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Variant interpretation report

COMT c.472G>A, p.Val158Met

NM_000754.4:c.472G>A NP_000745.1:p.(Val158Met) Missense · exon 4 View identifiers
Classification
Benign

Variant description:

The COMT NM_000754.4:c.472G>A (NP_000745.1:p.(Val158Met)) missense variant has previously been reported in somatic cancers (COSMIC; COSV52889256, n = 12 times). Experimental evidence: Variant-specific studies report approximately three- to fourfold lower COMT enzymatic activity for Met158 than Val158, but assay validation and controls are incompletely documented. Based on available guidelines, this variant is considered to be Benign.

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

Benign.A benign classification under the recorded framework.

In plain language

Gene-level background from the recorded interpretation.

About COMT

COMT encodes an enzyme that breaks down catecholamine neurotransmitters such as dopamine, epinephrine, and norepinephrine by adding a methyl group. It also helps process catecholamine-based medicines used to treat high blood pressure, asthma, and Parkinson disease, and is produced in both soluble and membrane-bound forms. COMT has no established 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: 2 Benign evidence criteria: 4
Pathogenic criteria applied · 2
PS3Supporting
PS3 · supporting

Met: variant-specific studies report approximately three- to fourfold lower COMT enzymatic activity for Met158 than Val158, but assay validation and controls are incompletely documented.

PS4Strong
PS4 · strong

Met: rapid-cycling bipolar subgroup OR 25.20, 95% CI 1.43–443.62, exceeds the >5.0 threshold and excludes 1.

Benign criteria applied · 4
BA1Stand alone
BA1 · stand alone

Met: gnomAD v4.1 grpmax FAF is 0.515321, exceeding the 0.05 BA1 threshold with 1,610,688 observed alleles.

BS1Strong
BS1 · strong

Met: gnomAD v4.1 grpmax FAF is 0.515321, far above the 0.01 generic BS1 threshold in a large population dataset.

BP4Supporting
BP4 · supporting

Met at supporting: missense REVEL 0.065 meets the BP4 threshold of <=0.29.

BP5Supporting
BP5 · supporting

Met: the exact variant was observed in VCFS cases primarily explained by 22q11.2 deletion, an alternate molecular basis for the disease.

Recorded classification: Benign

Benign: BA1 stand-alone benign is met by the gnomAD allele frequency, and no generic pathogenic combination is satisfied by PS4 strong plus PS3 supporting.

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
790,010 / 1,610,688 alleles

gnomAD v4.1: 790,010 / 1,610,688 alleles. Recorded AF 0.49048. Recorded homozygote count 197380.

gnomAD v2.1

This variant is present in gnomAD v2.1 (AF= 0.459739; MAF= 45.97390%, 128098/278632 alleles, homozygotes = 30461) and has highest observed frequency in the European (Finnish) population (AF= 0.552421; MAF= 55.24214%, 13004/23540 alleles, homozygotes = 3617); grpmax FAF= 0.516002.

gnomAD-Canada

Not available in gnomAD-Canada v1.0.

No screenshot for this evidence
REVEL score
0.065 recorded score

Recorded REVEL score: 0.065. Refer to the recorded PP3/BP4 rationale for interpretation.

ClinVar submissions
5 reported laboratory submissions

5 Benign. ClinVar API review status: criteria provided, multiple submitters, no conflicts.

Context only ClinVar ↗
No screenshot for this evidence
Functional evidence
Not recorded

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

COSMIC
Cancer Hotspots
Somatic evidence
12 recorded samples

This variant has previously been reported in somatic cancers (COSMIC; COSV52889256, n = 12 times).

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: 6 met · 7 not met · 11 not assessed · 4 not applicable. Open any row for the full reasoning, the rule and the evidence behind it.

Met Not met Not assessed Not applicable

The variant is COMT NM_000754.4:c.472G>A, p.Val158Met, a common functional polymorphism.

PS1 and PM5 cannot be applied without validated pathogenic comparator missense variants.

PM1 is not met because no qualifying COMT hotspot or critical domain without benign variation was documented.

PP2 is not met because the variant is highly prevalent in population data, contradicting the required low benign missense variation context.

BP1 remains not assessed because a primarily truncating COMT disease mechanism was not established by the available evidence.

PS2, PM6, PP1, and BS4 are not assessed because the available evidence does not contain a disease phenotype, proband-parent testing, or an informative family pedigree with genotype-phenotype data.

PS4 is supported by the small rapid-cycling bipolar subgroup case-control comparison in PMID:8886163, with computed continuity-corrected OR 25.20 and 95% CI 1.43-443.62.

BP5 is supported by the presence of the exact variant in VCFS cases primarily explained by 22q11.2 deletion, an alternate molecular basis.

PP4 is not assessed because no case-specific phenotype establishes a single-etiology COMT disorder.

PP5 and BP6 are not met because ClinVar has no exact-variant expert-panel assertion.

The variant is missense, so PP3 and BP4 use REVEL only and do not use SpliceAI or BayesDel.

REVEL 0.065 does not meet PP3 supporting (>=0.644) and meets BP4 supporting (<=0.29).

Population evidence supports a common benign polymorphism: BA1 and BS1 are met, PM2 is not met, and BS2 is not assessed because the case does not define a penetrant COMT disorder meeting the criterion's applicability requirements.

Met · 6

PS3 SupportingACMG_2015Met: variant-specific studies report approximately three- to fourfold lower COMT enzymatic activity for Met158 than Val158, but assay validation and controls are incompletely documented. Details ▾Hide ▴
Reasoning

NM_000754.4:c.472G>A (COMT p.Val158Met) is directly identified in functional literature as the G>A substitution that produces the low-activity COMT Met allele. PMID:10459407 reports that the substitution decreases COMT enzyme activity approximately three- to fourfold and distinguishes the Val allele as high-activity/thermostable from the Met allele as low-activity/thermolabile. PMID:8886163 likewise identifies the same codon 158 substitution and reports a 3- to 4-fold reduction in enzymatic activity for Met/Met versus Val/Val. These concordant, variant-specific biochemical findings support a damaging effect on COMT function. The evidence is assigned supporting rather than stronger PS3 because the available papers do not provide sufficient detail to verify assay validation, reproducibility, controls, or clinical diagnostic laboratory robustness, and PMID:8886163 cites prior functional work rather than measuring enzyme activity itself.

