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Variant interpretation report

CFTR c.1624G>T, p.Gly542Ter

NM_000492.4:c.1624G>T NP_000483.3:p.(Gly542Ter) Nonsense · exon 12 View identifiers
Classification
Pathogenic

Variant description:

The CFTR NM_000492.4:c.1624G>T (NP_000483.3:p.(Gly542Ter)) nonsense variant has not previously been reported in somatic cancers (COSMIC). This variant is predicted to result in an absent or disrupted protein product. Based on available guidelines, this variant is considered to be Pathogenic. This variant is considered to be Pathogenic by the VCEP (CFTR2; ClinVar ID 7115).

Five-step scale from benign to pathogenic. This variant is pathogenic. Select a step to read what it means.

Pathogenic.A pathogenic classification under the recorded framework.

In plain language

Gene-level background from the recorded interpretation.

About CFTR

CFTR encodes an ATP-binding cassette family protein that functions as a chloride channel, helping regulate salt and water movement across epithelial tissues. Disruption of CFTR causes cystic fibrosis, an inherited disorder affecting the lungs, digestive system, and other organs; CFTR has no established primary role in cancer.

LYFE Sciences is an AI system, and it can make mistakes. Criteria may be applied incorrectly, sources may be misread, and a confident-looking classification can still be wrong. Double-check every criterion and its underlying evidence before relying on any call.
01The reasoning

How it was classified

The recorded framework is Generic ACMG/AMP 2015 with ClinGen SVI recommendations. The criteria and strengths shown below come from the saved assessment; this page does not recalculate the classification.

Recorded applied criteria

The applied criteria and their strengths are shown as assessed under the stated framework.

Pathogenic evidence criteria: 3 Benign evidence criteria: 0
Pathogenic criteria applied · 3
PVS1Very strong
PVS1 · very strong

Met, very strong: CFTR c.1624G>T is an exon 12 nonsense variant causing p.Gly542Ter in a gene with an established germline loss-of-function disease mechanism.

PS4Strong
PS4 · strong

Met: G542X occurred in 14/370 French CF chromosomes versus 476/1,178,404 gnomAD NFE alleles, OR 93.67 (95% CI 54.52–160.93), exceeding OR >5 with CI excluding 1.

PP5Supporting
PP5 · supporting

Met: the exact CFTR c.1624G>T variant has a Pathogenic CFTR2 expert-panel classification in ClinVar, satisfying the supplied PP5 rule.

Benign criteria applied · 0

No benign criterion marked as applied in the recorded assessment.

Recorded classification: Pathogenic

Pathogenic: PVS1 very strong plus PS4 strong satisfy the generic ACMG/AMP rule for Pathogenic; PP5 supporting provides additional pathogenic evidence.

02The sources

Evidence at a glance

Evidence summaries and captured source records, where available. Missing entries should not be interpreted as negative findings.

gnomAD v4.1
gnomAD v2.1
Population frequency
585 / 1,612,120 alleles

gnomAD v4.1: 585 / 1,612,120 alleles. Recorded AF 0.000362876. Recorded homozygote count 0.

gnomAD v2.1

This variant is present in gnomAD v2.1 (AF= 0.000322338; MAF= 0.03223%, 91/282312 alleles, homozygotes = 0) and has highest observed frequency in the Ashkenazi Jewish population (AF= 0.0014476; MAF= 0.14476%, 15/10362 alleles, homozygotes = 0); grpmax FAF= 0.00055223.

gnomAD-Canada

Not available in gnomAD-Canada v1.0.

SpliceAI score
0.130 maximum delta

Recorded SpliceAI maximum delta score: 0.130. Refer to the recorded PP3/BP4 rationale for interpretation.

No listed criterion applied SpliceAI ↗
ClinVar submissions
35 reported laboratory submissions

33 Pathogenic · 2 pathogenic. ClinVar API review status: practice guideline.

No screenshot for this evidence
Functional evidence
Not recorded

No standalone functional evidence summary is recorded in evidence_summary.functional.

No listed criterion applied OncoKB ↗
COSMIC
Cancer Hotspots
Somatic evidence
No matching record reported

This variant has not previously been reported in somatic cancers (COSMIC).

Cancer Hotspots

This variant does not lie in a statistically significant hotspot.

For specialists

Technical detail

ACMG/AMP criteria under Generic ACMG/AMP 2015 with ClinGen SVI recommendations, with the data and sources behind each one.

28 criteria with recorded statuses: 3 met · 6 not met · 9 not assessed · 10 not applicable. Open any row for the full reasoning, the rule and the evidence behind it.

Met Not met Not assessed Not applicable

Neither PS3 nor BS3 is assessed because the reviewed studies do not report a validated, variant-specific functional result for CFTR c.1624G>T/p.G542*.

Clinical observations and general nonsense-variant mechanism evidence were not used as substitutes for the required functional-study evidence.

PS4 is met at strong strength because the verified affected-case frequency for G542X compared with gnomAD NFE gives OR 93.67 (95% CI 54.52-160.93), exceeding the ACMG OR >5.0 threshold with the CI excluding 1.

PP5 is met at supporting strength from the exact-variant CFTR2 expert-panel Pathogenic classification in ClinVar.

PP4 and BP5 are not assessed because the required patient-specific phenotype/family-history and alternate-molecular-basis evidence are unavailable; BP6 is not met because the exact-variant expert-panel classification is Pathogenic rather than benign.

Population evidence does not meet BA1, BS1, BS2, or PM2: the variant is rare but present above the PM2 cutoff, below benign-frequency thresholds, and has no observed homozygotes.

Met · 3

PVS1 Very strongACMG_2015Met, very strong: CFTR c.1624G>T is an exon 12 nonsense variant causing p.Gly542Ter in a gene with an established germline loss-of-function disease mechanism. Details ▾Hide ▴
Reasoning

PVS1 is met at full strength. NM_000492.4:c.1624G>T is a nonsense variant in the relevant CFTR transcript, producing NP_000483.3:p.(Gly542Ter) / p.(G542*), a premature termination well before the normal protein terminus. The affected exon is exon 12, not a distal terminal exon, and the available evidence supports CFTR loss of function as a germline disease mechanism. This is therefore a qualifying null variant with no case-specific evidence of NMD escape, rescue by an alternatively spliced transcript, repeat-region ambiguity, or a biologically non-critical exon that would trigger a downgrade. No named downgrade rule applies.

