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Variant interpretation report

APOL1 c.1024A>G, p.Ser342Gly

NM_003661.4:c.1024A>G NP_003652.2:p.(Ser342Gly) Missense · exon 6 View identifiers
Classification
Uncertain significance

Variant description:

The APOL1 NM_003661.4:c.1024A>G (NP_003652.2:p.(Ser342Gly)) missense variant has not previously been reported in somatic cancers (COSMIC). Based on available guidelines, this variant is considered to be a Variant of Uncertain Significance (VUS).

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

Uncertain.The recorded classification is uncertain significance.

In plain language

Gene-level background from the recorded interpretation.

About APOL1

APOL1 encodes apolipoprotein L1, a secreted HDL-associated protein involved in lipid transport and reverse cholesterol transport. Certain inherited APOL1 variants increase the risk of chronic kidney disease, including focal segmental glomerulosclerosis and HIV-associated nephropathy, particularly in people with recent African ancestry. APOL1 is not established as a cancer-predisposition gene or a central driver of 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: 0 Benign evidence criteria: 1
Pathogenic criteria applied · 0

No pathogenic criterion marked as applied in the recorded assessment.

Benign criteria applied · 1
BP4Supporting
BP4 · supporting

Met, supporting: missense REVEL score 0.081 is below the generic BP4 supporting cutoff of 0.29.

Recorded classification: Uncertain significance

VUS: BP4 supporting from REVEL 0.081 is the only applied criterion and does not satisfy a generic ACMG benign or likely benign combination rule.

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
18,406 / 1,614,072 alleles

gnomAD v4.1: 18,406 / 1,614,072 alleles. Recorded AF 0.0114035. Recorded homozygote count 2158.

gnomAD v2.1

This variant is present in gnomAD v2.1 (AF= 0.0211138; MAF= 2.11138%, 5970/282754 alleles, homozygotes = 689) and has highest observed frequency in the African/African American population (AF= 0.227568; MAF= 22.75682%, 5671/24920 alleles, homozygotes = 687); grpmax FAF= 0.225318.

gnomAD-Canada

Not available in gnomAD-Canada v1.0.

No screenshot for this evidence
REVEL score
0.081 recorded score

Recorded REVEL score: 0.081. Refer to the recorded PP3/BP4 rationale for interpretation.

ClinVar submissions
6 reported laboratory submissions

2 risk factor · 1 Likely risk allele · 1 Uncertain significance · 1 Pathogenic · 1 Pathogenic, low penetrance. ClinVar API review status: criteria provided, conflicting classifications.

Context only ClinVar ↗
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: 1 met · 8 not met · 14 not assessed · 5 not applicable. Open any row for the full reasoning, the rule and the evidence behind it.

Met Not met Not assessed Not applicable

For the requested codon, residue, domain, and missense-mechanism criteria, no criterion is met: PS1 and PM5 lack the required distinct comparator variants, PM1 lacks sufficiently established domain-without-benign-variation or hotspot evidence, and PP2/BP1 lack required gene-wide premises.

No proband-parent de novo observation, assumed-de-novo report, or family pedigree with informative segregation or non-segregation is available for this variant.

PS3 and BS3 were not assessed because the available studies do not provide a sufficiently validated, reproducible, variant-specific functional result for APOL1 S342G alone.

PS4 is not met because the exact S342G-only case-control estimate is OR 2.32 with 95% CI 0.81-6.69, failing both the OR >5.0 and CI-not-including-1.0 requirements.

PP4 and BP5 remain not assessed because the case materials do not provide the individual phenotype/family history or an alternate molecular diagnosis.

PP5 and BP6 are not met because ClinVar has conflicting laboratory submissions and no exact-variant expert-panel classification.

The variant is a missense substitution, so the generic PP3/BP4 assessment uses REVEL only; the SpliceAI score is not used for these criteria.

REVEL 0.081 does not meet PP3 supporting (>=0.644) and meets BP4 supporting (<=0.29).

Population evidence supports that APOL1 p.Ser342Gly is a common African-ancestry-enriched risk allele, not a rare variant suitable for PM2.

The high filtering frequency exceeds generic BA1 and BS1 defaults, but those criteria are not assessed because the allele has a documented recessive, incompletely penetrant, conditional kidney-disease association and lacks a disorder-specific maximum-credible-frequency calculation.

BS2 is not applicable because the governing rule requires full penetrance expected at an early age, which is inconsistent with the APOL1 risk-disease context.

Met · 1

BP4 SupportingACMGMet, supporting: missense REVEL score 0.081 is below the generic BP4 supporting cutoff of 0.29. Details ▾Hide ▴
Reasoning

Scope was settled first under the generic rule: this is a missense substitution, NM_003661.4:c.1024A>G, NP_003652.2:p.(Ser342Gly), so BP4 uses the REVEL path only; SpliceAI is not used for this missense BP4 assessment. REVEL is 0.081, at or below the generic BP4 supporting cutoff of <=0.29, so BP4 is met at supporting strength. The same REVEL prediction is not counted again for PP3.

Rule
BP4 (supporting): <= 0.29 — ClinGen SVI REVEL calibration (Pejaver et al. 2022, Am J Hum Genet) (PMID:36413997)
Evidence considered
  • Variant consequence is missense (NP_003652.2:p.(Ser342Gly)); the generic computational path for a missense variant is REVEL only, not SpliceAI.
  • Local REVEL lookup reports score 0.081 for APOL1 c.1024A>G.
  • Generic ClinGen SVI REVEL calibration: BP4 supporting requires REVEL <=0.29; threshold supplied in this case and attributed to Pejaver et al. 2022, PMID:36413997.
  • The REVEL result is assigned to BP4 only and is not double-counted for PP3 or BP7.
Sources
revel

Not met · 8 · evaluated, threshold not reached

PS1 ACMG_2015Not met: the evidence documents c.1024A>G itself but no different nucleotide change producing the same p.Ser342Gly amino-acid change. Details ▾Hide ▴
Reasoning

The variant is APOL1 p.Ser342Gly (c.1024A>G; rs73885319), and the reviewed literature documents this same nucleotide change, but no distinct nucleotide substitution producing the same amino-acid change was identified. Therefore, the required PS1 comparator is absent; observations of the queried variant itself do not satisfy PS1.