Rule
PS3: Well-established in vitro or in vivo functional studies supportive of a damaging effect on the gene or gene product.
Evidence considered
  • Palmatier et al. 1999, PMID:10459407: the exact COMT c.472G>A / p.Val158Met substitution is described as changing Val158 to Met and decreasing COMT activity 3- to 4-fold; the Val allele is characterized as high-activity and thermostable, while the Met allele is low-activity and thermolabile.
  • Lachman et al. 1996, PMID:8886163: the exact codon 158 G>A substitution is identified as the cause of low activity and heat lability; the paper reports a 3- to 4-fold reduction in enzymatic activity for COMT158Met homozygosity, while noting that the functional information was established in prior work rather than measured in this association study.
  • Strength calibration: variant-specific biochemical findings are concordant but the available reports do not document enough assay validation, controls, reproducibility, or clinical diagnostic laboratory robustness for a stronger PS3 level.
Still missing
  • Retrieve and assess the original biochemical studies cited by the variant-specific papers, including assay controls, replication, and validation details.
  • Confirm whether the functional assay has been validated and shown reproducible in a clinical diagnostic laboratory setting before considering a stronger PS3 level.
Sources
PS4 StrongACMG_2015Met: rapid-cycling bipolar subgroup OR 25.20, 95% CI 1.43–443.62, exceeds the >5.0 threshold and excludes 1. Details ▾Hide ▴
Reasoning

Generic ACMG/AMP PS4 is met based on Lachman et al. (PMID:8886163), which directly studied COMT158Met (NM_000754.4:c.472G>A; p.Val158Met) in affected VCFS psychiatric subgroups versus Caucasian controls. In the rapid-cycling bipolar-disorder subgroup, all 8 COMT alleles from 7 affected patients were Met, whereas the control Met frequency was 0.402 among 174 chromosomes (approximately 70 Met and 104 non-Met alleles). This is a case-control comparison even though the paper reports a P value rather than an odds ratio. Using the reported frequencies and a 0.5 continuity correction for the zero affected non-Met cell, I computed OR = (8.5 x 104.5)/(0.5 x 70.5) = 25.20, 95% CI 1.43-443.62; the interval excludes 1. The paper reports P = 0.013, but also describes the association as requiring replication. A separate Parkinson disease case-control study (PMID:8941353) found no enrichment (Met allele frequency 0.46 in 139 cases versus 0.52 in 173 controls); from the reported frequencies I computed OR approximately 0.79, 95% CI 0.57-1.08, which does not meet PS4. The positive, disease-subgroup-specific result supports PS4, but the small subgroup and very wide confidence interval require human review.

Rule
The prevalence of the variant in affected individuals is significantly increased compared to the prevalence in controls. ... 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
  • Lachman et al. 1996, Results: all eight COMT158Met alleles occurred in seven patients with rapid-cycling bipolar disorder; the comparison used 174 Caucasian control chromosomes with Met frequency 0.402 and reported P = 0.013.
  • Computed case-control enrichment from the reported counts/frequency: 8 Met and 0 non-Met affected alleles versus approximately 70 Met and 104 non-Met control alleles; continuity-corrected OR = 25.20, 95% CI 1.43-443.62.
  • Harris et al. 1996, Parkinson disease case-control study: Met allele frequency 0.46 in 139 cases versus 0.52 in 173 controls; computed OR approximately 0.79, 95% CI 0.57-1.08, not meeting the PS4 threshold.
Still missing
  • The positive association is based on only 7 patients and has a very wide confidence interval.
  • Independent replication of the rapid-cycling bipolar subgroup association is not established in the reviewed evidence.
Sources
BA1 Stand aloneACMG_2015Met: gnomAD v4.1 grpmax FAF is 0.515321, exceeding the 0.05 BA1 threshold with 1,610,688 observed alleles. Details ▾Hide ▴
Reasoning

BA1 is met. The governing generic threshold is >=0.05. The filtering allele frequency is the gnomAD v4.1 grpmax FAF of 0.515321, based on a population with 1,610,688 observed alleles overall; the gnomAD v2.1 non-cancer exome grpmax FAF is also 0.51591043. The gnomAD v4.1 highest point estimate is Amish AF 0.663736 from only 910 alleles and is not used for the decision, but the qualifying grpmax FAF remains above 5%. The variant is also recorded as Benign in ClinVar with multiple submitters and no conflicts, so there is no pathogenic-consensus conflict requiring BA1 to be withheld.

Rule
Allele frequency is above 5% in Exome Sequencing Project, 1000 Genomes or Exome Aggregation Consortium.
Evidence considered
  • gnomAD v4.1: all-comers AF=0.4904798446 (790010/1610688 alleles; homozygotes=197380); filtering grpmax FAF=0.51532097. The Amish point estimate was AF=0.6637362637 from 604/910 alleles and was not used because the group has fewer than 2000 observed alleles.
  • gnomAD v2.1 non-cancer exomes: AF=0.4599253948 (107514/233764 alleles; homozygotes=25554); filtering grpmax FAF=0.51591043. No governing VCEP specifies this source, so it is confirmatory rather than the default source.
  • ACMG/AMP stand-alone benign allele-frequency calibration supplied in the case: BA1 >=0.05, attributed to ACMG/AMP 2015 (PMID:25741868).
  • ClinVar variation 17591: Benign; criteria provided, multiple submitters, no conflicts; five clinical laboratories summarized as benign.
Sources
BS1 StrongACMG_2015Met: gnomAD v4.1 grpmax FAF is 0.515321, far above the 0.01 generic BS1 threshold in a large population dataset. Details ▾Hide ▴
Reasoning

BS1 is met. The generic default threshold is >=0.01, and the qualifying gnomAD v4.1 filtering grpmax FAF is 0.515321, far above that threshold, with 1,610,688 observed alleles overall. The gnomAD v2.1 non-cancer exome grpmax FAF is similarly high at 0.51591043. The high frequency is not limited to a small isolate: large ancestry groups also show high frequencies, including European non-Finnish AF=0.516409 in gnomAD v4.1 and Finnish AF=0.550217. This is consistent with a common COMT polymorphism rather than an allele causing a fully penetrant rare disorder; ClinVar also reports a benign, non-conflicting consensus.