Rule
PVS1: Null variant (nonsense, frameshift, canonical +/−1 or 2 splice sites, initiation codon, single or multi-exon deletion) in a gene where loss of function (LOF) is a known mechanism of disease.
Evidence considered
  • The case identifies NM_000492.4:c.1624G>T in CFTR as a nonsense variant, with NP_000483.3:p.(Gly542Ter) / p.(G542*) and exon 12 as the affected exon.
  • The gene-level PVS1 context marks CFTR loss of function as a supported germline disease mechanism and the generic PVS1 gene gate as eligible.
  • The ClinGen SVI PVS1 framework is the governing generic framework for this nonsense variant; no transcript, NMD-escape, non-critical-exon, repeat-region, or population-LoF caveat in the case requires downgrading.
  • 23974870 reports that premature termination codons commonly cause nonsense-mediated decay, with severe reduction in mRNA and no protein production; this supports the expected null consequence of the variant class, although the paper does not name G542* specifically.
Sources
PS4 StrongACMG_2015Met: G542X occurred in 14/370 French CF chromosomes versus 476/1,178,404 gnomAD NFE alleles, OR 93.67 (95% CI 54.52–160.93), exceeding OR >5 with CI excluding 1. Details ▾Hide ▴
Reasoning

The exact-variant paper PMID:1723032 reports G542X (CFTR c.1624G>T) on 14 of 370 CF chromosomes from 185 unrelated French families. This is a case-control comparison when compared with the matched broad European non-Finnish gnomAD v4.1 population frequency of 476/1,178,404 alleles: using allele-count odds, OR = (14/356)/(476/1,177,928) = 93.67, with an approximate 95% Wald CI of 54.52-160.93. The CI excludes 1 and OR exceeds the ACMG threshold >5.0, so PS4 is met. Human review is requested because gnomAD NFE is a population proxy rather than a study-specific French control cohort and the paper's case denominator is CF chromosomes rather than independently sampled affected individuals.

Rule
The prevalence of the variant in affected individuals is significantly increased compared to the prevalence in controls. ... Note 1: Relative risk (RR) or odds ratio (OR), as obtained from case-control studies, is >5.0 and the confidence interval around the estimate of RR or OR does not include 1.0.
Evidence considered
  • Nine mutations in the cystic fibrosis (CF) gene account for 80% of the CF chromosomes in French patients, Results/Population Screening/Table 1: G542X was found on 14 of 370 CF chromosomes from 185 unrelated French families; the paper states: "G542X was found in 14 patients, with 7 compound heterozygotes dF508/G542X, and 7 compound heterozygotes G542X/x. In all cases it was associated with haplotype B."
  • gnomAD v4.1 NFE: 476 alternate alleles among 1,178,404 total alleles; the case-control odds calculation was performed as (14/356)/(476/1,177,928) = OR 93.67, approximate 95% Wald CI 54.52-160.93.
  • The literature_pass PS4 lead for PMID:1723032 was verified against the full-text extraction; the paper provides affected-case prevalence but no directly enrolled unaffected control cohort, so gnomAD NFE was used as the population control comparator.
Still missing
  • The comparison uses gnomAD v4.1 non-Finnish European allele counts as a matched-ancestry population proxy, not a study-specific unaffected control cohort.
Sources
PP5 SupportingACMG_2015Met: the exact CFTR c.1624G>T variant has a Pathogenic CFTR2 expert-panel classification in ClinVar, satisfying the supplied PP5 rule. Details ▾Hide ▴
Reasoning

Expert panel CFTR2 classified as Pathogenic.

Rule
Reputable source recently reports variant as pathogenic, but the evidence is not available to the laboratory to perform an independent evaluation.
Evidence considered
  • ClinVar variation 7115 exact-variant record: NM_000492.4(CFTR):c.1624G>T (p.Gly542Ter); expert_panels lists Pathogenic: CFTR2, with review status reviewed by expert panel.
  • The ClinVar record also contains ordinary laboratory Pathogenic submissions, but those were explicitly excluded from the PP5 decision.
  • ClinVar expert panel classification
Sources

Not met · 6 · evaluated, threshold not reached

PM2 ACMG_2015Not met: the lower all-comers AF is 0.000322338, above the generic PM2 cutoff of 0.0001. Details ▾Hide ▴
Reasoning

PM2 is not met under the supplied generic supporting threshold. The generic cutoff is <=0.0001. This variant is present in the default all-comers population sources at AF 0.000322338 in gnomAD v2.1 and 0.000362876 in gnomAD v4.1, both above the cutoff. No governing VCEP specifies a non-cancer or exome-only source for this generic interpretation.

Rule
Absent from controls (or at extremely low frequency if recessive) in Exome Sequencing Project, 1000 Genomes or Exome Aggregation Consortium.
Evidence considered
  • gnomAD v2.1 all-comers: AF 0.000322338 (91/282312 alleles), homozygotes 0.
  • gnomAD v4.1 all-comers: AF 0.000362876 (585/1612120 alleles), homozygotes 0.
  • The generic ClinGen SVI recommendation supplied for this case sets PM2 supporting at <=0.0001 (PMID:25741868); both default all-comers frequencies exceed this cutoff.
Sources
BA1 ACMG_2015Not met: maximum qualifying grpmax FAF is 0.00055223, far below the 0.05 BA1 threshold. Details ▾Hide ▴
Reasoning

BA1 is not met. The generic stand-alone benign threshold is >=0.05. The applicable gnomAD all-comers filtering frequencies are grpmax FAF 0.00055223 in v2.1 and 0.00048844 in v4.1; both are far below 0.05. The highest observed Ashkenazi Jewish point estimates, 0.0014476 from 15/10362 alleles in v2.1 and 0.00135272 from 40/29570 alleles in v4.1, are not used because the required measure is grpmax FAF, and both source populations exceed 2000 observed alleles. The variant also has a pathogenic ClinVar practice-guideline consensus, so the low frequency does not justify a stand-alone benign conclusion.