Rule
Same amino acid change as a previously established pathogenic variant regardless of nucleotide change.
Evidence considered
  • PMID:20647424 explicitly identifies S342G as rs73885319 and part of the G1 allele.
  • PMID:21997394 reports S342G/G1S342G, including a rare S342G-only haplotype, but does not report an alternative nucleotide encoding p.Ser342Gly.
  • PMID:25853332 and PMID:32675303 also identify the queried S342G substitution, not a distinct same-amino-acid nucleotide change.
Sources
PS4 ACMG_2015Not met: the exact S342G-only comparison gives OR 2.32 (95% CI 0.81-6.69), below the >5.0 threshold with a CI including 1.0. Details ▾Hide ▴
Reasoning

The exact S342G-only haplotype was reported in 7 of 271 African American cases and 7 of 620 African American controls in Kopp et al. (PMID:21997394). Treating these as a case-control comparison, the calculated odds ratio is (7/264)/(7/613) = 2.32 with an approximate 95% CI of 0.81-6.69. The governing ACMG/AMP threshold is OR >5.0 with a confidence interval that does not include 1.0; the explicit comparison is 2.32 > 5.0? no, and 0.81-6.69 excludes 1.0? no. Therefore PS4 is not met. The same paper's broader G1/G2 results concern risk-allele genotypes or haplotypes rather than an isolated S342G estimate and do not establish the required exact-variant threshold.

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
  • Kopp et al. 2011, Results and Table 2: the rare G1G* haplotype carrying S342G alone was carried by 7 cases and 7 controls; the study included 271 African American cases and 620 African American controls (383 normal donors plus 237 HIV-positive hypernormal controls).
  • Calculated the case-control odds ratio from those counts: (7/264)/(7/613) = 2.321970; Wald 95% CI = 0.806431-6.685686.
  • Genovese et al. 2010 reports broader G1 haplotype enrichment (G1 includes S342G plus I384M), but that is not an isolated S342G case-control estimate.
  • The literature packet's ai_classified_papers array was empty; the PS4-indexed PMID:30976395 abstract reports a 79-case/83-control study but does not provide exact c.1024A>G or p.S342G carrier counts, so it cannot establish the PS4 threshold here.
Sources
PM1 ACMG_2015Not met: S342G is discussed in an SRA-interacting region, but no residue-bounded critical domain without benign variation or hotspot evidence is established. Details ▾Hide ▴
Reasoning

No VCEP covers APOL1 and vcep_materials.json contains no domain table. The literature places S342G in or near the APOL1 SRA-interacting region, but the available evidence does not establish a complete, residue-bounded critical domain without benign variation, and the hotspot searches were negative. The generic PM1 requirement is therefore not met.

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
  • PMID:25853332 states that APOL1 G1G p.S342G lies in the SRA-interacting domain, while the available extract does not provide residue boundaries or demonstrate absence of benign variation throughout that domain.
  • PMID:30332315 discusses the SRA-binding region for G1/G2 collectively but does not establish a residue-bounded PM1 domain for S342.
  • Cancer Hotspots returned no statistically significant hotspot for APOL1 S342, and COSMIC found no report for the queried variant.
  • gnomAD v4.1 reports the queried p.Ser342Gly allele at AF 0.0114035 overall and 0.228743 in the African/African American population; this population observation does not by itself prove benignity but provides no domain-specific absence-of-benign-variation support.
Sources
PM2 ACMGNot met: gnomAD all-comers AF is 1.14% in v4.1 and 2.11% in v2.1, far above the <=0.01% PM2 threshold. Details ▾Hide ▴
Reasoning

PM2 is not met because the variant is common in population controls. The supplied generic supporting threshold is allele frequency <=0.0001, whereas applicable all-comers gnomAD values are 0.0211138 in v2.1 and 0.0114035 in v4.1. The gnomAD v2.1 non-cancer exome-only subset also contains the variant at AF 0.0158214 (3748/236894 alleles; 447 homozygotes), so the specified subset does not restore rarity.

Rule
PM2: Absent from controls (or at extremely low frequency if recessive) in Exome Sequencing Project, 1000 Genomes or Exome Aggregation Consortium. ... PM2 (supporting): <= 0.0001 — SVI recommendation to downgrade PM2 to Supporting (ClinGen SVI 2020) (PMID:25741868)
Evidence considered
  • gnomAD v2.1 all-comers AF=0.0211138 (5970/282754 alleles; 689 homozygotes).
  • gnomAD v4.1 all-comers AF=0.0114035 (18406/1614072 alleles; 2158 homozygotes).
  • The gnomAD v2.1 non-cancer exome-only subset reports AF=0.0158214 (3748/236894 alleles; 447 homozygotes), which also exceeds the PM2 threshold.
  • The supplied generic PM2 calibration threshold is <=0.0001.
Sources
PM5 ACMG_2015Not met: the evidence identifies p.Ser342Gly itself but no different pathogenic missense substitution at residue 342. Details ▾Hide ▴
Reasoning

The queried variant changes Ser342 to Gly. The reviewed evidence identifies S342G itself and no different missense substitution at residue 342 that has been established as pathogenic. The PM5 same-residue comparator requirement is therefore not met.