Rule
Allele frequency is greater than expected for the disorder.
Evidence considered
  • gnomAD v4.1: filtering grpmax FAF=0.51532097; total AF=0.4904798446 from 790010/1610688 alleles. Large ancestry groups were also elevated, including European non-Finnish AF=0.5164090782 from 609120/1179530 alleles and Finnish AF=0.5502167041 from 33769/61374 alleles.
  • gnomAD v2.1 non-cancer exomes: filtering grpmax FAF=0.51591043 and AF=0.4599253948 from 107514/233764 alleles.
  • Generic SVI BS1 default supplied in the case: >=0.01; per-gene maximum-credible-frequency assessment is preferred (Whiffin et al. 2017, PMID:28518168). The observed frequency is so high and broadly distributed, and the variant is a documented common COMT polymorphism, that it is greater than expected for a rare fully penetrant disorder.
  • ClinVar variation 17591: Benign; criteria provided, multiple submitters, no conflicts.
Sources
BP4 SupportingACMGMet at supporting: missense REVEL 0.065 meets the BP4 threshold of <=0.29. Details ▾Hide ▴
Reasoning

The variant is a missense change, so the governing generic path is REVEL only; the SpliceAI result is not used for missense BP4. REVEL is 0.065, which is at or below the generic BP4 supporting threshold of <= 0.29 (ClinGen SVI REVEL calibration, Pejaver et al. 2022, PMID:36413997), supporting BP4 at supporting strength. BayesDel has no established generic ACMG-strength calibration and is not used.

Rule
Missense variant -> REVEL only. ... BP4 (supporting): <= 0.29 — ClinGen SVI REVEL calibration (Pejaver et al. 2022, Am J Hum Genet) (PMID:36413997)
Evidence considered
  • Variant consequence: missense, NM_000754.4:c.472G>A (NP_000745.1:p.(Val158Met)); therefore only the REVEL path applies.
  • Local REVEL lookup reports score 0.065 for this variant.
  • The supplied generic ClinGen SVI calibration sets BP4 supporting at <=0.29; threshold source: Pejaver et al. 2022, Am J Hum Genet (PMID:36413997).
  • SpliceAI max delta 0.006 was not counted for BP4 because a missense variant must use the REVEL path only; BayesDel -0.258812 was not used because no generic ACMG-strength calibration is established.
Sources
BP5 SupportingACMG_2015Met: the exact variant was observed in VCFS cases primarily explained by 22q11.2 deletion, an alternate molecular basis for the disease. Details ▾Hide ▴
Reasoning

PMID:8886163 reports the exact COMT158Met variant in patients with velo-cardio-facial syndrome, a condition in which 23 of 25 participants had detectable 22q11 deletions and the authors state that VCFS results from deletion of one or more genes on 22q11. Thus the variant was found in cases with an alternate molecular basis for the disease, satisfying generic BP5. The variant was investigated as a possible modifier of psychiatric manifestations, not as the molecular cause of the deletion syndrome. Human review is appropriate because two patients had typical VCFS stigmata without a detected large deletion and the paper's disease-genotype relationship is heterogeneous.

Rule
Variant found in a case with an alternate molecular basis for disease.
Evidence considered
  • Lachman et al. 1996, Results: among 25 VCFS patients, 23 had detectable deletions within 22q11; the study evaluated COMT158Met as a possible factor in psychiatric symptoms of VCFS.
  • Lachman et al. 1996, Introduction/Methods: VCFS is associated with an interstitial 22q11 deletion, and patients were ascertained for the clinical syndrome with deletion testing.
Still missing
  • The cohort included two clinically diagnosed VCFS patients without a detected large 22q11 deletion, so the alternate-basis evidence is not uniform across all cases.
Sources

Not met · 7 · evaluated, threshold not reached

PM1 ACMG_2015Not met: no established COMT hotspot or critical domain without benign variation was documented, and Cancer Hotspots returned no COMT V158 result. Details ▾Hide ▴
Reasoning

No VCEP covers COMT, vcep_materials.json contains no domain table, and the case evidence identifies no established COMT mutational hotspot or critical, well-established functional domain without benign variation. Cancer Hotspots returned no result for COMT V158; COSMIC occurrence alone is not sufficient generic PM1 evidence.

Rule
Located in a mutational hot spot and/or critical and well-established functional domain (e.g. active site of an enzyme) without benign variation.
Evidence considered
  • Cancer Hotspots query COMT V158 returned no hotspot row.
  • COSMIC reported the variant 12 times somatically, but generic ACMG/AMP PM1 requires a mutational hotspot or critical functional domain without benign variation; no such domain or hotspot was established here.
Sources
PM2 ACMG_2015Not met: gnomAD v4.1 AF is 0.490480, vastly exceeding the <=0.0001 PM2 supporting threshold. Details ▾Hide ▴
Reasoning

PM2 is not met. The generic PM2 supporting threshold is <=0.0001, whereas the gnomAD v4.1 all-comers AF is 0.4904798446 and the filtering grpmax FAF is 0.51532097. The gnomAD v2.1 non-cancer exome AF is 0.4599253948 with grpmax FAF=0.51591043. The variant is therefore common in population controls and is not absent or extremely rare.

Rule
Absent from controls (or at extremely low frequency if recessive) in Exome Sequencing Project, 1000 Genomes or Exome Aggregation Consortium.
Evidence considered
  • gnomAD v4.1: AF=0.4904798446 (790010/1610688 alleles; homozygotes=197380), filtering grpmax FAF=0.51532097.
  • gnomAD v2.1 non-cancer exomes: AF=0.4599253948 (107514/233764 alleles; homozygotes=25554), filtering grpmax FAF=0.51591043.
  • Generic PM2 supporting calibration supplied in the case: <=0.0001, attributed to ClinGen SVI 2020 and ACMG/AMP 2015 (PMID:25741868).
Sources
PP2 ACMG_2015Not met: COMT p.Val158Met has gnomAD v4.1 allele frequency 0.49048 with 197380 homozygotes, inconsistent with low benign missense variation. Details ▾Hide ▴
Reasoning

The required gene-level pattern is not supported: COMT p.Val158Met is a frequent population polymorphism (gnomAD v4.1 AF 0.49048; 790010/1610688 alleles; 197380 homozygotes), and the evidence does not establish COMT as a gene with a low rate of benign missense variation and a common disease-causing missense mechanism.