Rule
Allele frequency is above 5% in Exome Sequencing Project, 1000 Genomes or Exome Aggregation Consortium.
Evidence considered
  • gnomAD v2.1 all-comers: AF 0.000322338 (91/282312 alleles), homozygotes 0, grpmax FAF 0.00055223; the highest observed Ashkenazi Jewish point estimate is 0.0014476 from 15/10362 alleles.
  • gnomAD v4.1 all-comers: AF 0.000362876 (585/1612120 alleles), homozygotes 0, grpmax FAF 0.00048844; the highest observed Ashkenazi Jewish point estimate is 0.00135272 from 40/29570 alleles.
  • The generic ACMG/AMP 2015 calibration supplied for this case sets BA1 at >=0.05 (PMID:25741868); both qualifying grpmax FAF values are below this threshold.
  • ClinVar reports Pathogenic with practice-guideline review, including CFTR2 expert-panel evidence; this pathogenic consensus is inconsistent with ending classification using a default BA1 call.
Sources
BS1 ACMG_2015Not met: maximum qualifying grpmax FAF is 0.00055223, below the generic 0.01 BS1 threshold. Details ▾Hide ▴
Reasoning

BS1 is not met. The generic default threshold is grpmax FAF >=0.01, while the applicable gnomAD all-comers grpmax FAF values are 0.00055223 in v2.1 and 0.00048844 in v4.1. The relevant populations contributing the maximum FAF have more than 2000 observed alleles. The Ashkenazi Jewish point estimates are not substituted for grpmax FAF. CFTR-related cystic fibrosis is an early-onset autosomal-recessive disorder with substantial allelic heterogeneity, but no maximum-credible-frequency calculation is needed to reject BS1 because the filtering frequencies are already well below the supplied 1% default.

Rule
Allele frequency is greater than expected for the disorder.
Evidence considered
  • gnomAD v2.1 all-comers: grpmax FAF 0.00055223; the maximum-frequency Ashkenazi Jewish group has 10362 observed alleles, and its point estimate 0.0014476 is not used.
  • gnomAD v4.1 all-comers: grpmax FAF 0.00048844; the maximum-frequency Ashkenazi Jewish group has 29570 observed alleles, and its point estimate 0.00135272 is not used.
  • The generic SVI default supplied for this case is BS1 >=0.01; maximum-credible-frequency assessment is preferred when disease prevalence, penetrance, or allelic heterogeneity make the default questionable, per Whiffin et al. 2017 (PMID:28518168). Here both qualifying filtering frequencies are far below 0.01, so the default itself does not support BS1.
Sources
BS2 ACMG_2015Not met: gnomAD v2.1 and v4.1 each report zero homozygotes for this variant. Details ▾Hide ▴
Reasoning

BS2 is not met. For this recessive disorder, the qualifying observation would be a healthy adult homozygote. gnomAD reports zero homozygotes in v2.1 (91/282312 alleles) and v4.1 (585/1612120 alleles), and no healthy adult homozygous observation is provided elsewhere in the supplied evidence.

Rule
Observed in a healthy adult individual for a recessive (homozygous), dominant (heterozygous), or X-linked (hemizygous) disorder, with full penetrance expected at an early age.
Evidence considered
  • gnomAD v2.1 all-comers reports homozygotes = 0 for 91/282312 alleles.
  • gnomAD v4.1 all-comers reports homozygotes = 0 for 585/1612120 alleles.
Sources
BP2 ACMG_2015Not met: G542X was reported in trans in recessive CF, not the required dominant-trans or any-inheritance cis configuration. Details ▾Hide ▴
Reasoning

BP2 requires either observation in trans with a pathogenic variant in a fully penetrant dominant gene/disorder or observation in cis with a pathogenic variant in any inheritance pattern. CFTR-related cystic fibrosis is a recessive disorder, and PMID:1723032 reports G542X in compound-heterozygous configurations, which is trans evidence in a recessive context rather than the dominant-trans BP2 configuration. No cis observation with a pathogenic variant is reported in the available evidence. BP2 is therefore not met.

Rule
Observed in trans with a pathogenic variant for a fully penetrant dominant gene/disorder or observed in cis with a pathogenic variant in any inheritance pattern.
Evidence considered
  • Nine mutations in the cystic fibrosis (CF) gene account for 80% of the CF chromosomes in French patients, Results, Population Screening/Table 1: G542X was reported in compound-heterozygous configurations with ΔF508 or another allele.
  • No cis observation pairing G542X with a pathogenic CFTR variant was reported in the reviewed evidence.
Sources
BP6 ACMG_2015Not met: the exact variant has a Pathogenic CFTR2 expert-panel classification and no benign expert-panel classification is present. Details ▾Hide ▴
Reasoning

The exact-variant ClinVar record has a Pathogenic CFTR2 expert-panel classification, not a Benign or Likely benign expert-panel classification. No exact-variant benign expert-panel assertion was identified; ordinary laboratory submissions, aggregate labels, and non-expert assertions were not used to trigger BP6. Therefore BP6 is not met.

Rule
Reputable source recently reports variant as benign, but the evidence is not available to the laboratory to perform an independent evaluation.
Evidence considered
  • ClinVar variation 7115 exact-variant record: expert_panels lists Pathogenic: CFTR2; no Benign or Likely benign expert-panel classification is recorded.
  • Only the exact-variant expert-panel classification was considered for BP6; ordinary laboratory submissions and aggregate ClinVar labels were excluded.
Sources

Not assessed · 9 · no assessment recorded

PS2 ACMG_2015Not assessed: confirmed maternity, paternity, de novo status, and absence of family history are not documented for the proband. Details ▾Hide ▴
Reasoning

PS2 cannot be assessed because the available evidence does not document a disease-affected proband with confirmed maternity and paternity, a de novo occurrence, or absence of family history. The available variant-specific literature reports G542X in affected CF chromosomes but does not provide the required parentage and de novo testing for this case.

Rule
De novo (both maternity and paternity confirmed) in a patient with the disease and no family history.
Still missing
  • Documented proband phenotype and disease diagnosis
  • Confirmed maternity and paternity
  • Variant testing results in both biological parents
  • Documented absence of family history
PS3 ACMG_2015Not assessed: no cited study directly measured c.1624G>T/p.G542* function; PMID:23974870 addressed premature-termination variants generally rather than this variant. Details ▾Hide ▴
Reasoning

PS3 cannot be assessed from the available evidence. PMID:23974870 describes premature-termination-codon consequences and functional classification of CFTR variants generally, but does not explicitly study c.1624G>T/p.G542*. PMID:7691345 experimentally evaluates other CFTR variants (ΔF508 and G551D), not G542X. No validated, reproducible in vitro or in vivo assay with variant-specific controls and a result for G542X was identified, so the evidence does not establish the PS3 requirement.

