Genetic Information

Gene & Transcript Details

Gene
MLH1
Transcript
NM_000249.4 MANE Select
Total Exons
Reference Sequence
NC_000003.11
Alternative Transcripts
IDStatusDetails
NM_000249.4 MANE Select 2494 nt | 31–2301
NM_000249.3 RefSeq Select 2662 nt | 199–2469
NM_000249.2 Alternative 2524 nt | 61–2331

Variant Details

HGVS Notation
NM_000249.4:c.1990-23G>T
Protein Change
?
Location
Exon 17 (Exon 17 of )
17
5'Exon Structure3'
Functional Consequence
Loss of Function
Alternate Identifiers

Clinical & Population Data

Population Frequency

gnomAD
Global Frequency
0.000399 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
Unknown
0 publications
Clinical Statement

""

COSMIC Somatic Evidence

Open
COSMIC ID
Recurrence
0 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 MLH1.

Functional Studies & Therapeutic Relevance

Functional Summary

The MLH1 1990-23G>T 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
0.0
Threshold: ≥0.75 = PP3 applied

SpliceAI Scores

Window: ±500bp
Effect Type Score Position
- Acceptor Loss (AL) 0.15 1 bp
- Donor Loss (DL) 0.0 -241 bp
+ Acceptor Gain (AG) 0.01 23 bp
+ Donor Gain (DG) 0.0 -82 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 PVS1 rule applies to canonical ±1/2 splice site variants or null variants in MLH1. The rule states: "Variants at IVS±1 or IVS±2 where exon skipping or use of a cryptic splice site disrupts reading frame...". This variant is located at –23, outside the ±1/2 positions. Therefore, PVS1 is not applied.

PS1

PS1 (Not Applied)

According to standard ACMG guidelines, PS1 applies when the variant causes the same amino acid change as a known pathogenic variant. This variant is intronic and does not alter an amino acid. Therefore, PS1 is not applied.

PS2

PS2 (Not Applied)

According to standard ACMG guidelines, PS2 applies for confirmed de novo occurrences. No de novo data are available for this variant. Therefore, PS2 is not applied.

PS3

PS3 (Not Applied)

According to standard ACMG guidelines, PS3 requires well‐established functional studies showing damaging effect. No functional assay data exist for this variant. Therefore, PS3 is not applied.

PS4

PS4 (Not Applied)

According to standard ACMG guidelines, PS4 applies when variant prevalence is significantly increased in affected individuals versus controls. No case-control or patient frequency data are available. Therefore, PS4 is not applied.

PM1

PM1 (Not Applied)

According to standard ACMG guidelines, PM1 applies to variants in mutational hot spots or critical functional domains. This intronic variant does not lie in a known hotspot or domain. Therefore, PM1 is not applied.

PM2

PM2 (Supporting)

According to VCEP guidelines, PM2 supporting applies when a variant is absent or extremely rare (<1 in 50,000 alleles) in gnomAD v4. The rule states: "Absent/extremely rare (<1 in 50,000 alleles) in gnomAD v4 dataset." The variant is observed at 1/250,612 alleles (MAF≈0.00000399), below the threshold. Therefore, PM2 is applied at Supporting strength.

PM3

PM3 (Not Applied)

According to standard ACMG guidelines, PM3 applies for variants observed in trans with a known pathogenic variant in recessive disorders. MLH1-related Lynch syndrome is dominant and no trans data exist. Therefore, PM3 is not applied.

PM4

PM4 (Not Applied)

According to standard ACMG guidelines, PM4 applies to protein length changes due to in-frame indels or stop-loss. This variant is intronic with no coding effect. Therefore, PM4 is not applied.

PM5

PM5 (Not Applied)

According to standard ACMG guidelines, PM5 applies to novel missense changes at residues where other missense changes are pathogenic. This variant is intronic and not missense. Therefore, PM5 is not applied.

PM6

PM6 (Not Applied)

According to standard ACMG guidelines, PM6 applies to assumed de novo variants without confirmation. No de novo assumption data exist. Therefore, PM6 is not applied.

