Genetic Information

Gene & Transcript Details

Gene
ATM
Transcript
NM_000051.4 MANE Select
Total Exons
Reference Sequence
NC_000011.9
Alternative Transcripts
IDStatusDetails
NM_000051.3 RefSeq Select 13147 nt | 386–9556
NM_000051.4 MANE Select 12915 nt | 151–9321

Variant Details

HGVS Notation
NM_000051.4:c.8520G>C
Protein Change
L2840F
Location
Exon 58 (Exon 58 of )
58
5'Exon Structure3'
Functional Consequence
Loss of Function
Alternate Identifiers

Clinical & Population Data

Population Frequency

gnomAD
Global Frequency
0.0 in 100,000
Extremely Rare
ACMG Criteria Applied PM2
This variant is absent or extremely rare in population databases (PM2 criteria applies).

ClinVar

Open
Classification
Uncertain Significance (VUS)
1 publications
Publications List
PMID: 22649200

The ATM c.8520G>C (p.Leu2840Phe) variant has been reported in the published literature in a homozygous individual with ataxia telangiectasia who's biochemical evidence confirmed protein impairment (PMID: 22649200 (2012)). The frequency of this variant in the general population, 0.000013 (2/152098 chromosomes (Genome Aggregation Database, http://gnomad.broadinstitute.org)), is uninformative in the assessment of its pathogenicity. Analysis of this variant using bioinformatics tools for the prediction of the effect of amino acid changes on protein structure and function yielded predictions that this variant is damaging. Based on the available information, we are unable to determine the clinical significance of this variant.

PMID: 22649200

The p.L2840F variant (also known as c.8520G>C), located in coding exon 57 of the ATM gene, results from a G to C substitution at nucleotide position 8520. The leucine at codon 2840 is replaced by phenylalanine, an amino acid with highly similar properties. This alteration has been identified in the homozygous state in an individual with a clinical diagnosis of ataxia-telangiectasia (Carney EF et al. J. Immunol., 2012 Jul;189:261-8). This amino acid position is highly conserved in available vertebrate species. In addition, the in silico prediction for this alteration is inconclusive. Based on the available evidence, the clinical significance of this variant remains unclear.

PMID: 22649200

This sequence change replaces leucine, which is neutral and non-polar, with phenylalanine, which is neutral and non-polar, at codon 2840 of the ATM protein (p.Leu2840Phe). This variant is present in population databases (rs752652869, gnomAD no frequency). This missense change has been observed in individual(s) with ataxia-telangiectasia (PMID: 22649200). ClinVar contains an entry for this variant (Variation ID: 221124). Invitae Evidence Modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) indicates that this missense variant is not expected to disrupt ATM protein function with a negative predictive value of 95%. Experimental studies have shown that this missense change affects ATM function (PMID: 26896183). 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.

PMID: 22649200

This missense variant replaces leucine with phenylalanine at codon 2840 of the ATM protein. Computational prediction suggests that this variant may not impact protein structure and function. This variant has been reported in the homozygous state in individuals affected with ataxia-telangiectasia (PMID: 22649200, 26896183). Cells derived from these individuals have shown no detectable kinase activity. This variant has been identified in 1/246018 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance.

Clinical Statement

"This variant has been reported in ClinVar as Uncertain significance (9 clinical laboratories) and as Uncertain Significance by ClinGen Hereditary Breast, Ovarian and Pancreatic Cancer Variant Curation Expert Panel, ClinGen expert panel."

COSMIC Somatic Evidence

Open
COSMIC ID
COSM10346368
Recurrence
1 occurrences
PM1 Criteria
Not Applied
COSMIC Database Preview
COSMIC Preview
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Functional Impact & Domains

Functional Domain

Hotspot Status
Not a hotspot
Domain Summary
This variant is not located in a mutational hotspot or critical domain.
Related Variants in This Domain
No evidence of other pathogenic variants at this position in gene ATM.

Functional Studies & Therapeutic Relevance

Functional Summary

The ATM L2840F variant has not been functionally characterized.

Database Previews
OncoKB
OncoKB Preview
JAX-CKB
JAX-CKB Preview

Click on previews to view full database entries. External databases may require institutional access.

Computational Analysis

Pathogenicity Predictions

SpliceAI
Predictor Consensus
Mixed/VUS
PP3 Applied
No
REVEL Score
0.464
Threshold: ≥0.75 = PP3 applied

SpliceAI Scores

Window: ±500bp
Effect Type Score Position
- Acceptor Loss (AL) 0.0 45 bp
- Donor Loss (DL) 0.0 181 bp
+ Acceptor Gain (AG) 0.0 -101 bp
+ Donor Gain (DG) 0.01 64 bp
High impact (≥0.5) Medium impact (0.2-0.49) Low impact (<0.2)

VCEP Guidelines

Applied ACMG/AMP Criteria (VCEP Specific)

Filter Criteria:
PVS1

PVS1 (Not Applied)

According to VCEP guidelines: the rule for PVS1 is: "Very Strong Strength: Very Strong Use ATM PVS1 Decision Tree Modification Type: Gene-specific,Strength". The evidence for this variant shows: NM_000051.4:c.8520G>C is a missense change, not a null variant. Therefore, this criterion is not applied because the variant does not meet the null variant requirement.