Rule
Novel missense change at an amino acid residue where a different missense change determined to be pathogenic has been seen before.
Evidence considered
  • PMID:20647424, PMID:21997394, PMID:25853332, and PMID:32675303 describe S342G, not a different amino-acid substitution at Ser342.
  • The ClinVar record for NM_003661.4:c.1024A>G (p.Ser342Gly) contains conflicting classifications for the queried variant and does not provide a different pathogenic missense variant at residue 342.
Sources
PP3 ACMGNot met: missense REVEL score 0.081 is below the generic PP3 supporting threshold of 0.644. Details ▾Hide ▴
Reasoning

Scope was settled first under the generic rule: this is a missense substitution, NM_003661.4:c.1024A>G, NP_003652.2:p.(Ser342Gly), so PP3 uses the REVEL path only; SpliceAI is not used for this missense PP3/BP4 assessment, and BayesDel has no established generic ACMG-strength calibration. REVEL is 0.081, which is below the generic PP3 supporting threshold of >=0.644, so PP3 is not met. The low REVEL score is instead considered under BP4 without double-counting it.

Rule
PP3 (supporting): >= 0.644 — ClinGen SVI REVEL calibration (Pejaver et al. 2022, Am J Hum Genet) (PMID:36413997)
Evidence considered
  • Variant consequence is missense (NP_003652.2:p.(Ser342Gly)); the generic computational path for a missense variant is REVEL only, not SpliceAI.
  • Local REVEL lookup reports score 0.081 for APOL1 c.1024A>G.
  • Generic ClinGen SVI REVEL calibration: PP3 supporting requires REVEL >=0.644; threshold supplied in this case and attributed to Pejaver et al. 2022, PMID:36413997.
  • BayesDel score is not used because no generic ACMG-strength calibration is established for BayesDel.
Sources
revel
PP5 ACMG_2015Not met: ClinVar shows conflicting laboratory assertions but no exact-variant expert-panel pathogenic or likely pathogenic classification. Details ▾Hide ▴
Reasoning

ClinVar contains conflicting laboratory submissions for the exact variant, including risk factor, likely risk allele, uncertain significance, pathogenic, and pathogenic low penetrance, but no expert-panel submission. The available pathogenic assertions are ordinary laboratory submissions and do not satisfy the required exact-variant reputable-source condition for PP5 under the stated generic rule.

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 exact-variant record NM_003661.4(APOL1):c.1024A>G (p.Ser342Gly), variation 277678: review status is criteria provided, conflicting classifications; expert_panels is empty.
  • The ClinVar submission summary includes risk factor, likely risk allele, uncertain significance, pathogenic, and pathogenic low penetrance, with no expert-panel classification.
Sources
BP6 ACMG_2015Not met: ClinVar has no exact-variant expert-panel benign or likely benign classification and instead reports conflicting laboratory submissions. Details ▾Hide ▴
Reasoning

ClinVar contains conflicting laboratory submissions for the exact variant and no expert-panel submission. There is no exact-variant expert-panel benign or likely benign classification; therefore ordinary laboratory submissions and the conflicting aggregate record cannot trigger BP6 under the stated generic rule.

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 exact-variant record NM_003661.4(APOL1):c.1024A>G (p.Ser342Gly), variation 277678: review status is criteria provided, conflicting classifications; expert_panels is empty.
  • The ClinVar submission summary contains no benign or likely benign expert-panel classification.
Sources

Not assessed · 14 · no assessment recorded

PS2 ACMG_2015Not assessed: no proband-level de novo observation with confirmed maternity and paternity and no family history is documented. Details ▾Hide ▴
Reasoning

No proband-level case report or pedigree evidence documents this variant as de novo, and there is no confirmation of both maternity and paternity or documentation of no family history. The available literature concerns population association and functional studies rather than a de novo clinical observation.

Rule
De novo (both maternity and paternity confirmed) in a patient with the disease and no family history.
Evidence considered
  • The available evidence contains cohort association studies and functional assays, but no documented affected proband-parent trio, parental testing results, or de novo clinical observation for NM_003661.4:c.1024A>G (p.Ser342Gly).
Still missing
  • A clinical proband carrying NM_003661.4:c.1024A>G with the relevant disease phenotype must be identified.
  • Both maternity and paternity must be confirmed and parental variant testing results documented.
  • Family history must be documented as negative for the relevant disease.
PS3 ACMG_2015Not assessed: direct assays either showed weaker S342G-alone lysis or tested the combined S342G/I384M G1 haplotype rather than the queried substitution alone. Details ▾Hide ▴
Reasoning

The available functional literature is suggestive but does not establish a well-established, reproducible, variant-specific damaging assay result sufficient for PS3. PMID:20647424 directly tested S342G in recombinant ApoL1 assays and found that S342G alone was less lytic than the combined S342G/I384M G1 protein, with maximal lysis requiring the combined allele; the assay therefore does not isolate a clear disease-damaging effect of c.1024A>G. PMID:25853332 reports, in a review of prior work, that S342G-containing G1G can kill Trypanosoma brucei in vivo, but this is not a new validated experiment and trypanolysis is not by itself an established assay for the kidney-disease mechanism. PMID:32675303 reports dose-dependent toxicity and loss of viability for the combined G1 S342G/I384M haplotype in HEK293 cells, not for the queried S342G substitution alone. No validated clinical-laboratory assay, definitive assay calibration, or sufficiently specific control framework was identified. Accordingly, the evidence cannot be calibrated as PS3 at any strength under the generic rule.