PP1

PP1 (Not Applied)

According to standard ACMG guidelines, PP1 applies to co-segregation with disease in families. No segregation data are available. Therefore, PP1 is not applied.

PP2

PP2 (Not Applied)

According to standard ACMG guidelines, PP2 applies to missense variants in genes with low rate of benign missense. This variant is intronic. Therefore, PP2 is not applied.

PP3

PP3 (Not Applied)

According to VCEP guidelines, PP3 supporting applies when SpliceAI predicts a delta score ≥0.2 for non-canonical splice variants. The rule states: "Predicted splice defect for non-canonical splicing nucleotides using SpliceAI with delta score ≥ 0.2." The variant has a maximum SpliceAI delta of 0.15, below threshold. Therefore, PP3 is not applied.

PP4

PP4 (Not Applied)

According to VCEP guidelines, PP4 applies to tumor and expression data (MSI-H, loss of MMR protein). No tumor phenotype or IHC data are available. Therefore, PP4 is not applied.

PP5

PP5 (Not Applied)

According to standard ACMG guidelines, PP5 applies when reputable sources classify a variant as pathogenic. The variant is not reported in ClinVar or other databases. Therefore, PP5 is not applied.

BA1

BA1 (Not Applied)

According to VCEP guidelines, BA1 stand‐alone applies for gnomAD v4 filtering allele frequency ≥0.001. The variant’s highest frequency (0.000164) is below this. Therefore, BA1 is not applied.

BS1

BS1 (Strong)

According to VCEP guidelines, BS1 strong applies for gnomAD v4 filtering allele frequency ≥0.0001 and <0.001. The rule states: "GnomAD v4 Grpmax filtering allele frequency ≥ 0.0001 and < 0.001." The variant’s highest frequency is 0.000164, within this range. Therefore, BS1 is applied at Strong strength.

BS2

BS2 (Not Applied)

According to VCEP guidelines, BS2 applies for co-occurrence in trans with a known pathogenic MLH1 variant in a patient without CMMRD. No co-occurrence data exist. Therefore, BS2 is not applied.

BS3

BS3 (Not Applied)

According to standard ACMG guidelines, BS3 applies to well‐established functional studies showing no damaging effect. No such assays exist for this variant. Therefore, BS3 is not applied.

BS4

BS4 (Not Applied)

According to standard ACMG guidelines, BS4 applies to lack of segregation with disease. No segregation data are available. Therefore, BS4 is not applied.

BP1

BP1 (Not Applied)

According to standard ACMG guidelines, BP1 applies to missense variants in genes where only loss-of-function is disease mechanism. This variant is intronic. Therefore, BP1 is not applied.

BP2

BP2 (Not Applied)

According to standard ACMG guidelines, BP2 applies when variant is observed in cis with a pathogenic variant. No cis data exist. Therefore, BP2 is not applied.

BP3

BP3 (Not Applied)

According to standard ACMG guidelines, BP3 applies to in-frame indels in repetitive regions. This is a single-nucleotide intronic substitution. Therefore, BP3 is not applied.

BP4

BP4 (Not Applied)

According to VCEP guidelines, BP4 supporting applies when SpliceAI predicts no splicing impact with delta ≤0.1. The rule states: "SpliceAI predicts no splicing impact with delta score ≤ 0.1." The variant’s maximum delta is 0.15, above threshold. Therefore, BP4 is not applied.

BP5

BP5 (Not Applied)

According to VCEP guidelines, BP5 applies to tumor data inconsistent with MLH1 pathogenicity. No tumor or methylation data are available. Therefore, BP5 is not applied.

BP6

BP6 (Not Applied)

According to standard ACMG guidelines, BP6 applies when reputable sources classify a variant as benign. No such classifications exist. Therefore, BP6 is not applied.

BP7

BP7 (Supporting)

According to VCEP guidelines, BP7 supporting applies to intronic variants at or beyond –21 from the exon. The rule states: "A synonymous (silent) or intronic variant at or beyond -21/+7." This variant is at –23. Therefore, BP7 is applied at Supporting strength.