Rule
Well-established in vitro or in vivo functional studies supportive of a damaging effect on the gene or gene product.
Evidence considered
  • PMID:23974870: The extracted paper finding states that the study did not explicitly name c.1624G>T or p.G542* and instead discussed premature termination codons, nonsense-mediated decay, and no protein production for the variant class.
  • PMID:7691345: The extracted paper finding describes biochemical, cell-biological, and anion-permeability assays for ΔF508 and G551D CFTR in transduced murine L cells, not for G542X; therefore it cannot establish variant-specific PS3 evidence.
Still missing
  • A variant-specific, well-established in vitro or in vivo functional assay for CFTR c.1624G>T/p.G542* with appropriate controls and a reported result is needed.
Sources
PM3 ACMG_2015Not assessed: G542X appeared in compound heterozygotes, but parental or offspring testing establishing phase was not documented. Details ▾Hide ▴
Reasoning

PM3 is applicable to the recessive CFTR disorder when the variant is demonstrated in trans with a pathogenic variant. PMID:1723032 reports seven patients described as compound heterozygotes for ΔF508/G542X and seven as G542X/x, which supports an allelic trans configuration for G542X in affected individuals. However, the available extraction does not document testing of parents or offspring establishing phase, and it does not identify the partner variants in the G542X/x group or independently establish the pathogenicity of each partner variant. The required phase evidence is therefore insufficient for a definitive PM3 assessment.

Rule
For recessive disorders, detected in trans with a pathogenic variant ... This requires testing of parents (or offspring) to determine phase.
Evidence considered
  • Nine mutations in the cystic fibrosis (CF) gene account for 80% of the CF chromosomes in French patients, Results, Population Screening/Table 1: G542X was found in 14 patients, including 7 described as compound heterozygotes ΔF508/G542X and 7 as G542X/x.
  • The report used allele-specific oligonucleotide testing and linked-marker RFLP haplotyping in 370 CF chromosomes from 185 unrelated French families; the extracted evidence does not state that parental or offspring testing was performed to establish phase.
Still missing
  • Document parental or offspring testing establishing that G542X is in trans with a pathogenic CFTR variant.
  • Identify the partner variant(s) and document their pathogenic classification.
Sources
PM6 ACMG_2015Not assessed: no case-specific evidence establishes assumed de novo origin or parental testing for this variant. Details ▾Hide ▴
Reasoning

PM6 cannot be assessed because the available evidence does not establish an assumed de novo variant in a patient with the disease. No case-specific parental testing or documentation of de novo status is provided; the literature only reports the variant in affected CF chromosomes without establishing de novo origin.

Rule
Assumed de novo, but without confirmation of paternity and maternity.
Still missing
  • Documented proband phenotype and disease diagnosis
  • Case-specific parental genotypes
  • Evidence that the variant is absent from both parents or otherwise assumed de novo
PP1 ACMG_2015Not assessed: G542X occurred on 14 of 370 screened CF chromosomes, but affected-relative co-segregation and meioses are not reported. Details ▾Hide ▴
Reasoning

PP1 cannot be assessed because no multiple affected family members with variant-status data are documented. PMID:1723032 reports G542X in 14 CF chromosomes from 185 unrelated French families, including seven patients with deltaF508/G542X and seven with G542X/x, but this is a population screening study and does not provide case-specific co-segregation across affected relatives or meioses.

Rule
Co-segregation with disease in multiple affected family members in a gene definitively known to cause the disease. ... Note: May be used as stronger evidence with increasing segregation data.
Evidence considered
  • Nine mutations in the cystic fibrosis (CF) gene account for 80% of the CF chromosomes in French patients, Results, Population Screening/Table 1: G542X was found on 14 of 370 CF chromosomes from 185 unrelated French families; the report lists compound-genotype categories but does not provide family-level co-segregation analysis for affected relatives.
Still missing
  • Pedigree with multiple affected relatives
  • Variant testing results for affected relatives
  • Phenotype consistency among affected relatives
  • Number of informative meioses
Sources
PP4 ACMG_2015Not assessed: no patient-specific phenotype or family history is available to test the PP4 requirement for a highly specific single-etiology disease presentation. Details ▾Hide ▴
Reasoning

The generic PP4 rule requires a patient's phenotype or family history that is highly specific for a disease with a single genetic etiology. The available case evidence identifies the variant and CFTR-related disease context but does not provide a patient-specific phenotype or family history sufficiently detailed to evaluate this criterion.

Rule
Patient’s phenotype or family history is highly specific for a disease with a single genetic etiology.
Still missing
  • Patient-specific clinical phenotype and family history, including diagnostic findings and their specificity for cystic fibrosis, are missing.
BS3 ACMG_2015Not assessed: no cited study showed normal CFTR function or splicing for c.1624G>T/p.G542*; available assays tested other variants or variant classes. Details ▾Hide ▴
Reasoning

BS3 cannot be assessed from the available evidence. The reviewed functional literature did not provide a well-established assay showing that CFTR c.1624G>T/p.G542* has no damaging effect on protein function or splicing. PMID:23974870 discusses premature-termination-codon consequences generally, while PMID:7691345 tests different CFTR variants; neither supplies a benign, variant-specific functional result for G542X.

Rule
Well-established in vitro or in vivo functional studies show no damaging effect on protein function or splicing.
Evidence considered
  • PMID:23974870: The extracted paper finding concerns premature termination, nonsense-mediated decay, and loss of protein for a broader CFTR variant class; it does not report a normal-function or normal-splicing result for G542X.
  • PMID:7691345: The extracted paper finding reports assays of ΔF508 and G551D CFTR, not c.1624G>T/p.G542*, so it cannot support BS3 for this variant.
Still missing
  • A variant-specific, well-established functional assay demonstrating no damaging effect on CFTR protein function or splicing is needed.
Sources
BS4 ACMG_2015Not assessed: no affected relatives without G542X are documented, so lack of segregation cannot be evaluated. Details ▾Hide ▴
Reasoning

BS4 cannot be assessed because no affected family members lacking the variant are documented. The available G542X literature does not provide a family pedigree, affected relatives tested for the variant, or a non-segregation observation that could establish lack of segregation.