PS1

PS1 (Not Applied)

According to VCEP guidelines: the rule for PS1 is: "Strong Strength: Strong Use for protein changes as long as splicing is ruled-out for both alterations. Use ATM PS1 Splicing table for splicing variants with similar predictions or observations of splice defect." The evidence for this variant shows: p.Leu2840Phe is not a previously established pathogenic amino acid change. Therefore, this criterion is not applied because there is no known pathogenic variant with the same amino acid change.

PS2

PS2 (Not Applied)

According to standard ACMG guidelines: the rule for PS2 is: "De novo (both maternity and paternity confirmed) in a patient with the disease and no family history." The evidence for this variant shows: no de novo information is available. Therefore, this criterion is not applied due to lack of de novo confirmation.

PS3

PS3 (Not Applied)

According to VCEP guidelines: the rule for PS3 (Moderate) is: "Moderate Strength: Moderate Use when a variant fails to rescue both an ATM-specific feature (e.g. phosphorylation of ATM-specific targets) AND radiosensitivity. Modification Type: Gene-specific,Strength." The evidence for this variant shows: no functional assays evaluating ATM-specific features or radiosensitivity have been reported. Therefore, this criterion is not applied because functional data are missing.

PS4

PS4 (Not Applied)

According to VCEP guidelines: the rule for PS4 is: "Strong Strength: Strong Case-control studies; p-value ≤.05 AND (Odds ratio, hazard ratio, or relative risk ≥2 OR lower 95% CI ≥1.5). Modification Type: General recommendation." The evidence for this variant shows: no case-control data are available. Therefore, this criterion is not applied due to lack of case-control evidence.

PM1

PM1 (Not Applied)

According to standard ACMG guidelines: the rule for PM1 is: "Located in a mutational hot spot and/or critical functional domain without benign variation." The evidence for this variant shows: there is no evidence that p.Leu2840 is in a known mutational hot spot or critical domain. Therefore, this criterion is not applied.

PM2

PM2 (Supporting)

According to VCEP guidelines: the rule for PM2 is: "Supporting Strength: Supporting Frequency ≤.001% if n=1 in a single sub population, that is sufficiently rare and PM2_supporting would apply Modification Type: Gene-specific,Strength." The evidence for this variant shows: it is absent from population databases (gnomAD MAF=0%). Therefore, this criterion is applied at Supporting strength because the variant is extremely rare/absent in controls.

PM3

PM3 (Not Applied)

According to VCEP guidelines: the rule for PM3 is: "Supporting Strength: Supporting Use ATM PM3/BP2 table Modification Type: Disease-specific,General recommendation,Gene-specific,Strength." The evidence for this variant shows: no evidence of trans occurrence with another pathogenic ATM variant. Therefore, this criterion is not applied.

PM4

PM4 (Not Applied)

According to VCEP guidelines: the rule for PM4 is: "Moderate Strength: Moderate Use for stop-loss variants. Modification Type: General recommendation,Gene-specific." The evidence for this variant shows: it is a missense change, not a stop-loss. Therefore, this criterion is not applied.

PM5

PM5 (Not Applied)

According to VCEP guidelines: the rule for PM5 is: "Supporting Strength: Supporting Use for genomic frameshift and truncating variants with PTC upstream of p.R3047. Apply also to splice variants as PM5_supporting... Modification Type: Gene-specific,Strength." The evidence for this variant shows: it is a missense variant, not a frameshift or truncating change. Therefore, this criterion is not applied.

PM6

PM6 (Not Applied)

According to standard ACMG guidelines: the rule for PM6 is: "Unconfirmed de novo (without confirmation of paternity and maternity)." The evidence for this variant shows: no de novo data are available. Therefore, this criterion is not applied.

PP1

PP1 (Not Applied)

According to standard ACMG guidelines: the rule for PP1 is: "Co-segregation with disease in multiple affected family members in a gene definitively known to cause the disease." The evidence for this variant shows: no family segregation data are available. Therefore, this criterion is not applied.

PP2

PP2 (Not Applied)

According to standard ACMG guidelines: the rule for PP2 is: "Missense variant in a gene that has a low rate of benign missense variation and where missense variants are a common mechanism of disease." The evidence for this variant shows: there is insufficient data on benign vs. pathogenic missense rates in ATM to apply PP2. Therefore, this criterion is not applied.