Rule
PS3
Evidence considered
  • Genovese et al. (PMID:20647424), Results and Fig. 3C: recombinant ApoL1 assays included S342G alone and the combined S342G/I384M G1 protein; S342G alone was less lytic against T. b. rhodesiense and the combination was required for maximal lysis.
  • Bruggeman et al. (PMID:25853332), review section on APOL1 and trypanosome infection: reports that G1G containing p.S342G can kill T. b. rhodesiense in vivo, but provides no new experiment and does not establish the kidney-disease mechanism.
  • Datta et al. (PMID:32675303), HEK293 functional studies: the tested G1 construct was S342G/I384M and caused dose-dependent loss of viability and other cellular stress phenotypes; the study did not isolate S342G alone.
  • The available studies do not provide a validated clinical diagnostic assay, a complete control scheme with quantitative thresholds, or reproducible variant-specific evidence adequate for PS3 strength assignment.
Still missing
  • A validated, reproducible functional assay testing APOL1 S342G alone with appropriate wild-type, pathogenic, and neutral controls.
  • A disease-relevant assay demonstrating that S342G alone produces the APOL1 functional abnormality responsible for kidney disease.
  • Quantitative assay results and predefined thresholds supporting strength calibration.
Sources
PM3 ACMG_2015Not assessed: no affected-proband observation documents APOL1 p.Ser342Gly in trans with a qualifying pathogenic variant or establishes phase by parental or offspring testing. Details ▾Hide ▴
Reasoning

PM3 cannot be assessed because the available evidence does not document the queried APOL1 p.Ser342Gly allele in trans with a pathogenic variant in an affected proband, nor does it provide parent or offspring testing establishing phase. The literature identifies p.Ser342Gly as part of the G1 haplotype with p.Ile384Met and reports a rare p.Ser342Gly-only haplotype, but it does not establish a qualifying pathogenic variant in trans for this case.

Rule
For recessive disorders, detected in trans with a pathogenic variant ... This requires testing of parents (or offspring) to determine phase.
Evidence considered
  • Genovese et al. 2010 (PMID:20647424), Results and Fig. 3C: APOL1 p.Ser342Gly (rs73885319) is one component of the G1 allele with p.Ile384Met; the source describes association and functional data but does not report parent/offspring phase or an affected proband carrying the queried allele in trans with a qualifying pathogenic variant.
  • Kopp et al. 2011 (PMID:21997394), Results/Table 2/Discussion: a rare G1G* haplotype containing p.Ser342Gly alone was observed in seven cases and seven controls, while common G1 was discussed as a p.Ser342Gly plus p.Ile384Met haplotype; no qualifying trans pathogenic allele or parental phase was reported for the queried variant.
Still missing
  • Affected-proband data with a confirmed pathogenic APOL1 variant in trans are unavailable.
  • Parental or offspring testing establishing phase is unavailable.
  • The available reports do not independently establish p.Ile384Met as a qualifying pathogenic variant for PM3.
Sources
PM6 ACMG_2015Not assessed: no clinical assumed-de novo observation is reported with parental testing information insufficient for confirmation. Details ▾Hide ▴
Reasoning

No clinical report documents this variant as assumed de novo. The available evidence does not provide a proband with the relevant disease, parental testing information, or a statement that maternity and paternity were unconfirmed.

Rule
Assumed de novo, but without confirmation of paternity and maternity.
Evidence considered
  • The available evidence contains population association and functional studies, but no clinical assumed-de-novo observation or parental testing report for NM_003661.4:c.1024A>G (p.Ser342Gly).
Still missing
  • A clinical proband carrying the variant with the relevant disease phenotype must be identified.
  • Parental testing or an explicit report of assumed de novo status without maternity and paternity confirmation is required.
PP1 ACMG_2015Not assessed: no pedigree-based segregation is reported, and the seven cases versus seven controls were not affected relatives with informative meioses. Details ▾Hide ▴
Reasoning

No family pedigree or genotype-phenotype segregation series is documented for this variant. PMID:21997394 reports S342G-only haplotypes in seven cases and seven controls in a case-control study, not multiple affected family members with informative meioses; therefore, PP1 cannot be assessed from that study.

Rule
Co-segregation with disease in multiple affected family members in a gene definitively known to cause the disease. ... May be used as stronger evidence with increasing segregation data.
Evidence considered
  • Kopp et al. (PMID:21997394), Table 2 and the associated results, describe seven S342G-only haplotypes in cases and seven in controls in a case-control cohort; this is not family co-segregation with disease across affected relatives.
Still missing
  • Multiple affected relatives carrying the variant must be documented in a gene definitively known to cause the relevant disease.
  • Informative unaffected relatives, phase, and the number of informative meioses should be reported for segregation assessment.
Sources
PP2 ACMG_2015Not assessed: APOL1 missense risk alleles are documented, but no gene-wide evidence establishes a low rate of benign missense variation. Details ▾Hide ▴
Reasoning

The case documents important APOL1 missense risk alleles and functional effects, but it does not provide a gene-wide estimate demonstrating a low rate of benign missense variation. Because that required gene-level premise cannot be established from the supplied evidence, PP2 is not assessed.

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
  • PMID:20647424 and PMID:21997394 document APOL1 missense risk alleles and disease associations.
  • PMID:32675303 reports functional effects of the APOL1 G1 missense allele in HEK293 cells.
  • These sources establish missense-associated APOL1 risk biology but do not establish the required gene-wide low rate of benign missense variation.
Still missing
  • A validated gene-wide assessment of benign missense variation in APOL1 is not provided.
Sources
PP4 ACMG_2015Not assessed: no individual phenotype or family history is provided to determine whether the presentation is highly specific for a single-genetic-etiology disease. Details ▾Hide ▴
Reasoning

No individual case phenotype or family history is supplied for this interpretation. The available literature describes APOL1 S342G/G1 as a kidney-disease risk allele associated with heterogeneous conditions including FSGS and HIVAN, rather than documenting that this patient's phenotype is highly specific for a disease with a single genetic etiology. The criterion cannot be assessed without the patient's phenotype and relevant differential diagnosis.