Rule
Missense variant in a gene that has a low rate of benign missense variation and where missense variants are a common mechanism of disease.
Evidence considered
  • gnomAD v4.1 reports AF 0.49048, 790010/1610688 alleles, and 197380 homozygotes for COMT p.Val158Met.
  • PMID:10459407 reports COMT*L allele frequencies from 0.01 to 0.62 across 30 populations and identifies Val158Met as a common functional polymorphism.
  • ClinVar variation 17591 is classified Benign with multiple submitters and no conflicts.
Sources
PP3 ACMGNot met: missense REVEL 0.065 is below the PP3 supporting threshold of >=0.644. Details ▾Hide ▴
Reasoning

The variant is a missense change, so the governing generic path is REVEL only; SpliceAI is not used for missense PP3/BP4. REVEL is 0.065, which is below the generic PP3 supporting threshold of >= 0.644 (ClinGen SVI REVEL calibration, Pejaver et al. 2022, PMID:36413997), so PP3 is not met. BayesDel has no established generic ACMG-strength calibration and is not evidence for PP3.

Rule
Missense variant -> REVEL only. ... PP3 (supporting): >= 0.644 — ClinGen SVI REVEL calibration (Pejaver et al. 2022, Am J Hum Genet) (PMID:36413997)
Evidence considered
  • Variant consequence: missense, NM_000754.4:c.472G>A (NP_000745.1:p.(Val158Met)); therefore only the REVEL path applies.
  • Local REVEL lookup reports score 0.065 for this variant.
  • The supplied generic ClinGen SVI calibration sets PP3 supporting at >=0.644; threshold source: Pejaver et al. 2022, Am J Hum Genet (PMID:36413997).
  • SpliceAI max delta 0.006 and BayesDel -0.258812 were not used for PP3 because the missense rule selects REVEL only and BayesDel lacks generic ACMG-strength calibration.
Sources
PP5 ACMG_2015Not met: ClinVar has zero expert-panel submissions for the exact variant and no expert-panel Pathogenic/Likely pathogenic classification. Details ▾Hide ▴
Reasoning

The exact ClinVar record is classified Benign without an expert-panel submission. The available assertions are from clinical laboratories or OMIM/literature-only records, and the submission audit reports zero expert-panel submissions. Therefore no exact-variant ClinVar expert-panel Pathogenic or Likely pathogenic classification is available to support PP5.

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 17591 exact-match audit: overall Benign; expert_panel_submissions = 0; available records are non-expert laboratory or literature-only assertions.
  • The literature reviewed for this group does not constitute an exact-variant ClinVar expert-panel assertion.
Sources
BS3 ACMG_2015Not met: reviewed studies report approximately three- to fourfold reduced COMT activity for Met158 rather than no damaging effect on protein function or splicing. Details ▾Hide ▴
Reasoning

No variant-specific functional study in the reviewed evidence shows no damaging effect on COMT protein function or splicing. Instead, the available variant-specific biochemical evidence reports approximately three- to fourfold lower enzymatic activity and reduced thermostability for the Met158 allele compared with Val158. Therefore, the evidence does not satisfy BS3 and is directionally inconsistent with a benign functional effect.

Rule
BS3: Well-established in vitro or in vivo functional studies show no damaging effect on protein function or splicing.
Evidence considered
  • Palmatier et al. 1999, PMID:10459407: the exact p.Val158Met substitution is reported to decrease COMT enzyme activity approximately three- to fourfold and to distinguish a low-activity thermolabile Met allele from a high-activity thermostable Val allele.
  • Lachman et al. 1996, PMID:8886163: the exact codon 158 G>A substitution is associated with low activity and heat lability, with a reported 3- to 4-fold reduction in enzymatic activity for Met158 homozygosity.
Still missing
  • No well-established variant-specific benign functional assay demonstrating normal COMT protein function or splicing was identified.
Sources
BP6 ACMG_2015Not met: the exact variant lacks a ClinVar expert-panel Benign/Likely benign classification; available assertions are non-expert records. Details ▾Hide ▴
Reasoning

The exact ClinVar record is Benign, but the submission audit reports zero expert-panel submissions. The available benign assertions are from ordinary laboratory submissions or an OMIM/literature-only record, not an exact-variant ClinVar expert-panel classification. Under the required generic BP6 rule, these records cannot trigger BP6.

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 17591 exact-match audit: overall Benign; expert_panel_submissions = 0; available submissions are non-expert laboratory or literature-only assertions.
Sources

Not assessed · 11 · no assessment recorded

PS1 ACMG_2015Not assessed: no previously established pathogenic variant with the same COMT p.Val158Met amino-acid change was identified. Details ▾Hide ▴
Reasoning

The variant is COMT p.Val158Met, but the available evidence does not identify a previously established pathogenic variant producing the same amino-acid change. The cited literature describes this allele as a common functional polymorphism, not as a pathogenic comparator. A validated pathogenic same-amino-acid comparator is required before PS1 can be applied.

Rule
Same amino acid change as a previously established pathogenic variant regardless of nucleotide change.
Evidence considered
  • COMT c.472G>A is reported as p.Val158Met and as a common functional polymorphism in PMID:10459407 and PMID:8886163.
  • ClinVar variation 17591 is classified Benign with multiple submitters and no conflicts; this does not provide a pathogenic PS1 comparator.
Still missing
  • Validated pathogenic same-amino-acid comparator variant with appropriate evidence and citation.
Sources
PS2 ACMG_2015Not assessed: no proband phenotype, confirmed maternity and paternity, de novo test, or family-history information is documented. Details ▾Hide ▴
Reasoning

No case-level information establishes that NM_000754.4:c.472G>A occurred de novo in a patient with a relevant disease, confirms both maternity and paternity, or documents absence of family history. The available evidence describes a common COMT polymorphism and population or functional studies, not a proband-parent trio or disease phenotype.