PP3

PP3 (Not Applied)

According to VCEP guidelines: the rule for PP3 is: "Supporting Strength: Supporting Protein Analysis: REVEL >.7333; RNA: At least one well-established in silico predictor (e.g. SpliceAI) shows impact on splicing. Modification Type: Gene-specific." The evidence for this variant shows: REVEL=0.46 (<0.7333) and SpliceAI=0.01 (no splicing impact). Therefore, this criterion is not applied.

PP4

PP4 (Not Applied)

According to standard ACMG guidelines: the rule for PP4 is: "Patient's phenotype or family history is highly specific for a disease with a single genetic etiology." The evidence for this variant shows: no phenotype or family history information is available. Therefore, this criterion is not applied.

PP5

PP5 (Not Applied)

According to standard ACMG guidelines: the rule for PP5 is: "Reputable source recently reports variant as pathogenic, but the evidence is not available for review." The evidence for this variant shows: ClinVar classifies it as VUS, not pathogenic. Therefore, this criterion is not applied.

BA1

BA1 (Not Applied)

According to standard ACMG guidelines: the rule for BA1 is: "Allele frequency is >5% in Exome Sequencing Project, 1000 Genomes Project, or ExAC." The evidence for this variant shows: MAF=0%. Therefore, this criterion is not applied.

BS1

BS1 (Not Applied)

According to standard ACMG guidelines: the rule for BS1 is: "Allele frequency is greater than expected for disorder." The evidence for this variant shows: MAF=0%. Therefore, this criterion is not applied.

BS2

BS2 (Not Applied)

According to standard ACMG guidelines: the rule for BS2 is: "Observed in a healthy adult individual for a dominant (with full penetrance expected at an early age), X-linked or mitochondrial disorder with full penetrance expected at an early age." The evidence for this variant shows: no such observations. Therefore, this criterion is not applied.

BS3

BS3 (Not Applied)

According to VCEP guidelines: the rule for BS3 (Moderate) is: "Moderate Strength: Moderate Use when a variant rescues both an ATM-specific feature (e.g. phosphorylation of ATM-specific targets) AND radiosensitivity. Modification Type: Disease-specific,Gene-specific,Strength." The evidence for this variant shows: no functional rescue data. Therefore, this criterion is not applied.

BS4

BS4 (Not Applied)

According to standard ACMG guidelines: the rule for BS4 is: "Lack of segregation in affected members of a family." The evidence for this variant shows: no segregation data. Therefore, this criterion is not applied.

BP1

BP1 (Not Applied)

According to standard ACMG guidelines: the rule for BP1 is: "Missense variant in a gene for which primarily truncating variants are known to cause disease." The evidence for this variant shows: ATM has known pathogenic missense variants. Therefore, this criterion is not applied.

BP2

BP2 (Not Applied)

According to VCEP guidelines: the rule for BP2 is: "Supporting Strength: Supporting Use ATM PM3/BP2 table Modification Type: Disease-specific,General recommendation,Gene-specific,Strength." The evidence for this variant shows: no evidence of cis/trans configuration with another pathogenic variant. Therefore, this criterion is not applied.

BP3

BP3 (Not Applied)

According to standard ACMG guidelines: the rule for BP3 is: "In-frame deletions/insertions in a repetitive region without a known function." The evidence for this variant shows: it is a missense single nucleotide change. Therefore, this criterion is not applied.

BP4

BP4 (Not Applied)

According to VCEP guidelines: the rule for BP4 is: "Supporting Strength: Supporting Protein Analysis: Metapredictor REVEL score ≤.249; RNA: At least one well-established in silico predictor (e.g. SpliceAI) shows impact on splicing." The evidence for this variant shows: REVEL=0.46 (>0.249) and SpliceAI=0.01 (no impact), failing the thresholds. Therefore, this criterion is not applied.

BP5

BP5 (Not Applied)

According to standard ACMG guidelines: the rule for BP5 is: "Variant found in a case with an alternate molecular basis for disease." The evidence for this variant shows: no such alternate molecular basis. Therefore, this criterion is not applied.

BP6

BP6 (Not Applied)

According to standard ACMG guidelines: the rule for BP6 is: "Reputable source recently reports variant as benign, but evidence is not available for review." The evidence for this variant shows: no reputable benign classification. Therefore, this criterion is not applied.

BP7

BP7 (Not Applied)

According to standard ACMG guidelines: the rule for BP7 is: "Synonymous variant for which splicing prediction algorithms predict no impact on the splice consensus sequence nor the creation of a new splice site; the nucleotide is not highly conserved." The evidence for this variant shows: it is a missense variant. Therefore, this criterion is not applied.