Genetic Information

Gene & Transcript Details

Gene
MSH6
Transcript
NM_000179.3 MANE Select
Total Exons
Reference Sequence
NC_000002.11
Alternative Transcripts
IDStatusDetails
NM_000179.2 RefSeq Select 4435 nt | 153–4235
NM_000179.1 Alternative 4264 nt | 88–4170
NM_000179.3 MANE Select 4265 nt | 90–4172

Variant Details

HGVS Notation
NM_000179.3:c.866G>A
Protein Change
G289D
Location
Exon 4 (Exon 4 of )
4
5'Exon Structure3'
Functional Consequence
Loss of Function
Alternate Identifiers

Clinical & Population Data

Population Frequency

gnomAD
Global Frequency
0.0092 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)
3 publications
Publications List
PMID: 18269114

The p.G289D variant (also known as c.866G>A), located in coding exon 4 of the MSH6 gene, results from a G to A substitution at nucleotide position 866. The glycine at codon 289 is replaced by aspartic acid, an amino acid with similar properties. This amino acid position is well conserved through mammals but not in all available vertebrate species. In addition, this alteration is predicted to be tolerated by in silico analysis. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear.

Clinical Statement

"This variant has been reported in ClinVar as Benign (1 clinical laboratories) and as Uncertain significance (3 clinical laboratories) and as Likely benign (1 clinical laboratories)."

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 MSH6.

Functional Studies & Therapeutic Relevance

Functional Summary

The MSH6 G289D variant has not been functionally characterized. In vitro assays indicate that it does not demonstrate reduced mismatch repair activity compared to the wild-type protein, but its effect on MSH6 protein function remains unknown due to incomplete biochemical characterization.

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) 0.0 70 bp
- Donor Loss (DL) 0.0 -145 bp
+ Acceptor Gain (AG) 0.01 -234 bp
+ Donor Gain (DG) 0.0 418 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 Nonsense/frameshift variant introducing Premature Termination Codon (PTC) ≤ codon 1341 in MSH6...". The evidence for this variant shows it is a missense change (G289D) and does not introduce a stop codon or frameshift. Therefore, this criterion is not applied.

PS1

PS1 (Not Applied)

According to VCEP guidelines, the rule for PS1 is: "A predicted missense substitution that encodes the same amino acid change with a different underlying nucleotide change previously established by this VCEP as Pathogenic." The evidence for this variant shows no previously established pathogenic variant encoding G289D. Therefore, this criterion is not applied.

PS2

PS2 (Not Applied)

According to VCEP guidelines, the rule for PS2 is: "Very Strong ≥4 de novo points; Strong 2–3 de novo points; Moderate 1 de novo point; Supporting 0.5 de novo points." The evidence for this variant shows no information on de novo occurrence. Therefore, this criterion is not applied.

PS3

PS3 (Not Applied)

According to VCEP guidelines, the rule for PS3 is: "Strong: Calibrated functional assays with functional odds for Pathogenicity >18.7; Moderate: functional odds >4.3 and ≤18.7." The evidence for this variant shows in vitro assays indicate no reduction in MMR activity. There is no evidence of a functional defect. Therefore, PS3 is not applied.

PS4

PS4 (Not Applied)

According to standard ACMG guidelines, the rule for PS4 is: "Statistically increased prevalence in affected individuals compared to controls." The evidence for this variant shows no case-control or prevalence data in affected individuals. Therefore, this criterion is not applied.

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 no data placing codon 289 in a known hotspot or critical domain. Therefore, this criterion is not applied.

PM2

PM2 (Not Applied)

According to VCEP guidelines, the rule for PM2 (Supporting) is: "Absent/extremely rare (<1 in 50,000 alleles) in gnomAD v4." The evidence for this variant shows a global MAF of 0.0092% (9.2×10⁻⁵), which exceeds the threshold. Therefore, PM2 is not applied.

PM3

PM3 (Not Applied)

According to standard ACMG guidelines, the rule for PM3 is: "Detected in trans with a pathogenic variant for recessive disorders." The evidence for this variant shows no data on trans occurrence and MSH6 is associated with dominant Lynch syndrome. Therefore, this criterion is not applied.

PM4

PM4 (Not Applied)

According to standard ACMG guidelines, the rule for PM4 is: "Protein length changes due to in-frame deletions/insertions or stop-loss." The evidence for this variant shows a single amino acid substitution without length change. Therefore, this criterion is not applied.