Rule
Patient’s phenotype or family history is highly specific for a disease with a single genetic etiology.
Evidence considered
  • Kopp et al. 2011 studied biopsy-proven primary FSGS and HIVAN as separate case groups and described APOL1 risk genotypes as associated with kidney disease risk; this does not supply the phenotype of the present patient.
  • Genovese et al. 2010 similarly reports population associations with FSGS and hypertension-attributed ESKD, but does not establish a single-genetic-etiology phenotype for the present case.
Still missing
  • Documented patient phenotype, clinical diagnosis, and family history are required to assess specificity.
  • A relevant differential diagnosis or evidence that the phenotype has a single genetic etiology is absent.
Sources
BA1 ACMGNot assessed: grpmax FAF is 22.6%, but APOL1 G1 is an incompletely penetrant kidney-disease risk allele with conflicting clinical classifications. Details ▾Hide ▴
Reasoning

The required filtering frequency exceeds the generic BA1 threshold: gnomAD v2.1 grpmax FAF is 0.225318 and gnomAD v4.1 grpmax FAF is 0.225877, both from African/African American samples with more than 2,000 observed alleles. BA1 is not assessed because APOL1 p.Ser342Gly is the G1 risk allele with a documented recessive, incompletely penetrant and conditional kidney-disease association, and ClinVar classifications conflict, including risk factor, likely risk allele, pathogenic and pathogenic low penetrance. Applying a stand-alone benign conclusion from the generic 5% threshold would be unsafe without a disorder-specific maximum-credible-frequency calculation and resolution of the disease-associated risk interpretation.

Rule
BA1 (stand-alone): >= 0.05 — ACMG/AMP 2015 stand-alone benign allele frequency (PMID:25741868)
Evidence considered
  • gnomAD v2.1: all-comers AF 0.0211138 (5970/282754 alleles; 689 homozygotes); African/African American AF 0.227568 (5671/24920 alleles; 687 homozygotes); grpmax FAF=0.225318.
  • gnomAD v4.1: all-comers AF 0.0114035 (18406/1614072 alleles; 2158 homozygotes); African/African American AF 0.228743 (17142/74940 alleles; 2135 homozygotes); grpmax FAF=0.225877.
  • The filtering metric is grpmax FAF rather than the population point estimate, and the African/African American population has more than 2,000 observed alleles.
  • ClinVar variation 277678 reports conflicting classifications: risk factor, likely risk allele, uncertain significance, pathogenic and pathogenic low penetrance; review status is criteria provided, conflicting classifications.
  • PMID:20647424 explicitly identifies S342G as part of the APOL1 G1 allele and reports its association with FSGS and hypertension-attributed end-stage kidney disease in African Americans.
  • PMID:21997394 describes APOL1 kidney-disease risk under a recessive model and identifies the S342G-only G1G* haplotype in cases and controls.
  • PMID:30332315 describes APOL1 kidney-disease risk as recessive and incompletely penetrant/conditional, with disease-inducing effects dependent on an environmental or cellular stressor.
Still missing
  • A disorder-specific maximum credible allele frequency calculation using disease prevalence, penetrance and allelic heterogeneity is not available.
  • The conflicting clinical interpretation of APOL1 p.Ser342Gly has not been resolved by an expert-panel consensus.
Sources
BS1 ACMGNot assessed: grpmax FAF is 22.6%, but APOL1 G1 is a common ancestry-enriched, incompletely penetrant risk allele requiring disorder-specific frequency calibration. Details ▾Hide ▴
Reasoning

The generic BS1 default is exceeded by the filtering frequency: grpmax FAF is 0.225318 in gnomAD v2.1 and 0.225877 in gnomAD v4.1, with the elevated frequency concentrated in African/African American samples exceeding 2,000 observed alleles. BS1 is not assessed from the default 1% threshold alone because APOL1 G1 is an established recessive, incompletely penetrant and environmentally conditional kidney-disease risk allele, so the high ancestry-enriched frequency may be compatible with disease risk. No disorder-specific maximum-credible-frequency calculation using prevalence, penetrance and allelic heterogeneity is available.

Rule
BS1 (strong): >= 0.01 — Generic SVI default; per-gene derivation preferred (Whiffin et al. 2017) (PMID:28518168)
Evidence considered
  • gnomAD v2.1 grpmax FAF=0.225318; African/African American AF=0.227568 from 5671/24920 alleles and 687 homozygotes.
  • gnomAD v4.1 grpmax FAF=0.225877; African/African American AF=0.228743 from 17142/74940 alleles and 2135 homozygotes.
  • Both African/African American population allele counts exceed the 2,000-observed-allele minimum; the filtering FAF rather than the popmax point estimate was used.
  • PMID:21997394 reports a recessive APOL1 kidney-disease model and identifies S342G as determining the G1 pathogenic phenotype.
  • PMID:30332315 states that APOL1 kidney-disease risk is recessive, incompletely penetrant and conditional on an appropriate environmental or cellular stressor.
  • The generic SVI default is 1%; Whiffin et al. 2017 (PMID:28518168) is the named publication for evaluating a disorder-specific maximum credible allele frequency rather than applying that default mechanically.
  • ClinVar variation 277678 contains conflicting risk-factor and pathogenic classifications, including a pathogenic low-penetrance assertion.
Still missing
  • A maximum credible allele frequency calculation using disease prevalence, penetrance and allelic heterogeneity is not available.
  • The relevant APOL1-associated kidney-disease phenotype and penetrance for this allele are not sufficiently specified for a numeric BS1 threshold.
Sources
BS3 ACMG_2015Not assessed: no well-established assay showed normal APOL1 function or splicing for S342G, and reduced S342G-alone lysis is not evidence of benignity. Details ▾Hide ▴
Reasoning

No well-established functional study demonstrating that APOL1 S342G has no damaging effect on protein function or splicing was identified. PMID:20647424 reported reduced trypanolytic activity for S342G alone relative to the combined G1 protein, but this is not a benign functional result and does not establish normal protein function or normal splicing. The other reviewed functional sources describe either S342G-containing G1 activity or the combined S342G/I384M haplotype and do not support a benign interpretation. Therefore BS3 is not assessed rather than applied or rejected on the basis of an inadequate negative assay.