Rule
De novo (both maternity and paternity confirmed) in a patient with the disease and no family history.
Evidence considered
  • The available case evidence contains no proband-parent trio results, maternity or paternity confirmation, de novo finding, disease phenotype, or family-history assessment for NM_000754.4:c.472G>A.
Still missing
  • Documented disease phenotype and diagnostic relevance in the proband
  • Variant testing results for the proband and both biological parents
  • Confirmation of both maternity and paternity
  • Documented family history or absence of family history
PM3 ACMG_2015Not assessed: no affected-proband observation, pathogenic variant in trans, recessive disorder context, parental testing, or phase information was established. Details ▾Hide ▴
Reasoning

PM3 cannot be assessed because the available evidence does not establish that COMT c.472G>A occurs in an affected proband with a pathogenic COMT variant in trans, and it does not establish a recessive COMT disorder, parental testing, or phase. Population, functional, and general association observations do not substitute for the required allelic phase evidence.

Rule
For recessive disorders, detected in trans with a pathogenic variant. ... This requires testing of parents (or offspring) to determine phase.
Evidence considered
  • The case evidence documents COMT c.472G>A (p.Val158Met) as a common polymorphism and provides functional and population observations, but does not provide an affected-proband compound-heterozygous observation, a pathogenic allele in trans, parental testing, or phase information.
  • The available gene-level context does not establish a recessive COMT disorder or a disease-specific inheritance mode applicable to PM3.
Still missing
  • An affected-proband observation relevant to a recessive COMT disorder
  • A confirmed pathogenic variant in the same proband
  • Parental or offspring testing establishing trans phase
  • An established recessive COMT disorder and inheritance mode
PM5 ACMG_2015Not assessed: no different pathogenic missense variant at COMT residue 158 was documented for comparison with p.Val158Met. Details ▾Hide ▴
Reasoning

The case evidence does not provide a validated pathogenic missense comparator at COMT residue 158. The comparator harvest contains zero same-residue candidates, and the available papers describe Val158Met itself rather than a different pathogenic missense change at residue 158.

Rule
Novel missense change at an amino acid residue where a different missense change determined to be pathogenic has been seen before.
Evidence considered
  • The PM5 candidate file reports zero same-residue candidates and does not establish classic PM5 semantics.
  • PMID:10459407 and PMID:8886163 discuss COMT p.Val158Met itself, not a different pathogenic missense change at residue 158.
Still missing
  • Validated pathogenic alternate missense variant at COMT residue 158 with an auditable source.
Sources
PM6 ACMG_2015Not assessed: no assumed de novo occurrence or parental testing result is documented for a disease-affected proband. Details ▾Hide ▴
Reasoning

No case-level information documents an assumed de novo occurrence of NM_000754.4:c.472G>A in a patient with a relevant disease. There is also no proband-parent testing evidence showing that the variant was absent from one or both parents, whether or not maternity and paternity were confirmed.

Rule
Assumed de novo, but without confirmation of paternity and maternity.
Evidence considered
  • The available case evidence contains no parent-genotype results or clinical report describing NM_000754.4:c.472G>A as de novo or assumed de novo in an affected proband.
Still missing
  • Documented disease phenotype in the proband
  • Evidence that the variant was absent from tested parent(s)
  • Description of whether maternity and paternity were confirmed
PP1 ACMG_2015Not assessed: no affected relatives, disease-linked genotypes, pedigree, or meioses are documented for segregation analysis. Details ▾Hide ▴
Reasoning

No affected family members, pedigrees, meioses, variant genotypes, or phenotype assessments are documented for NM_000754.4:c.472G>A. The reviewed family analysis in PMID:7304673 concerns inherited COMT activity classes rather than segregation of this variant with a defined disease, so it cannot establish PP1.

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
  • PMID:7304673 reports family analysis of 48 low-activity probands, 96 parents, and 89 siblings, but the study concerns COMT enzyme-activity classes and does not provide disease segregation for c.472G>A/p.Val158Met.
  • No case-level pedigree or disease-phenotype segregation data are available for this variant.
Still missing
  • A disease-defined family pedigree
  • Genotypes and phenotype status for affected and unaffected relatives
  • Number of informative meioses and co-segregating relatives
  • Evidence that COMT is definitively established as the cause of the relevant familial disease
Sources
PP4 ACMG_2015Not assessed: reviewed cohorts provide no index-patient phenotype specific for a single-etiology COMT c.472G>A disorder. Details ▾Hide ▴
Reasoning

The reviewed literature describes patients with VCFS, psychiatric diagnoses, Parkinson disease, and cognitive phenotypes, but it does not provide an index-patient phenotype for this case that is highly specific for a disease caused by a single genetic etiology attributable to COMT c.472G>A. VCFS is primarily associated with a 22q11.2 deletion, and the COMT polymorphism was studied as a possible modifier; therefore the available cohort phenotypes cannot be used as PP4 for this variant.

Rule
Patient’s phenotype or family history is highly specific for a disease with a single genetic etiology.
Evidence considered
  • Lachman et al. 1996 studied 25 patients with VCFS, most with 22q11.2 deletions, and evaluated COMT158Met as a possible psychiatric modifier rather than as the established sole cause of VCFS.
  • Cognitive correlates study PMID:16542388 evaluated 21 children with 22q11.2 deletion syndrome; the phenotype was attributable to the microdeletion syndrome, not shown to be specific for COMT c.472G>A.
Still missing
  • No case-specific clinical phenotype or established single-gene COMT disorder was supplied for PP4 assessment.
Sources
BS2 ACMG_2015Not assessed: gnomAD reports 197,380 homozygotes, but no specific COMT disorder with expected early full penetrance is established for applying BS2. Details ▾Hide ▴
Reasoning

BS2 is not assessed. gnomAD documents 197,380 homozygotes in v4.1 and 30,461 homozygotes in v2.1, but the case provides no specific COMT disorder, inheritance model, expected age of onset, or evidence that full penetrance is expected early in life. Therefore, the presence of homozygotes in a population reference dataset cannot be interpreted under the BS2 requirement without defining the disease and its penetrance.