PM5

PM5 (Not Applied)

According to VCEP guidelines, the rule for PM5 (Moderate) is: "Missense change at an amino acid residue where a different missense change was classified as Pathogenic by this VCEP." The evidence for this variant shows no other pathogenic missense at residue 289. Therefore, this criterion is not applied.

PM6

PM6 (Not Applied)

According to standard ACMG guidelines, the rule for PM6 is: "Assumed de novo without confirmation of paternity/maternity." The evidence for this variant shows no de novo information. 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." The evidence for this variant shows no segregation data. 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 with low rate of benign missense variation and where missense is a common mechanism of disease." The evidence for this variant shows no gene-specific constraint data. Therefore, this criterion is not applied.

PP3

PP3 (Not Applied)

According to VCEP guidelines, the rule for PP3 is: "Moderate: HCI prior >0.81 OR predicted splice defect with SpliceAI δ≥0.2." The evidence for this variant shows SpliceAI δ=0.01 and no HCI prior data. Therefore, this criterion is not applied.

PP4

PP4 (Not Applied)

According to VCEP guidelines, the rule for PP4 is: "Supporting: 1 CRC/Endometrial MSI-H tumor or loss of MMR expression consistent with variant." The evidence for this variant shows no tumor phenotype or MMR expression data. Therefore, this criterion is not applied.

PP5

PP5 (Not Applied)

According to standard ACMG guidelines, the rule for PP5 is: "Reputable source reports variant as pathogenic." The evidence for this variant shows conflicting ClinVar assertions (Benign, Likely Benign, VUS). Therefore, this criterion is not applied.

BA1

BA1 (Not Applied)

According to VCEP guidelines, the rule for BA1 (Stand Alone) is: "GnomAD v4 filtering allele frequency ≥0.0022." The evidence for this variant shows a maximum allele frequency of 0.000194, below threshold. Therefore, this criterion is not applied.

BS1

BS1 (Not Applied)

According to VCEP guidelines, the rule for BS1 (Strong) is: "GnomAD v4 filtering allele frequency ≥0.00022 and <0.0022." The evidence for this variant shows 0.000092, below 0.00022. Therefore, this criterion is not applied.

BS2

BS2 (Not Applied)

According to VCEP guidelines, the rule for BS2 (Strong) is: "Co-occurrence in trans with a pathogenic variant in a patient without CMMRD." The evidence for this variant shows no co-occurrence data. Therefore, this criterion is not applied.

BS3

BS3 (Supporting)

According to VCEP guidelines, the rule for BS3 (Supporting) is: "Variant-specific proficient function in protein and mRNA-based lab assays as per MMR functional assay flowchart." The evidence for this variant shows in vitro assays indicating no reduction in mismatch repair activity. Therefore, BS3 is applied at Supporting strength.

BS4

BS4 (Not Applied)

According to standard ACMG guidelines, the rule for BS4 is: "Lack of co-segregation with disease." The evidence for this variant shows no segregation analysis. 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 where only truncating variants cause disease." The evidence for this variant shows missense variants are known in MSH6. Therefore, this criterion is not applied.

BP2

BP2 (Not Applied)

According to standard ACMG guidelines, the rule for BP2 is: "Observed in cis with a pathogenic variant." The evidence for this variant shows no data on cis occurrence. 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 repetitive regions." The evidence for this variant shows a missense change, not an indel. Therefore, this criterion is not applied.

BP4

BP4 (Supporting)

According to VCEP guidelines, the rule for BP4 is: "Supporting: Missense variant with HCI-prior <0.11 OR SpliceAI predicts no splicing impact with δ≤0.1." The evidence for this variant shows SpliceAI δ=0.01. Therefore, BP4 is applied at Supporting strength.

BP5

BP5 (Not Applied)

According to VCEP guidelines, the rule for BP5 (Supporting) is: "Tumors with alternate etiology inconsistent with gene." The evidence for this variant shows no tumor or alternate cause data. Therefore, this criterion is not applied.

BP6

BP6 (Not Applied)

According to standard ACMG guidelines, the rule for BP6 is: "Reputable source reports variant as benign." The evidence for this variant shows conflicting assertions in ClinVar. Therefore, this criterion is not applied.

BP7

BP7 (Not Applied)

According to VCEP guidelines, the rule for BP7 is: "Supporting: Synonymous or intronic variants at or beyond −21/+7 with no splicing impact." The evidence for this variant shows a missense change. Therefore, this criterion is not applied.