Rule
BS3
Evidence considered
  • Genovese et al. (PMID:20647424) tested S342G in a trypanolytic assay but reported reduced activity relative to the combined G1 protein; this does not demonstrate normal APOL1 function or splicing.
  • The reviewed APOL1 functional literature did not provide a well-established negative assay for the queried S342G substitution with quantitative normal-function thresholds.
Still missing
  • A validated assay showing normal APOL1 protein function or splicing for S342G with appropriate controls and quantitative interpretation.
Sources
BS4 ACMG_2015Not assessed: no affected-family pedigree shows absence of the variant, and cohort association data cannot establish non-segregation. Details ▾Hide ▴
Reasoning

No affected family members and no family genotype-phenotype analysis are documented, so lack of segregation cannot be evaluated. PMID:21997394 and PMID:25993319 are cohort studies rather than pedigrees; their case-control or aggregate association results do not establish non-segregation in affected relatives, and no family-level phenocopy assessment is provided.

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
  • Kopp et al. (PMID:21997394) reports case-control haplotype data rather than non-segregation in affected relatives.
  • Limou et al. (PMID:25993319) reports aggregate sequencing and association analyses in sporadic FSGS/HIVAN cases and controls, without an affected-family pedigree or family-level genotype-phenotype analysis.
Still missing
  • An affected family with variant testing in affected members is required to evaluate lack of segregation.
  • Phenocopies and the possibility of more than one pathogenic variant in the family should be considered when interpreting any apparent non-segregation.
Sources
BP1 ACMG_2015Not assessed: available evidence shows APOL1 missense risk alleles but lacks a systematic gene-wide comparison proving whether truncating variants primarily cause disease. Details ▾Hide ▴
Reasoning

The supplied evidence documents APOL1 missense risk alleles and does not establish that APOL1 disease is caused primarily by truncating variants. However, it also does not provide a systematic gene-wide variant spectrum sufficient to make the converse conclusion under BP1, so the criterion is not assessed.

Rule
Missense variant in a gene for which primarily truncating variants are known to cause disease.
Evidence considered
  • PMID:20647424 and PMID:21997394 describe APOL1 missense risk alleles associated with kidney disease.
  • PMID:25853332 and PMID:32675303 discuss functional and toxic effects of APOL1 missense risk alleles.
  • These papers do not provide a systematic gene-wide analysis establishing that truncating variants are the primary known disease mechanism.
Still missing
  • A validated gene-wide disease-variant spectrum comparing truncating and missense mechanisms is not provided.
Sources
BP2 ACMG_2015Not assessed: p.Ser342Gly is reported in cis with p.Ile384Met, but p.Ile384Met is not established as a qualifying pathogenic variant and no qualifying dominant observation is documented. Details ▾Hide ▴
Reasoning

BP2 cannot be assessed because the available evidence does not establish that APOL1 p.Ser342Gly is observed in trans with a pathogenic variant in a fully penetrant dominant disorder, or in cis with an independently qualifying pathogenic variant. The reports describe p.Ser342Gly in cis with p.Ile384Met as the G1 haplotype and also describe p.Ser342Gly alone, but they do not establish p.Ile384Met as a pathogenic variant under the governing BP2 definition or provide a qualifying dominant-disorder observation.

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
  • Genovese et al. 2010 (PMID:20647424), Results: the G1 allele is a two-locus allele consisting of p.Ser342Gly and p.Ile384Met, which documents the reported cis haplotype but does not independently classify p.Ile384Met as pathogenic for BP2.
  • Kopp et al. 2011 (PMID:21997394), Results/Table 2/Discussion: the study reports common G1 containing p.Ser342Gly plus p.Ile384Met and a rare p.Ser342Gly-only haplotype; it provides no qualifying fully penetrant dominant disorder observation or independently pathogenic cis partner.
Still missing
  • Independent pathogenic classification of the cis partner p.Ile384Met is unavailable.
  • A fully penetrant dominant APOL1 disorder context with the queried allele in trans with a pathogenic variant is unavailable.
  • Direct phase-confirmed case data for a qualifying BP2 configuration are unavailable.
Sources
BP5 ACMG_2015Not assessed: no alternate molecular diagnosis is documented for the patient carrying this variant. Details ▾Hide ▴
Reasoning

No case-level information documents that the variant was found in a patient with an alternate molecular basis for disease. The population and literature sources describe APOL1 risk associations but do not establish an alternate molecular diagnosis for the present case, so BP5 cannot be adjudicated.

Rule
Variant found in a case with an alternate molecular basis for disease.
Still missing
  • A documented alternate molecular basis for the patient's disease is required.
Not applicable · 5· 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_003661.4:c.1024A>G in APOL1 is a missense substitution predicted to produce NP_003652.2:p.(Ser342Gly). 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 APOL1, 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_003661.4:c.1024A>G in APOL1 is a missense substitution predicted to produce NP_003652.2:p.(Ser342Gly). 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 APOL1, 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
BS2 N/ANot applicable: APOL1 G1 kidney-disease risk is recessive and incompletely penetrant, so gnomAD homozygotes do not establish healthy adults with early full penetrance. Details ▾Hide ▴
Reasoning

BS2 is not applicable because its governing definition requires observation in a healthy adult for a disorder with full penetrance expected at an early age. APOL1 G1-associated kidney disease is described as recessive, incompletely penetrant and conditional on additional environmental or cellular stressors. gnomAD documents many homozygotes (689 in v2.1 and 2,158 in v4.1), but these database observations do not establish healthy-adult status or full early-age penetrance and therefore cannot satisfy BS2.

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 reports 689 total homozygotes, including 687 in the African/African American population.
  • gnomAD v4.1 reports 2,158 total homozygotes, including 2,135 in the African/African American population.
  • The gnomAD evidence does not establish healthy-adult status or full penetrance expected at an early age for these individuals.
  • PMID:30332315 describes APOL1 kidney-disease risk as recessive, incompletely penetrant and conditional on environmental or cellular stressors.
  • PMID:21997394 evaluates APOL1 kidney-disease risk under a recessive model.
Sources
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_003661.4:c.1024A>G in APOL1 is a missense substitution predicted to produce NP_003652.2:p.(Ser342Gly). 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 APOL1, 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_003661.4:c.1024A>G in APOL1 is a missense substitution predicted to produce NP_003652.2:p.(Ser342Gly). 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 APOL1, 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
APOL1
Transcript
NM_003661.4
Coding (HGVS c.)
NM_003661.4:c.1024A>G
Protein (HGVS p.)
NP_003652.2:p.(Ser342Gly)
GRCh38
chr22:36265860 A>G
GRCh37
chr22:36661906 A>G
Location and type
Exon 6 · missense
ClinVar
1120175, 634949, 277678, 6080, 634950, 127198, 6081

Gene diagram

Every interpreted variant in APOL1, mapped onto the exon structure of NM_003661.4. Select a row to find it on the plot.