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 v4.1 reports 197380 homozygotes among 1610688 observed alleles; gnomAD v2.1 reports 30461 homozygotes among 278632 observed alleles.
  • These aggregate population counts show homozygosity but do not establish the BS2-specific combination of a defined disorder, the relevant inheritance model, healthy adult status, and full early penetrance.
Still missing
  • A defined COMT-associated disorder and inheritance model
  • Evidence that the disorder is expected to show full penetrance at an early age
  • Clinically characterized healthy adult homozygote observations rather than aggregate population-genotype counts
Sources
BS4 ACMG_2015Not assessed: no affected-family genotypes and phenotypes are available to demonstrate lack of segregation. Details ▾Hide ▴
Reasoning

No affected family members with known NM_000754.4:c.472G>A genotypes are documented, so there is no evaluable non-segregation observation. The available population, functional, and association studies do not establish lack of segregation in an affected family, and the phenocopy caveat cannot be evaluated without family phenotype data.

Rule
Lack of segregation in affected members of a family. ... Caveat: The presence of phenocopies for common phenotypes (i.e. cancer, epilepsy) can mimic lack of segregation among affected individuals.
Evidence considered
  • No family-level genotype and phenotype data document an affected relative who lacks NM_000754.4:c.472G>A.
Still missing
  • Affected-family-member genotypes
  • Affected-family-member phenotype confirmation
  • Pedigree and inheritance structure
  • Assessment for phenocopies or more than one pathogenic variant in the family
BP1 ACMG_2015Not assessed: no reliable gene-level evidence showed that COMT disease is caused primarily by truncating rather than missense variants. Details ▾Hide ▴
Reasoning

The available case evidence does not establish that disease in COMT is caused primarily by truncating variants. The presence of a common COMT missense polymorphism and functional effects does not by itself demonstrate the gene-level truncating-variant disease mechanism required for BP1.

Rule
Missense variant in a gene for which primarily truncating variants are known to cause disease.
Still missing
  • Gene-level disease spectrum demonstrating that primarily truncating COMT variants cause disease.
BP2 ACMG_2015Not assessed: no phase-resolved pathogenic variant in trans or cis, affected-proband observation, or fully penetrant dominant COMT disorder was established. Details ▾Hide ▴
Reasoning

BP2 cannot be assessed because the available evidence does not establish either a pathogenic variant in trans in a fully penetrant dominant COMT disorder or a pathogenic variant in cis with COMT c.472G>A. No phase-resolved affected-proband or family observation supports either BP2 pathway.

Rule
BP2: 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
  • The case evidence does not provide a phase-resolved pathogenic variant in cis or trans with COMT c.472G>A.
  • The available evidence does not establish an affected-proband observation or a fully penetrant dominant COMT disorder relevant to BP2.
Still missing
  • A fully penetrant dominant COMT disorder, if the trans pathway is intended
  • A confirmed pathogenic variant observed in trans or cis
  • Family or molecular testing establishing phase
Not applicable · 4· recorded as not applicable Show reasons ▾Hide reasons ▴
PVS1 N/ANot applicable: PVS1 requires a null variant (nonsense, frameshift, canonical splice, start-loss or stop-loss), and this is a missense variant. Details ▾Hide ▴
Reasoning

PVS1 (ClinGen SVI PVS1 recommendations, PMC6185798, pvs1_generic_framework) applies only to null variant classes — nonsense, frameshift, canonical ±1/2 splice-consensus, translation-initiation-codon loss, and stop-loss variants — each expected to trigger nonsense-mediated decay or otherwise abolish normal protein function. NM_000754.4:c.472G>A in COMT is a missense substitution predicted to produce NP_000745.1:p.(Val158Met). As a result, no null-variant mechanism (nonsense-mediated decay, truncation, or canonical splice disruption) is triggered by this variant class, so PVS1's structural prerequisite is not met by this variant class. No VCEP criteria specification covers PVS1 for COMT, 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_null_variant_class
Evidence considered
  • Deterministic consequence classification: missense (prefetch.json normalized protein consequence)
  • VCEP criterion policy: absent
Sources
pvs1_generic_framework ↗generic_acmg_combination_rules
PM4 N/ANot applicable: PM4 requires a protein-length change, and this is a missense 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_000754.4:c.472G>A in COMT is a missense substitution predicted to produce NP_000745.1:p.(Val158Met). 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 COMT, 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: missense (prefetch.json normalized protein consequence)
  • VCEP criterion policy: absent
Sources
pvs1_generic_framework ↗generic_acmg_combination_rules
BP3 N/ANot applicable: BP3 requires an in-frame indel in a repeat region, and this is a missense 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_000754.4:c.472G>A in COMT is a missense substitution predicted to produce NP_000745.1:p.(Val158Met). 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 COMT, 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: missense (prefetch.json normalized protein consequence)
  • VCEP criterion policy: absent
Sources
pvs1_generic_framework ↗generic_acmg_combination_rules
BP7 N/ANot applicable: BP7 requires a synonymous variant, and this is a missense 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_000754.4:c.472G>A in COMT is a missense substitution predicted to produce NP_000745.1:p.(Val158Met). 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 COMT, 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: missense (prefetch.json normalized protein consequence)
  • VCEP criterion policy: absent
Sources
generic_acmg_combination_rules

Identifiers

Gene
COMT
Transcript
NM_000754.4
Coding (HGVS c.)
NM_000754.4:c.472G>A
Protein (HGVS p.)
NP_000745.1:p.(Val158Met)
GRCh38
chr22:19963748 G>A
GRCh37
chr22:19951271 G>A
Location and type
Exon 4 · missense
ClinVar
17591
COSMIC
COSV52889256

Gene diagram

Every interpreted variant in COMT, mapped onto the exon structure of NM_000754.4. Select a row to find it on the plot.

