LYFE Sciences · Project HERA
Variant Interpretation · Classification Report
Generated: 2026-08-26
Case ID: NM_004004.6_c.445G_A_20260826_053000
Framework: ACMG/AMP 2015
Variant classification summary

NM_004004.6:c.445G>A

GJB2  · NP_003995.2:p.(Ala149Thr)  · NM_004004.6
GRCh37: chr13:20763276 C>T  ·  GRCh38: chr13:20189137 C>T
Gene: GJB2 Transcript: NM_004004.6
Final call
VUS
BP4 supporting
All criteria require review: For research and educational purposes only.
Gene
GJB2
Transcript
NM_004004.6
Protein
NP_003995.2:p.(Ala149Thr)
gnomAD AF
5.204525458803703e-05 (v4.1)
ClinVar
Uncertain significance
OncoKB
Interpretation summary
Generated evidence synthesis
1
BP4 (Supporting): SpliceAI predicts no impact on splicing (max delta 0.00), meeting the VCEP's no-splicing-impact clause.
2
VUS: with only BP4 (Supporting) applied and no pathogenic criteria met, the variant is classified as a variant of uncertain significance under the ACMG/AMP 2015 fallback.
Final determination: 1 BP(Supporting) alone does not reach any Pathogenic/LP/Benign/LB threshold under generic ACMG 2015 rules → Uncertain Significance.
ACMG/AMP criteria review
Criteria shown when status is available
All criteria require review: For research and educational purposes only.
Criterion Status Rationale Evidence used
PVS1 N/A Not applicable: missense substitution, so no null-variant mechanism (nonsense-mediated decay, truncation, splice disruption) applies.
pvs1_generic_framework generic_acmg_combination_rules
PS1 Not assessed Not assessed: no established pathogenic variant producing the identical p.Ala149Thr change via a different nucleotide was identified.
clinvar
PS2 Not assessed Not assessed: no confirmed or assumed de novo occurrence was documented for this variant.
cspec PMID:10982180 PMID:15146474 PMID:16300957 PMID:23073770
PS3 Not assessed Not assessed: no functional assay of p.Ala149Thr was found in the four full-text papers reviewed.
cspec PMID:10982180 PMID:15146474 PMID:16300957 PMID:23073770
PS4 Not assessed Not assessed: no eligible case-control comparison or qualifying proband count was available.
cspec PMID:10982180 PMID:15146474 PMID:23073770
PM1 Not assessed Not assessed: the VCEP PM1 rule covers only KCNQ4 amino acids 271-292; no GJB2 hotspot rule applies.
cspec PMID:10982180 PMID:23073770
PM2 Not met Not met: gnomAD v4.1 Middle Eastern allele frequency 0.000329 exceeds the 0.00007 (0.007%) PM2 threshold.
cspec gnomad_v4 gnomad_v2 gnomad_canada
PM3 Not assessed Not assessed: no reliable confirmation that the variant lies in trans with a pathogenic allele was available.
cspec PMID:10982180 PMID:15146474 PMID:16300957 PMID:23073770
PM4 N/A Not applicable: missense substitution causes no change in protein length.
pvs1_generic_framework generic_acmg_combination_rules
PM5 Not assessed Not assessed: no alternate established pathogenic missense change at codon 149 was available as a comparator.
pm5_candidates cspec
PM6 Not assessed Not assessed: parental testing and inheritance data were insufficient to infer a de novo event.
cspec PMID:10982180 PMID:15146474 PMID:16300957 PMID:23073770
PP1 Not assessed Not assessed: no validated segregation of this variant through affected relatives was reported.
cspec PMID:10982180 PMID:15146474 PMID:16300957 PMID:23073770
PP2 N/A Not applicable: the Hearing Loss VCEP marks PP2 as not applicable for GJB2.
cspec
PP3 Not met Not met: REVEL 0.499 is below the >=0.7 PP3 threshold.
cspec revel spliceai
PP4 Not assessed Not assessed: no phenotype data or evidence of full relevant-gene-set sequencing was available.
cspec
PP5 N/A Not applicable: no expert-panel ClinVar submission supports PP5.
cspec clinvar
BA1 Not met Not met: the highest observed allele frequency (0.000329, Middle Eastern) is far below the 0.005 BA1 threshold.
cspec gnomad_v4 gnomad_v2
BS1 Not met Not met: the highest allele frequency (0.000329) is below even the 0.0007 supporting BS1 threshold.
cspec gnomad_v4 gnomad_v2 gnomad_canada
BS2 Not met Not met: no homozygotes or biallelic control observations were documented for this variant.
cspec gnomad_v4 gnomad_v2 PMID:15146474
BS3 Not assessed Not assessed: no assay showed p.Ala149Thr function comparable to wildtype.
cspec PMID:10982180 PMID:15146474 PMID:16300957 PMID:23073770
BS4 Not assessed Not assessed: no validated genotype/phenotype-discordant family member was documented.
cspec PMID:10982180 PMID:15146474 PMID:16300957 PMID:23073770
BP1 N/A Not applicable: the Hearing Loss VCEP marks BP1 as not applicable for GJB2.
cspec
BP2 Not met Not met: no confirmed cis configuration with a pathogenic variant or trans with a dominant variant was documented.
cspec PMID:10982180 PMID:15146474 PMID:16300957 PMID:23073770
BP3 N/A Not applicable: missense substitution, not an in-frame indel in a repetitive region.
pvs1_generic_framework generic_acmg_combination_rules
BP4 Met Met (Supporting): SpliceAI predicts no splicing impact (max delta 0.00), satisfying BP4's no-impact clause. Flagged for human review: MaxEntScan was not available, so SpliceAI was used for the BP4 splicing sub-path.
cspec revel spliceai
BP5 N/A Not applicable: BP5 must not be used for autosomal-recessive disease, where carriers may have an alternate cause.
cspec
BP6 N/A Not applicable: no benign/likely-benign expert-panel ClinVar classification exists for this variant.
cspec clinvar
BP7 N/A Not applicable: missense substitution, not a synonymous variant.
generic_acmg_combination_rules
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