APOL1NM_003661.4
Fetching transcript structure from UCSC…
gnomAD v4.1 18,406 / 1,614,072 alleles AF 0.0114 · 2158 homozygotes · FAF 0.226
gnomAD v2.1 5,970 / 282,754 alleles AF 0.0211 · 689 homozygotes · FAF 0.225
gnomAD-Canada v1.0 Allele count data not recorded

By genetic ancestry

gnomAD v4.1

AF 0.011 · 18406 / 1,614,072 alleles · 2158 hom · FAF 0.23
African/African American17142 / 74,940 0.232135 hom
Remaining individuals645 / 62,508 0.0118 hom
Admixed American527 / 60,022 0.00884 hom
Middle Eastern9 / 6,062 0.00151 hom
South Asian14 / 91,076 0.00015
European (non-Finnish)69 / 1,180,036 5.8e-05
0 alternate alleles recorded in 4 other groups: European (Finnish), Amish, East Asian, Ashkenazi Jewish.

gnomAD v2.1

AF 0.021 · 5970 / 282,754 alleles · 689 hom · FAF 0.23
African/African American5671 / 24,920 0.23687 hom
Admixed American240 / 35,438 0.00681 hom
Remaining individuals42 / 7,214 0.00581 hom
European (non-Finnish)14 / 129,126 0.00011
South Asian3 / 30,616 9.8e-05
0 alternate alleles recorded in 3 other groups: Ashkenazi Jewish, East Asian, European (Finnish).

Statements

gnomAD v4.1

This variant is present in gnomAD v4.1 (AF= 0.0114035; MAF= 1.14035%, 18406/1614072 alleles, homozygotes = 2158) and has highest observed frequency in the African/African American population (AF= 0.228743; MAF= 22.87430%, 17142/74940 alleles, homozygotes = 2135); grpmax FAF= 0.225877.

gnomAD v2.1

This variant is present in gnomAD v2.1 (AF= 0.0211138; MAF= 2.11138%, 5970/282754 alleles, homozygotes = 689) and has highest observed frequency in the African/African American population (AF= 0.227568; MAF= 22.75682%, 5671/24920 alleles, homozygotes = 687); grpmax FAF= 0.225318.

gnomAD-Canada

Not available in gnomAD-Canada v1.0.

SpliceAI and Pangolin

SpliceAI acceptor lossat -218 bp
0.005
SpliceAI acceptor gainat -475 bp
0.002
SpliceAI donor lossat -4 bp
0.009
SpliceAI donor gainat +34 bp
0.000
Pangolin splice lossmagnitude shown
-0.076
Pangolin splice gain
0.037

Other predictors

REVEL
0.081
BayesDel
-0.734

How the predictions were used

BP4 SupportingACMGMet, supporting: missense REVEL score 0.081 is below the generic BP4 supporting cutoff of 0.29. Details ▾Hide ▴
Reasoning

Scope was settled first under the generic rule: this is a missense substitution, NM_003661.4:c.1024A>G, NP_003652.2:p.(Ser342Gly), so BP4 uses the REVEL path only; SpliceAI is not used for this missense BP4 assessment. REVEL is 0.081, at or below the generic BP4 supporting cutoff of <=0.29, so BP4 is met at supporting strength. The same REVEL prediction is not counted again for PP3.

Rule
BP4 (supporting): <= 0.29 — ClinGen SVI REVEL calibration (Pejaver et al. 2022, Am J Hum Genet) (PMID:36413997)
Evidence considered
  • Variant consequence is missense (NP_003652.2:p.(Ser342Gly)); the generic computational path for a missense variant is REVEL only, not SpliceAI.
  • Local REVEL lookup reports score 0.081 for APOL1 c.1024A>G.
  • Generic ClinGen SVI REVEL calibration: BP4 supporting requires REVEL <=0.29; threshold supplied in this case and attributed to Pejaver et al. 2022, PMID:36413997.
  • The REVEL result is assigned to BP4 only and is not double-counted for PP3 or BP7.
Sources
revel
PP3 ACMGNot met: missense REVEL score 0.081 is below the generic PP3 supporting threshold of 0.644. Details ▾Hide ▴
Reasoning

Scope was settled first under the generic rule: this is a missense substitution, NM_003661.4:c.1024A>G, NP_003652.2:p.(Ser342Gly), so PP3 uses the REVEL path only; SpliceAI is not used for this missense PP3/BP4 assessment, and BayesDel has no established generic ACMG-strength calibration. REVEL is 0.081, which is below the generic PP3 supporting threshold of >=0.644, so PP3 is not met. The low REVEL score is instead considered under BP4 without double-counting it.

Rule
PP3 (supporting): >= 0.644 — ClinGen SVI REVEL calibration (Pejaver et al. 2022, Am J Hum Genet) (PMID:36413997)
Evidence considered
  • Variant consequence is missense (NP_003652.2:p.(Ser342Gly)); the generic computational path for a missense variant is REVEL only, not SpliceAI.
  • Local REVEL lookup reports score 0.081 for APOL1 c.1024A>G.
  • Generic ClinGen SVI REVEL calibration: PP3 supporting requires REVEL >=0.644; threshold supplied in this case and attributed to Pejaver et al. 2022, PMID:36413997.
  • BayesDel score is not used because no generic ACMG-strength calibration is established for BayesDel.
Sources
revel
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_003661.4:c.1024A>G in APOL1 is a missense substitution predicted to produce NP_003652.2:p.(Ser342Gly). 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 APOL1, 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 = 0.081. BayesDel score = -0.733948.