COMTNM_000754.4
Fetching transcript structure from UCSC…
gnomAD v4.1 790,010 / 1,610,688 alleles AF 0.49 · 197380 homozygotes · FAF 0.515
gnomAD v2.1 128,098 / 278,632 alleles AF 0.46 · 30461 homozygotes · FAF 0.516
gnomAD-Canada v1.0 Allele count data not recorded

By genetic ancestry

gnomAD v4.1

AF 0.49 · 790010 / 1,610,688 alleles · 197380 hom · FAF 0.52
Amish604 / 910 0.66203 hom
European (Finnish)33769 / 61,374 0.559240 hom
European (non-Finnish)609120 / 1,179,530 0.52157401 hom
Middle Eastern3053 / 6,062 0.5794 hom
Remaining individuals28976 / 62,464 0.466885 hom
Ashkenazi Jewish13590 / 29,582 0.463099 hom
South Asian40795 / 91,046 0.459343 hom
Admixed American24411 / 59,924 0.414986 hom
African/African American22941 / 74,964 0.313598 hom
East Asian12751 / 44,832 0.281831 hom

gnomAD v2.1

AF 0.46 · 128098 / 278,632 alleles · 30461 hom · FAF 0.52
European (Finnish)13004 / 23,540 0.553617 hom
European (non-Finnish)66166 / 127,280 0.5217083 hom
Remaining individuals3417 / 7,150 0.48810 hom
Ashkenazi Jewish4747 / 10,292 0.461097 hom
South Asian13437 / 30,548 0.442982 hom
Admixed American14255 / 35,236 0.42896 hom
African/African American7693 / 24,742 0.311219 hom
East Asian5379 / 19,844 0.27757 hom

Statements

gnomAD v4.1

This variant is present in gnomAD v4.1 (AF= 0.49048; MAF= 49.04798%, 790010/1610688 alleles, homozygotes = 197380) and has highest observed frequency in the Amish population (AF= 0.663736; MAF= 66.37363%, 604/910 alleles, homozygotes = 203); grpmax FAF= 0.515321.

gnomAD v2.1

This variant is present in gnomAD v2.1 (AF= 0.459739; MAF= 45.97390%, 128098/278632 alleles, homozygotes = 30461) and has highest observed frequency in the European (Finnish) population (AF= 0.552421; MAF= 55.24214%, 13004/23540 alleles, homozygotes = 3617); grpmax FAF= 0.516002.

gnomAD-Canada

Not available in gnomAD-Canada v1.0.

SpliceAI and Pangolin

SpliceAI acceptor lossat -74 bp
0.001
SpliceAI acceptor gainat +362 bp
0.004
SpliceAI donor lossat +96 bp
0.006
SpliceAI donor gainat +11 bp
0.000
Pangolin splice lossmagnitude shown
-0.003
Pangolin splice gain
0.002

Other predictors

REVEL
0.065
BayesDel
-0.259

How the predictions were used

BP4 SupportingACMGMet at supporting: missense REVEL 0.065 meets the BP4 threshold of <=0.29. Details ▾Hide ▴
Reasoning

The variant is a missense change, so the governing generic path is REVEL only; the SpliceAI result is not used for missense BP4. REVEL is 0.065, which is at or below the generic BP4 supporting threshold of <= 0.29 (ClinGen SVI REVEL calibration, Pejaver et al. 2022, PMID:36413997), supporting BP4 at supporting strength. BayesDel has no established generic ACMG-strength calibration and is not used.

Rule
Missense variant -> REVEL only. ... BP4 (supporting): <= 0.29 — ClinGen SVI REVEL calibration (Pejaver et al. 2022, Am J Hum Genet) (PMID:36413997)
Evidence considered
  • Variant consequence: missense, NM_000754.4:c.472G>A (NP_000745.1:p.(Val158Met)); therefore only the REVEL path applies.
  • Local REVEL lookup reports score 0.065 for this variant.
  • The supplied generic ClinGen SVI calibration sets BP4 supporting at <=0.29; threshold source: Pejaver et al. 2022, Am J Hum Genet (PMID:36413997).
  • SpliceAI max delta 0.006 was not counted for BP4 because a missense variant must use the REVEL path only; BayesDel -0.258812 was not used because no generic ACMG-strength calibration is established.
Sources
PP3 ACMGNot met: missense REVEL 0.065 is below the PP3 supporting threshold of >=0.644. Details ▾Hide ▴
Reasoning

The variant is a missense change, so the governing generic path is REVEL only; SpliceAI is not used for missense PP3/BP4. REVEL is 0.065, which is below the generic PP3 supporting threshold of >= 0.644 (ClinGen SVI REVEL calibration, Pejaver et al. 2022, PMID:36413997), so PP3 is not met. BayesDel has no established generic ACMG-strength calibration and is not evidence for PP3.

Rule
Missense variant -> REVEL only. ... PP3 (supporting): >= 0.644 — ClinGen SVI REVEL calibration (Pejaver et al. 2022, Am J Hum Genet) (PMID:36413997)
Evidence considered
  • Variant consequence: missense, NM_000754.4:c.472G>A (NP_000745.1:p.(Val158Met)); therefore only the REVEL path applies.
  • Local REVEL lookup reports score 0.065 for this variant.
  • The supplied generic ClinGen SVI calibration sets PP3 supporting at >=0.644; threshold source: Pejaver et al. 2022, Am J Hum Genet (PMID:36413997).
  • SpliceAI max delta 0.006 and BayesDel -0.258812 were not used for PP3 because the missense rule selects REVEL only and BayesDel lacks generic ACMG-strength calibration.
Sources
BP7 N/ANot applicable: BP7 requires a synonymous variant, and this is a missense 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_000754.4:c.472G>A in COMT is a missense substitution predicted to produce NP_000745.1:p.(Val158Met). 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 COMT, 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: missense (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 = 0.01). REVEL score = 0.065. BayesDel score = -0.258812.

10 paper records listed. 3 cited in the classification.

Cited in the classification

  • Global variation in the frequencies of functionally different catechol-O-methyltransferase alleles.
    Palmatier MA et al. · 1999 Aug 15
    The paper explicitly describes COMT c.472G>A as a Val158Met substitution and a common functional polymorphism. It reports COMT*L allele frequencies from 0.01 to 0.62 across 30 populations and describes the Met allele as lower activity than the Val allele.
    → PS3 · supporting → BA1 · stand-alone benign → BS1 · strong Names this variant
    PMID 10459407 ↗
    Source detail
    A single base pair change (G 3 A) in exon 4 of the COMT gene, at position 472 in the long mRNA, and 322 in the short mRNA, results in an amino acid change (Val 3 Met), at codon 158 of MB-COMT and codon 108 of S-COMT, that decreases the activity level of the COMT enzyme 3 to 4 fold (Lachman et al 1996b; Lotta et al 1995).

