rs962041031

Variant summary

Our verdict is Pathogenic. Variant got 15 ACMG points: 15P and 0B. PM1PM2PP2PP3_ModeratePP5_Very_Strong

The NM_000165.5(GJA1):​c.443G>A​(p.Arg148Gln) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.00000657 in 152,174 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Likely pathogenic (★★).

Frequency

Genomes: 𝑓 0.0000066 ( 0 hom., cov: 32)

Consequence

GJA1
NM_000165.5 missense

Scores

5
5
9

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:5U:1

Conservation

PhyloP100: 7.78
Variant links:
Genes affected
GJA1 (HGNC:4274): (gap junction protein alpha 1) This gene is a member of the connexin gene family. The encoded protein is a component of gap junctions, which are composed of arrays of intercellular channels that provide a route for the diffusion of low molecular weight materials from cell to cell. The encoded protein is the major protein of gap junctions in the heart that are thought to have a crucial role in the synchronized contraction of the heart and in embryonic development. A related intronless pseudogene has been mapped to chromosome 5. Mutations in this gene have been associated with oculodentodigital dysplasia, autosomal recessive craniometaphyseal dysplasia and heart malformations. [provided by RefSeq, May 2014]

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ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 15 ACMG points.

PM1
In a topological_domain Cytoplasmic (size 57) in uniprot entity CXA1_HUMAN there are 17 pathogenic changes around while only 0 benign (100%) in NM_000165.5
PM2
Very rare variant in population databases, with high coverage;
PP2
Missense variant in the GJA1 gene, where missense mutations are typically associated with disease (based on misZ statistic). The gene has 41 curated pathogenic missense variants (we use a threshold of 10). The gene has 1 curated benign missense variants. Gene score misZ: 1.2784 (below the threshold of 3.09). Trascript score misZ: 3.3775 (above the threshold of 3.09). GenCC associations: The gene is linked to craniometaphyseal dysplasia, autosomal recessive, Hallermann-Streiff syndrome, syndactyly type 3, oculodentodigital dysplasia, nonsyndromic genetic hearing loss, hypoplastic left heart syndrome 1, autosomal dominant palmoplantar keratoderma and congenital alopecia, oculodentodigital dysplasia, autosomal recessive, craniometaphyseal dysplasia, erythrokeratodermia variabilis et progressiva 3, erythrokeratodermia variabilis.
PP3
MetaRNN computational evidence supports a deleterious effect, 0.846
PP5
Variant 6-121447290-G-A is Pathogenic according to our data. Variant chr6-121447290-G-A is described in ClinVar as [Likely_pathogenic]. Clinvar id is 435324.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-121447290-G-A is described in Lovd as [Likely_pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
GJA1NM_000165.5 linkc.443G>A p.Arg148Gln missense_variant Exon 2 of 2 ENST00000282561.4 NP_000156.1 P17302A0A654IBU3

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
GJA1ENST00000282561.4 linkc.443G>A p.Arg148Gln missense_variant Exon 2 of 2 1 NM_000165.5 ENSP00000282561.3 P17302
GJA1ENST00000647564.1 linkc.443G>A p.Arg148Gln missense_variant Exon 2 of 2 ENSP00000497565.1 P17302
GJA1ENST00000649003.1 linkc.443G>A p.Arg148Gln missense_variant Exon 2 of 2 ENSP00000497283.1 P17302
GJA1ENST00000650427.1 linkc.443G>A p.Arg148Gln missense_variant Exon 2 of 2 ENSP00000497367.1 P17302

Frequencies

GnomAD3 genomes
AF:
0.00000657
AC:
1
AN:
152174
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00110
Gnomad AMR
AF:
0.00
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.00
Gnomad OTH
AF:
0.00
GnomAD4 exome
Cov.:
32
GnomAD4 genome
AF:
0.00000657
AC:
1
AN:
152174
Hom.:
0
Cov.:
32
AF XY:
0.0000135
AC XY:
1
AN XY:
74340
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:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.00
Gnomad4 OTH
AF:
0.00
Bravo
AF:
0.00000378

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:5Uncertain:1
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Pathogenic:3Uncertain:1
Nov 02, 2022
GeneDx
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Published functional studies demonstrate improper protein localization and impaired ability to form functional gap junctions (Zheng et al., 2020); Not observed at significant frequency in large population cohorts (gnomAD); This variant is associated with the following publications: (PMID: 36142674, 14729836, 34502077, 32318302, 21871435, 32676758, 31023660, 18946008, 19338053, 35023121, 33080786) -

-
Genome Diagnostics Laboratory, Amsterdam University Medical Center
Significance: Likely pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

Jan 01, 2022
Revvity Omics, Revvity
Significance: Uncertain significance
Review Status: flagged submission
Collection Method: clinical testing

- -

-
Joint Genome Diagnostic Labs from Nijmegen and Maastricht, Radboudumc and MUMC+
Significance: Likely pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

Oculodentodigital dysplasia Pathogenic:1
Sep 15, 2015
Genetic Services Laboratory, University of Chicago
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Oculodentodigital dysplasia, autosomal recessive Pathogenic:1
Jul 20, 2023
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

For these reasons, this variant has been classified as Pathogenic. Experimental studies have shown that this missense change affects GJA1 function (PMID: 33080786). 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 not expected to disrupt GJA1 protein function. ClinVar contains an entry for this variant (Variation ID: 435324). This missense change has been observed in individuals with autosomal dominant oculodentodigital dysplasia (PMID: 14729836, 33080786, 35023121). This variant is not present in population databases (gnomAD no frequency). This sequence change replaces arginine, which is basic and polar, with glutamine, which is neutral and polar, at codon 148 of the GJA1 protein (p.Arg148Gln). -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.22
BayesDel_addAF
Pathogenic
0.34
D
BayesDel_noAF
Pathogenic
0.25
CADD
Uncertain
25
DANN
Uncertain
0.99
DEOGEN2
Pathogenic
0.81
D;D;D;D;D
Eigen
Benign
0.027
Eigen_PC
Benign
0.085
FATHMM_MKL
Uncertain
0.85
D
LIST_S2
Benign
0.77
.;.;.;.;T
M_CAP
Uncertain
0.12
D
MetaRNN
Pathogenic
0.85
D;D;D;D;D
MetaSVM
Uncertain
0.32
D
MutationAssessor
Benign
1.6
L;L;L;L;L
PrimateAI
Uncertain
0.72
T
PROVEAN
Benign
-1.2
.;.;N;.;.
REVEL
Pathogenic
0.69
Sift
Benign
0.069
.;.;T;.;.
Sift4G
Benign
0.37
.;.;T;.;.
Polyphen
0.77
P;P;P;P;P
Vest4
0.36
MutPred
0.84
Loss of methylation at R148 (P = 0.012);Loss of methylation at R148 (P = 0.012);Loss of methylation at R148 (P = 0.012);Loss of methylation at R148 (P = 0.012);Loss of methylation at R148 (P = 0.012);
MVP
0.98
MPC
0.58
ClinPred
0.88
D
GERP RS
4.5
Varity_R
0.22
gMVP
0.83

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: rs962041031; hg19: chr6-121768436; COSMIC: COSV56998562; API