Rule
Lack of segregation in affected members of a family.
Evidence considered
  • The reviewed G542X report describes population screening in unrelated French families rather than affected-family non-segregation; it supplies no affected relative who was shown to lack the variant.
Still missing
  • Family pedigree and affected-member phenotypes
  • Variant testing results for affected family members
  • Information identifying affected relatives who lack the variant
  • Assessment of possible phenocopies or multiple pathogenic variants
Sources
BP5 ACMG_2015Not assessed: no case-level evidence shows the exact variant alongside an alternate molecular basis for the patient's disease. Details ▾Hide ▴
Reasoning

No evidence in the reviewed case materials demonstrates that this exact variant was found in a case with an alternate molecular basis for disease. The CFTR expert-panel classification and disease-associated reports are not evidence of an alternate molecular basis, so BP5 cannot be assessed.

Rule
Variant found in a case with an alternate molecular basis for disease.
Still missing
  • A case report or cohort record documenting an alternate molecular diagnosis in a patient carrying CFTR c.1624G>T is missing.
Not applicable · 10· recorded as not applicable Show reasons ▾Hide reasons ▴
PS1 N/ANot applicable: PS1 requires a missense variant, and this is a nonsense variant. Details ▾Hide ▴
Reasoning

PS1 (Richards et al. 2015, PMID:25741868) requires the same amino acid change as a previously established pathogenic variant, evaluated regardless of the underlying nucleotide change. NM_000492.4:c.1624G>T in CFTR is a nonsense substitution introducing a premature stop codon predicted to produce NP_000483.3:p.(Gly542Ter). As a result, no altered amino acid exists at this position to compare against any previously established pathogenic missense variant, so PS1's structural prerequisite is not met by this variant class. No VCEP criteria specification covers PS1 for CFTR, so the generic ACMG/AMP 2015 definition applies. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication.

Rule
deterministic_prefilter: requires_missense
Evidence considered
  • Deterministic consequence classification: nonsense (prefetch.json normalized protein consequence)
  • VCEP criterion policy: absent
Sources
generic_acmg_combination_rules
PM1 N/ANot applicable: PM1 requires a missense variant, and this is a nonsense variant. Details ▾Hide ▴
Reasoning

PM1 (Richards et al. 2015, PMID:25741868) applies to a missense variant located in a mutational hot spot and/or a critical, well-established functional domain without benign variation. NM_000492.4:c.1624G>T in CFTR is a nonsense substitution introducing a premature stop codon predicted to produce NP_000483.3:p.(Gly542Ter). As a result, no altered residue exists to evaluate for mutational hot-spot or critical-domain membership, so PM1's structural prerequisite is not met by this variant class. No VCEP criteria specification covers PM1 for CFTR, so the generic ACMG/AMP 2015 definition applies. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication.

Rule
deterministic_prefilter: requires_missense
Evidence considered
  • Deterministic consequence classification: nonsense (prefetch.json normalized protein consequence)
  • VCEP criterion policy: absent
Sources
generic_acmg_combination_rules
PM4 N/ANot applicable: PM4 requires a protein-length change, and this is a nonsense variant. Details ▾Hide ▴
Reasoning

PM4 (Richards et al. 2015, PMID:25741868) applies to protein length changes: in-frame insertions/deletions in a non-repetitive region, or stop-loss variants that extend the protein past the reference stop codon. NM_000492.4:c.1624G>T in CFTR is a nonsense substitution introducing a premature stop codon predicted to produce NP_000483.3:p.(Gly542Ter). As a result, no change in protein length occurs, so there is nothing for this criterion to evaluate, so PM4's structural prerequisite is not met by this variant class. No VCEP criteria specification covers PM4 for CFTR, so the generic ACMG/AMP 2015 definition applies. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication.

Rule
deterministic_prefilter: requires_stop_loss_or_nonrepeat_indel
Evidence considered
  • Deterministic consequence classification: nonsense (prefetch.json normalized protein consequence)
  • VCEP criterion policy: absent
Sources
pvs1_generic_framework ↗generic_acmg_combination_rules
PM5 N/ANot applicable: PM5 requires a missense variant, and this is a nonsense variant. Details ▾Hide ▴
Reasoning

PM5 (Richards et al. 2015, PMID:25741868) requires a novel missense change at an amino acid residue where a different missense change has previously been determined to be pathogenic. NM_000492.4:c.1624G>T in CFTR is a nonsense substitution introducing a premature stop codon predicted to produce NP_000483.3:p.(Gly542Ter). As a result, no missense change exists at this residue to compare against a different pathogenic missense change at the same position, so PM5's structural prerequisite is not met by this variant class. No VCEP criteria specification covers PM5 for CFTR, so the generic ACMG/AMP 2015 definition applies. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication.

Rule
deterministic_prefilter: requires_missense
Evidence considered
  • Deterministic consequence classification: nonsense (prefetch.json normalized protein consequence)
  • VCEP criterion policy: absent
Sources
generic_acmg_combination_rules
PP2 N/ANot applicable: PP2 requires a missense variant, and this is a nonsense variant. Details ▾Hide ▴
Reasoning

PP2 (Richards et al. 2015, PMID:25741868) applies to a missense variant in a gene with a low rate of benign missense variation, where missense variants are a common mechanism of disease. NM_000492.4:c.1624G>T in CFTR is a nonsense substitution introducing a premature stop codon predicted to produce NP_000483.3:p.(Gly542Ter). As a result, the gene's missense-constraint properties are irrelevant because no missense change is present to evaluate, so PP2's structural prerequisite is not met by this variant class. No VCEP criteria specification covers PP2 for CFTR, so the generic ACMG/AMP 2015 definition applies. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication.

Rule
deterministic_prefilter: requires_missense
Evidence considered
  • Deterministic consequence classification: nonsense (prefetch.json normalized protein consequence)
  • VCEP criterion policy: absent
Sources
generic_acmg_combination_rules
PP3 N/ANot applicable: c.1624G>T is a nonsense variant, outside generic PP3 scope regardless of its SpliceAI max delta of 0.13. Details ▾Hide ▴
Reasoning

PP3 is not applicable because NM_000492.4:c.1624G>T is a nonsense variant, producing NP_000483.3:p.(G542*), and the governing generic scope excludes nonsense and other truncating/protein-length-changing variants. The available SpliceAI max delta of 0.13 is therefore not used for PP3; no REVEL path applies.