    Location Introduction, paragraph describing the functional COMT polymorphism; Results section on nonhuman primate sequencing; Table 2

    Context Global population survey of 1,314 individuals from 30 populations using PCR amplification of the COMT region followed by NlaIII digestion and electrophoresis; sequencing of PCR products from seven nonhuman primates.

  • Association of codon 108/158 catechol-O-methyltransferase gene polymorphism with the psychiatric manifestations of velo-cardio-facial syndrome.
    The paper describes the COMT codon 158 G>A polymorphism as Val158Met, corresponding to c.472G>A and p.Val158Met, and reports a 3- to 4-fold reduction in enzymatic activity for Met/Met compared with Val/Val.
    → PS3 · supporting → PS4 · strong → BP5 · supporting Names this variant
    PMID 8886163 ↗
    Source detail
    We and others have recently established that low activity and heat lability are primarily due to a G+A transition at codon 158 of the gene encoding the membrane-bound form of the enzyme (MB-COMT), which corresponds to codon 108 of the soluble form (S-COMT), leading to a valine+ methionine substitution [Lotta et al., 1995; Lachman et al., 1996].

    Location Introduction, paragraph describing the codon 108/158 polymorphism; Results, Table III

    Context Association study of 25 patients with velo-cardio-facial syndrome and psychiatric diagnoses, with Caucasian North American controls; COMT genotype determined by PCR-RFLP analysis using NlaIII digestion.

  • No association between Parkinson's disease and low-activity alleles of catechol O-methyltransferase.
    This paper directly evaluates the COMT val-108-met polymorphism corresponding to p.Val158Met under the membrane-bound COMT numbering used here. In 139 patients with idiopathic Parkinson disease and 173 controls, the Met allele frequency was 0.46 in cases versus 0.52 in controls, and genotype frequencies did not differ significantly, providing a negative case-control comparison for PS4.
    → PS4 · strong Names this variant
    PMID 8941353 ↗
    Source detail
    There was no significant difference in the genotype frequencies between the two groups.

    Location Results and Discussion, Table 1 and allele/genotype association analysis

    Context PCR-RFLP/ARMS genotyping in 139 Caucasian idiopathic Parkinson disease patients and 173 Caucasian controls, with allele and genotype frequencies compared statistically.

Other recorded publications

  • Catechol O-methyltransferase gene variant and birth weight predict early-onset antisocial behavior in children with attention-deficit/hyperactivity disorder.
    No paper-specific finding is recorded.
    PMID 16275815 ↗
  • Cognitive correlates of a functional COMT polymorphism in children with 22q11.2 deletion syndrome.
    This paper explicitly studies the COMT Val158Met polymorphism in 21 non-psychotic children with 22q11.2 deletion syndrome. The Met allele was associated with higher IQ, achievement, and sustained-attention measures than the Val allele, but the cohort phenotype is the microdeletion syndrome rather than a phenotype specific to a single COMT c.472G>A disorder.
    Names this variant
    PMID 16542388 ↗
    Quoted passage
    Our results show that children with 22q11DS who have the Met allele have higher IQ and achievement scores and perform better on measures of prefrontal cognition, such as the Continuous Performance Task, as compared with those with the Val allele.

    Abstract; Results; Table 1; Discussion

  • 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.
    No paper-specific finding is recorded.
    PMID 25741868 ↗
  • Genetics of red cell COMT activity: analysis of thermal stability and family data.
    This paper does not explicitly mention COMT c.472G>A or NP_000745.1:p.(V158M). It investigates inherited variation in human red-cell COMT activity, modeling two alleles that produce three genotype classes, and includes a family analysis of low-activity probands, their parents, and siblings; it does not establish segregation of the variant with a defined disease.
    Does not name this variant
    PMID 7304673 ↗
    Quoted passage
    The correspondence between basal activity and thermostability suggests moreover that the high- and low-activity alleles are themselves the structural genes for RBC COMT, although genetically determined posttranslational modification of COMT is also a possibility.

    Discussion, page 289; Table II

  • Genetic polymorphism of catechol-O-methyltransferase (COMT): correlation of genotype with individual variation of S-COMT activity and comparison of the allele frequencies in the normal population and parkinsonian patients in Finland.
    No paper-specific finding is recorded.
    PMID 9110364 ↗
  • Pharmacogenetics: from bench to byte--an update of guidelines.
    No paper-specific finding is recorded.
    PMID 21412232 ↗
  • Clinical Pharmacogenetics Implementation Consortium Guideline for CYP2D6, OPRM1, and COMT Genotypes and Select Opioid Therapy.
    No paper-specific finding is recorded.
    PMID 33387367 ↗

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= 0.49048; MAF= 49.04798%, 790010/1610688 alleles, homozygotes = 197380) and has highest observed frequency in the Amish population (AF= 0.663736; MAF= 66.37363%, 604/910 alleles, homozygotes = 203); grpmax FAF= 0.515321.

gnomAD v2.1

This variant is present in gnomAD v2.1 (AF= 0.459739; MAF= 45.97390%, 128098/278632 alleles, homozygotes = 30461) and has highest observed frequency in the European (Finnish) population (AF= 0.552421; MAF= 55.24214%, 13004/23540 alleles, homozygotes = 3617); grpmax FAF= 0.516002.

gnomAD-Canada

Not available in gnomAD-Canada v1.0.

ClinVar

This variant has been reported in ClinVar as Benign (5 clinical laboratories). (ClinVarID = 17591)

In silico

SpliceAI predicts no significant splice impact for this variant (max delta score = 0.01). REVEL score = 0.065. BayesDel score = -0.258812.

Somatic

This variant does not lie in a statistically significant hotspot. This variant has previously been reported in somatic cancers (COSMIC; COSV52889256, n = 12 times).

Cancer Hotspots

This variant does not lie in a statistically significant hotspot.