8 paper records listed. No publication is explicitly linked to an applied criterion in the recorded metadata.

Recorded publications

  • Association of trypanolytic ApoL1 variants with kidney disease in African Americans.
    Genovese G et al. · 2010
    The paper explicitly describes APOL1 S342G as rs73885319, one of the two nonsynonymous variants comprising the G1 allele with I384M. G1 was associated with FSGS and H-ESKD, and recombinant-protein assays found that S342G alone was less lytic than the combined S342G/I384M G1 protein.
    Names this variant
    PMID 20647424 ↗
    Quoted passage
    The strongest signal was obtained for a two-locus allele, termed G1, consisting of the two derived nonsynonymous coding variants rs73885319 [S342→G342 (S342G) (15)] and rs60910145 (I384M) in the last exon of APOL1.

    Results, initial FSGS association analysis; Results, recombinant ApoL1 functional assays (Fig. 3C)

  • APOL1 genetic variants in focal segmental glomerulosclerosis and HIV-associated nephropathy.
    Kopp JB et al. · 2011
    The paper explicitly describes APOL1 S342G as the G1 risk allele and reports a rare S342G-only haplotype in seven controls and seven cases. The authors state that the data strongly suggest S342G determines the G1 pathogenic phenotype and that I384M is not required.
    Names this variant
    PMID 21997394 ↗
    Quoted passage
    the G1GM/GG* association strongly suggests that the single G1S342G allele determines the G1 pathogenic phenotype

    Results, paragraph beginning 'Among African American subjects'; Table 2; Discussion

  • A systematic approach to assessing the clinical significance of genetic variants.
    No paper-specific finding is recorded.
    PMID 24033266 ↗
  • APOL1 toxin, innate immunity, and kidney injury.
    The paper identifies APOL1 p.S342G as the G1G component of the G1 renal-risk allele and places G1G in the SRA-interacting domain. It summarizes functional and toxicity evidence for APOL1 risk isoforms while noting that the kidney-disease mechanism remained unresolved.
    Names this variant
    PMID 25853332 ↗
    Quoted passage
    The G1 allele is composed of two SNPs in near-perfect linkage disequilibrium (G1G, p.S342G and G1M, p.I384M) but only G1G can kill trypanosome in vivo.

    Section 'APOL1 and resistance to trypanosome infection,' paragraph discussing the APOL1 G1 and G2 renal risk alleles

  • Sequencing rare and common APOL1 coding variants to determine kidney disease risk.
    Limou S et al. · 2015
    The study sequenced APOL1 exons in 1,437 individuals and analyzed 33 coding variants, but it reports aggregate association results rather than a family pedigree, de novo observation, or family-level segregation analysis for S342G.
    Does not name this variant
    PMID 25993319 ↗
    Quoted passage
    We exhaustively analyzed 33 rare and common variants using association analyses, gene-set analyses and compound heterozygous complementation of a single G1 or G2 risk allele analyses, but found no evidence of association with FSGS/HIVAN for other APOL1 variants.

    Discussion, paragraph 1

  • APOL1 polymorphisms and kidney disease: loss-of-function or gain-of-function?
    The review discusses APOL1 G1 and G2 collectively, describing effects involving the SRA-binding region and reduced VAMP8 binding, with recessive and incompletely penetrant kidney-disease risk that may require an environmental or cellular stressor. It does not explicitly name S342G.
    Does not name this variant
    PMID 30332315 ↗
    Quoted passage
    Similar to the SRA protein, the variants G1 and G2 have a similar diminished capacity to bind VAMP8 in human cells.

    Loss-of-function section, lines 242-250

  • Kidney Disease-Associated APOL1 Variants Have Dose-Dependent, Dominant Toxic Gain-of-Function.
    Datta S et al. · 2020
    The paper identifies APOL1 G1 as the S342G/I384M coding variant and reports dose-dependent loss of viability, cellular swelling, potassium efflux, stress signaling, altered metabolism, and transcriptomic changes in inducible HEK293 cells expressing G1 compared with G0.
    Names this variant
    PMID 32675303 ↗
    Quoted passage
    Mechanisms by which two coding variants (G1, S342G/I384M and G2, del388N389Y) of the APOL1 gene contribute to the excess rate of non-diabetic ESKD

    Introduction; Results sections describing monoallelic and biallelic APOL1 G0/G1/G2 expression

  • G1 is the major APOL1 risk allele for hypertension-attributed nephropathy in Central Africa.
    No paper-specific finding is recorded.
    PMID 30976395 ↗

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= 0.0114035; MAF= 1.14035%, 18406/1614072 alleles, homozygotes = 2158) and has highest observed frequency in the African/African American population (AF= 0.228743; MAF= 22.87430%, 17142/74940 alleles, homozygotes = 2135); grpmax FAF= 0.225877.

gnomAD v2.1

This variant is present in gnomAD v2.1 (AF= 0.0211138; MAF= 2.11138%, 5970/282754 alleles, homozygotes = 689) and has highest observed frequency in the African/African American population (AF= 0.227568; MAF= 22.75682%, 5671/24920 alleles, homozygotes = 687); grpmax FAF= 0.225318.

gnomAD-Canada

Not available in gnomAD-Canada v1.0.

ClinVar

This variant has been reported in ClinVar as risk factor (2 clinical laboratories) and as Likely risk allele (1 clinical laboratory) and as Uncertain significance (1 clinical laboratory) and as Pathogenic (1 clinical laboratory) and as Pathogenic, low penetrance (1 clinical laboratory). (ClinVarID = 277678)

In silico

SpliceAI predicts no significant splice impact for this variant (max delta score = 0.01). REVEL score = 0.081. BayesDel score = -0.733948.

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.