Rule
PP3/BP4 apply only to a missense variant, or to a splice-region/intronic variant via the SpliceAI path - never to a frameshift, nonsense, or other truncating/protein-length-changing variant.
Evidence considered
  • The case assessment identifies NM_000492.4:c.1624G>T as a nonsense variant with protein consequence NP_000483.3:p.(G542*) and variant bucket nonsense.
  • The case evidence reports SpliceAI max delta 0.13, but this score is not used because PP3 is outside scope for a nonsense variant.
Sources
pvs1_variant_assessment
BP1 N/ANot applicable: BP1 requires a missense variant, and this is a nonsense variant. Details ▾Hide ▴
Reasoning

BP1 (Richards et al. 2015, PMID:25741868) applies to a missense variant in a gene for which primarily truncating variants are known to cause disease. NM_000492.4:c.1624G>T in CFTR is a nonsense substitution introducing a premature stop codon predicted to produce NP_000483.3:p.(Gly542Ter). As a result, the gene's truncating-variant mechanism is irrelevant because no missense change is present to evaluate, so BP1's structural prerequisite is not met by this variant class. No VCEP criteria specification covers BP1 for CFTR, so the generic ACMG/AMP 2015 definition applies. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication.

Rule
deterministic_prefilter: requires_missense
Evidence considered
  • Deterministic consequence classification: nonsense (prefetch.json normalized protein consequence)
  • VCEP criterion policy: absent
Sources
generic_acmg_combination_rules
BP3 N/ANot applicable: BP3 requires an in-frame indel in a repeat region, and this is a nonsense variant. Details ▾Hide ▴
Reasoning

BP3 (Richards et al. 2015, PMID:25741868) applies to in-frame insertions/deletions located in a repetitive region without a known function. NM_000492.4:c.1624G>T in CFTR is a nonsense substitution introducing a premature stop codon predicted to produce NP_000483.3:p.(Gly542Ter). As a result, the variant does not alter protein length within a repeat region, so there is nothing for this criterion to evaluate, so BP3's structural prerequisite is not met by this variant class. No VCEP criteria specification covers BP3 for CFTR, so the generic ACMG/AMP 2015 definition applies. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication.

Rule
deterministic_prefilter: requires_repeat_region_indel
Evidence considered
  • Deterministic consequence classification: nonsense (prefetch.json normalized protein consequence)
  • VCEP criterion policy: absent
Sources
pvs1_generic_framework ↗generic_acmg_combination_rules
BP4 N/ANot applicable: BP4 excludes nonsense variants, so SpliceAI max delta 0.13 cannot support absence of gene-product impact. Details ▾Hide ▴
Reasoning

BP4 is not applicable because NM_000492.4:c.1624G>T is a nonsense variant, producing NP_000483.3:p.(G542*), and BP4 does not cover truncating variants. The SpliceAI max delta of 0.13 cannot provide BP4 because absence of a strong predicted splice effect does not negate the truncating protein consequence; splice prediction for this variant is relevant only to PVS1-type rescue assessment.

Rule
BP4 on a frameshift or nonsense variant is not_applicable: a 'no predicted splice impact' result leaves the truncating protein effect in place, so it is not evidence of no impact on the gene product - a splice prediction for such a variant matters only to PVS1 (e.g. predicted rescue).
Evidence considered
  • The case assessment identifies NM_000492.4:c.1624G>T as a nonsense variant with protein consequence NP_000483.3:p.(G542*) and variant bucket nonsense.
  • The case evidence reports SpliceAI max delta 0.13; this result is not used for BP4 because BP4 is outside scope for a nonsense variant.
Sources
pvs1_variant_assessment
BP7 N/ANot applicable: BP7 requires a synonymous variant, and this is a nonsense variant. Details ▾Hide ▴
Reasoning

BP7 (Richards et al. 2015, PMID:25741868) is defined for a synonymous (silent) variant for which splicing prediction algorithms predict no impact to the splice consensus sequence and the nucleotide is not highly conserved. NM_000492.4:c.1624G>T in CFTR is a nonsense substitution introducing a premature stop codon predicted to produce NP_000483.3:p.(Gly542Ter). As a result, the encoded protein sequence is altered, so the criterion's silent-variant premise does not hold regardless of any splicing prediction, so BP7's structural prerequisite is not met by this variant class. No VCEP criteria specification covers BP7 for CFTR, so the generic ACMG/AMP 2015 definition applies. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication.

Rule
deterministic_prefilter: requires_synonymous
Evidence considered
  • Deterministic consequence classification: nonsense (prefetch.json normalized protein consequence)
  • VCEP criterion policy: absent
Sources
generic_acmg_combination_rules

Identifiers

Gene
CFTR
Transcript
NM_000492.4
Coding (HGVS c.)
NM_000492.4:c.1624G>T
Protein (HGVS p.)
NP_000483.3:p.(Gly542Ter)
GRCh38
chr7:117587778 G>T
GRCh37
chr7:117227832 G>T
Location and type
Exon 12 · nonsense
ClinVar
7115, 818113, 632747, 35822

Gene diagram

Every interpreted variant in CFTR, mapped onto the exon structure of NM_000492.4. Select a row to find it on the plot.

CFTRNM_000492.4
Fetching transcript structure from UCSC…
gnomAD v4.1 585 / 1,612,120 alleles AF 0.000363 · 0 homozygotes · FAF 0.000488
gnomAD v2.1 91 / 282,312 alleles AF 0.000322 · 0 homozygotes · FAF 0.000552
gnomAD-Canada v1.0 Allele count data not recorded

By genetic ancestry

gnomAD v4.1

AF 0.00036 · 585 / 1,612,120 alleles · 0 hom · FAF 0.00049
Ashkenazi Jewish40 / 29,570 0.0014
Admixed American39 / 59,920 0.00065
European (non-Finnish)476 / 1,178,404 0.0004
Remaining individuals25 / 62,416 0.0004
Middle Eastern1 / 6,046 0.00017
African/African American3 / 74,990 4e-05
South Asian1 / 91,052 1.1e-05
0 alternate alleles recorded in 3 other groups: European (Finnish), Amish, East Asian.

gnomAD v2.1

AF 0.00032 · 91 / 282,312 alleles · 0 hom · FAF 0.00055
Ashkenazi Jewish15 / 10,362 0.0014
Admixed American27 / 35,300 0.00076
European (non-Finnish)46 / 128,830 0.00036
Remaining individuals2 / 7,200 0.00028
African/African American1 / 24,966 4e-05
0 alternate alleles recorded in 3 other groups: East Asian, European (Finnish), South Asian.

