoimmune and non-absolute/near-absolute insulin-deficient diabetes; however, PS4_Moderate cannot be applied because this number is below the ClinGen MDEP threshold (internal lab contributors). One of these individuals had a clinical history highly specific for HNF1A-monogenic diabetes (MODY probability calculator result nearly 50%, negative genetic testing for HNF4A, and negative antibodies). While the MODY probability score was slightly below 50%, the patient was on insulin with a C-peptide in the normal range and thus the score was likely an underestimate, and clinical judgment was used to apply PP4_Moderate (internal lab contributors). Another missense variant, c.779C>T p.Thr260Met, has been classified as pathogenic by the ClinGen MDEP but has a greater Grantham distance than p.Thr260Lys (PM5_Supporting). In summary, c.779C>A meets the criteria to be classified as likely pathogenic for monogenic diabetes. ACMG/AMP criteria applied, as specified by the ClinGen MDEP (specification version 2.1.0, approved 8/11/2023): PP4_Moderate, PP3, PM1_Supporting, PM2_Supporting, PM5_Supporting. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
1.0
BayesDel_addAF
Pathogenic
0.49
D
BayesDel_noAF
Pathogenic
0.47
CADD
Pathogenic
29
DANN
Uncertain
1.0
DEOGEN2
Pathogenic
0.92
.;D;D;.
Eigen
Pathogenic
0.71
Eigen_PC
Pathogenic
0.67
FATHMM_MKL
Pathogenic
0.98
D
LIST_S2
Uncertain
0.97
D;D;D;D
M_CAP
Pathogenic
0.80
D
MetaRNN
Pathogenic
0.97
D;D;D;D
MetaSVM
Pathogenic
1.1
D
PrimateAI
Pathogenic
0.90
D
PROVEAN
Pathogenic
-4.5
D;.;D;D
REVEL
Pathogenic
0.93
Sift
Uncertain
0.0010
D;.;D;D
Sift4G
Uncertain
0.0020
D;D;D;D
Polyphen
1.0
.;.;.;D
Vest4
0.96
MutPred
0.82
Gain of methylation at T260 (P = 0.0167);Gain of methylation at T260 (P = 0.0167);Gain of methylation at T260 (P = 0.0167);Gain of methylation at T260 (P = 0.0167);
MVP
0.97
MPC
2.3
ClinPred
1.0
D
GERP RS
4.8
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.7
gMVP
0.99

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

No publications associated with this variant yet.

Other links and lift over

hg19: chr12-121432032; API