Statements

gnomAD v4.1

This variant is present in gnomAD v4.1 (AF= 0.000362876; MAF= 0.03629%, 585/1612120 alleles, homozygotes = 0) and has highest observed frequency in the Ashkenazi Jewish population (AF= 0.00135272; MAF= 0.13527%, 40/29570 alleles, homozygotes = 0); grpmax FAF= 0.00048844.

gnomAD v2.1

This variant is present in gnomAD v2.1 (AF= 0.000322338; MAF= 0.03223%, 91/282312 alleles, homozygotes = 0) and has highest observed frequency in the Ashkenazi Jewish population (AF= 0.0014476; MAF= 0.14476%, 15/10362 alleles, homozygotes = 0); grpmax FAF= 0.00055223.

gnomAD-Canada

Not available in gnomAD-Canada v1.0.

SpliceAI and Pangolin

SpliceAI acceptor lossat -39 bp
0.130
SpliceAI acceptor gainat -46 bp
0.000
SpliceAI donor lossat +55 bp
0.121
SpliceAI donor gainat -47 bp
0.000
Pangolin splice lossmagnitude shown
-0.091
Pangolin splice gain
0.003

Other predictors

REVEL
Not available
BayesDel
0.660

How the predictions were used

PP3 N/ANot applicable: c.1624G>T is a nonsense variant, outside generic PP3 scope regardless of its SpliceAI max delta of 0.13. Details ▾Hide ▴
Reasoning

PP3 is not applicable because NM_000492.4:c.1624G>T is a nonsense variant, producing NP_000483.3:p.(G542*), and the governing generic scope excludes nonsense and other truncating/protein-length-changing variants. The available SpliceAI max delta of 0.13 is therefore not used for PP3; no REVEL path applies.

Rule
PP3/BP4 apply only to a missense variant, or to a splice-region/intronic variant via the SpliceAI path - never to a frameshift, nonsense, or other truncating/protein-length-changing variant.
Evidence considered
  • The case assessment identifies NM_000492.4:c.1624G>T as a nonsense variant with protein consequence NP_000483.3:p.(G542*) and variant bucket nonsense.
  • The case evidence reports SpliceAI max delta 0.13, but this score is not used because PP3 is outside scope for a nonsense variant.
Sources
pvs1_variant_assessment
BP4 N/ANot applicable: BP4 excludes nonsense variants, so SpliceAI max delta 0.13 cannot support absence of gene-product impact. Details ▾Hide ▴
Reasoning

BP4 is not applicable because NM_000492.4:c.1624G>T is a nonsense variant, producing NP_000483.3:p.(G542*), and BP4 does not cover truncating variants. The SpliceAI max delta of 0.13 cannot provide BP4 because absence of a strong predicted splice effect does not negate the truncating protein consequence; splice prediction for this variant is relevant only to PVS1-type rescue assessment.

Rule
BP4 on a frameshift or nonsense variant is not_applicable: a 'no predicted splice impact' result leaves the truncating protein effect in place, so it is not evidence of no impact on the gene product - a splice prediction for such a variant matters only to PVS1 (e.g. predicted rescue).
Evidence considered
  • The case assessment identifies NM_000492.4:c.1624G>T as a nonsense variant with protein consequence NP_000483.3:p.(G542*) and variant bucket nonsense.
  • The case evidence reports SpliceAI max delta 0.13; this result is not used for BP4 because BP4 is outside scope for a nonsense variant.
Sources
pvs1_variant_assessment
BP7 N/ANot applicable: BP7 requires a synonymous variant, and this is a nonsense variant. Details ▾Hide ▴
Reasoning

BP7 (Richards et al. 2015, PMID:25741868) is defined for a synonymous (silent) variant for which splicing prediction algorithms predict no impact to the splice consensus sequence and the nucleotide is not highly conserved. NM_000492.4:c.1624G>T in CFTR is a nonsense substitution introducing a premature stop codon predicted to produce NP_000483.3:p.(Gly542Ter). As a result, the encoded protein sequence is altered, so the criterion's silent-variant premise does not hold regardless of any splicing prediction, so BP7's structural prerequisite is not met by this variant class. No VCEP criteria specification covers BP7 for CFTR, so the generic ACMG/AMP 2015 definition applies. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication.

Rule
deterministic_prefilter: requires_synonymous
Evidence considered
  • Deterministic consequence classification: nonsense (prefetch.json normalized protein consequence)
  • VCEP criterion policy: absent
Sources
generic_acmg_combination_rules

Statement

In silico

SpliceAI predicts no significant splice impact for this variant (max delta score = 0.13). BayesDel score = 0.66.

10 paper records listed. 4 cited in the classification.

Cited in the classification

  • Nine mutations in the cystic fibrosis (CF) gene account for 80% of the CF chromosomes in French patients.
    The paper explicitly reports G542X, corresponding to CFTR c.1624G>T and p.(G542*). In a screening study of 370 CF chromosomes from 185 unrelated French families, G542X was identified on 14 chromosomes (3.8%); seven patients were compound heterozygotes for deltaF508/G542X and seven were G542X/x. The study does not provide case-specific parental testing, affected-relative co-segregation, or non-segregation data.
    → PS4 · strong Names this variant
    PMID 1723032 ↗
    Source detail
    G542X was found in 14 patients, with 7 compound heterozygotes dF508/G542X, and 7 compound heterozygotes G542X/x. In all cases it was associated with haplotype B.

    Location Results, Population Screening; Table 1; Prenatal Diagnosis

    Context Allele-specific oligonucleotide hybridization screening of 13 CFTR mutations in 370 CF chromosomes from 185 unrelated French families; RFLP haplotyping at linked XV-2c and KM19 markers; one prenatal-diagnosis application using G542X-specific probes.

  • Defining the disease liability of variants in the cystic fibrosis transmembrane conductance regulator gene.
    The paper does not explicitly name CFTR c.1624G>T or p.G542*. It describes the mechanism relevant to this CFTR nonsense variant class: variants introducing a premature termination codon are expected to trigger nonsense-mediated decay, causing a severe reduction in CFTR mRNA and no protein production; the analyzed premature-termination variants were predicted to be clinically deleterious and cystic-fibrosis-causing.
    → PVS1 · very strong Does not name this variant
    PMID 23974870 ↗
    Source detail
    A common consequence of a PTC variant is nonsense-mediated decay (NMD) of mRNA, resulting in a severe reduction in mRNA levels and no protein produced.

    Location Results, Functional analysis, paragraph beginning “A common consequence of a PTC variant”

    Context CFTR2 phenotype-driven study of 39,696 individuals with cystic fibrosis; functional classification included predicted premature-termination-codon effects, clinical sweat-chloride analysis, and other CFTR functional assays.

  • Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology.
    The paper does not explicitly mention CFTR c.1624G>T or NP_000483.3:p.(G542*). It uses CFTR as an example of a gene in which heterozygous nonsense variants are expected to act as recessive pathogenic variants because loss-of-function is an established disease mechanism. The paper also cautions that null-variant interpretation depends on the inheritance pattern, transcript context, exon position, nonsense-mediated decay, and whether the affected exon is alternatively spliced.
    → PVS1 · very strong Does not name this variant
    PMID 25741868 ↗
    Source detail
    A novel heterozygous nonsense variant in the CFTR gene would likely be considered a recessive pathogenic variant.

    Location Proposed Criteria for Interpretation of Sequence Variants, PVS1 Null variants

  • Relation between mutations of the cystic fibrosis gene and idiopathic pancreatitis.
    The paper names G542X among 16 CFTR mutations tested in 27 patients with idiopathic chronic pancreatitis, but G542X was not detected in the reported patients; it therefore supplies no patient-specific G542X prevalence evidence for PS4.
    → PS4 · strong Names this variant
    PMID 9725922 ↗
    Source detail
    DNA was tested for 16 CFTR mutations — ΔF508, W1282X, R117H, 621+1(G→T), R334W, R347P, A455E, ΔI507, 1717−1(G→A), G542X, S549N, G551D, R553X, R560T, N1303K, and 3849+10Kb(C→T) — using reverse dot blot strips.

    Location Methods, DNA Studies; Results, paragraph 1

    Context Blood-DNA testing in 27 patients referred for idiopathic chronic pancreatitis evaluation; 17 CFTR mutations were assayed by reverse dot blot, with detected alleles ΔF508, R117H, and N1303K.

Other recorded publications

  • A cluster of cystic fibrosis mutations in the first nucleotide-binding fold of the cystic fibrosis conductance regulator protein.
    No paper-specific finding is recorded.
    PMID 1695717 ↗
  • Identification of mutations in regions corresponding to the two putative nucleotide (ATP)-binding folds of the cystic fibrosis gene.
    No paper-specific finding is recorded.
    PMID 2236053 ↗
  • Lumacaftor-Ivacaftor in Patients with Cystic Fibrosis Homozygous for Phe508del CFTR.
    No paper-specific finding is recorded.
    PMID 25981758 ↗
  • Molecular basis of defective anion transport in L cells expressing recombinant forms of CFTR.
    This paper does not explicitly mention CFTR c.1624G>T or p.G542*. It investigates other CFTR variants, primarily ΔF508 and G551D, in retrovirus-transduced murine L cells. The study reports that G551D CFTR was processed and localized to the plasma membrane similarly to wild-type CFTR but showed little or no cAMP-stimulated anion conductance under standard stimulation; responses were observed in a subset of cells when IBMX was increased to 4 mM. The paper therefore provides functional evidence about CFTR channel activity and mechanisms of defective anion transport, but not about the specific G542* variant.
    Does not name this variant
    PMID 7691345 ↗
    Quoted passage
    This report provides a thorough characterization of two mutant CFTR proteins, AF508 and G551D, in stably transduced cells studied by biochemical, cell biological, and physiological methods.

    Discussion, first paragraph; Results sections on intracellular processing, subcellular localization, and functional analyses

  • Laboratory standards and guidelines for population-based cystic fibrosis carrier screening.
    Grody WW et al. · 2001
    No paper-specific finding is recorded.
    PMID 11280952 ↗
  • Cystic Fibrosis Foundation evidence-based guidelines for management of infants with cystic fibrosis.
    No paper-specific finding is recorded.
    PMID 19914445 ↗

Screenshots represent source records captured during evidence collection. Select one to view the recorded source content.

All source links

Statements for reports

The evidence statements recorded by the interpretation pipeline. They have not been reinterpreted by the page.

gnomAD v4.1

This variant is present in gnomAD v4.1 (AF= 0.000362876; MAF= 0.03629%, 585/1612120 alleles, homozygotes = 0) and has highest observed frequency in the Ashkenazi Jewish population (AF= 0.00135272; MAF= 0.13527%, 40/29570 alleles, homozygotes = 0); grpmax FAF= 0.00048844.

gnomAD v2.1

This variant is present in gnomAD v2.1 (AF= 0.000322338; MAF= 0.03223%, 91/282312 alleles, homozygotes = 0) and has highest observed frequency in the Ashkenazi Jewish population (AF= 0.0014476; MAF= 0.14476%, 15/10362 alleles, homozygotes = 0); grpmax FAF= 0.00055223.

gnomAD-Canada

Not available in gnomAD-Canada v1.0.

ClinVar

This variant has been reported in ClinVar as Pathogenic (33 clinical laboratories) and as pathogenic (2 clinical laboratories) and as Pathogenic by CFTR2 (expert panel). (ClinVarID = 7115)

In silico

SpliceAI predicts no significant splice impact for this variant (max delta score = 0.13). BayesDel score = 0.66.

Somatic

This variant does not lie in a statistically significant hotspot. This variant has not previously been reported in somatic cancers (COSMIC).

Cancer Hotspots

This variant does not lie in a statistically significant hotspot.