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Variant interpretation report

TNFRSF13B c.310T>C, p.Cys104Arg

NM_012452.3:c.310T>C NP_036584.1:p.(Cys104Arg) Missense · exon 3 View identifiers
Classification
Pathogenic

Variant description:

The TNFRSF13B NM_012452.3:c.310T>C (NP_036584.1:p.(Cys104Arg)) missense variant has previously been reported in somatic cancers (COSMIC; COSV55430181, n = 2 times). Experimental evidence: Independent human-cell and murine assays consistently showed reduced ligand binding, signaling, B-cell responses, and antibody production for C104R/C76R. Based on available guidelines, this variant is considered to be Pathogenic.

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

Pathogenic.A pathogenic classification under the recorded framework.

In plain language

Gene-level background from the recorded interpretation.

About TNFRSF13B

The protein encoded by this gene is a lymphocyte-specific member of the tumor necrosis factor (TNF) receptor superfamily. It interacts with calcium-modulator and cyclophilin ligand (CAML). The protein induces activation of the transcription factors NFAT, AP1, and NF-kappa-B and plays a crucial role in humoral immunity by interacting with a TNF ligand. This gene is located within the Smith-Magenis syndrome region on chromosome 17. [provided by RefSeq, Jul 2008]

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: 5 Benign evidence criteria: 1
Pathogenic criteria applied · 5
PS3Strong
PS3 · strong

Met, strong: independent human-cell and murine assays consistently showed reduced ligand binding, signaling, B-cell responses, and antibody production for C104R/C76R.

PS4Strong
PS4 · strong

Met: autoimmunity was 8/15 versus 1/11 in non-carriers, giving OR 11.43 (95% CI 1.15-113.12), above 5.0 with the interval excluding 1.0.

PM3Moderate
PM3 · moderate

Met: one affected individual with CVID was compound heterozygous for C104R/S194X, establishing C104R in trans with the S194X stop-codon allele.

PP1Supporting
PP1 · supporting

Met at supporting: multiple affected relatives carried C104R, but seven-member familial data showed inconsistent phenotype correlation and reduced penetrance.

PP3Moderate
PP3 · moderate

Met at moderate strength: REVEL 0.919 meets the >=0.773 PP3 threshold but remains below the >=0.932 strong threshold.

Benign criteria applied · 1
BS4Supporting
BS4 · supporting

Met at supporting: affected and unaffected relatives showed inconsistent C104R phenotype correlation, including an affected CVID child reported without the variant.

Recorded classification: Pathogenic

Pathogenic: PS3 strong and PS4 strong satisfy the generic ACMG/AMP rule for two strong pathogenic criteria, with additional PM3, PP1, and PP3 support.

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
8,783 / 1,614,226 alleles

gnomAD v4.1: 8,783 / 1,614,226 alleles. Recorded AF 0.005441. Recorded homozygote count 32.

gnomAD v2.1

This variant is present in gnomAD v2.1 (AF= 0.00347485; MAF= 0.34748%, 983/282890 alleles, homozygotes = 4) and has highest observed frequency in the European (non-Finnish) population (AF= 0.00539515; MAF= 0.53952%, 697/129190 alleles, homozygotes = 3); grpmax FAF= 0.00508582.

gnomAD-Canada

Not available in gnomAD-Canada v1.0.

No screenshot for this evidence
REVEL score
0.919 recorded score

Recorded REVEL score: 0.919. Refer to the recorded PP3/BP4 rationale for interpretation.

ClinVar submissions
51 reported laboratory submissions

23 Pathogenic · 21 Likely pathogenic · 5 Uncertain significance · 1 Likely benign · 1 risk factor. 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.

COSMIC
Cancer Hotspots
Somatic evidence
2 recorded samples

This variant has previously been reported in somatic cancers (COSMIC; COSV55430181, n = 2 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 · 10 not met · 7 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

The queried variant is TNFRSF13B NP_036584.1:p.(Cys104Arg) (C104R), a missense change in the second extracellular cysteine-rich domain.

PS1 and PM5 are not met because the reviewed evidence does not provide a distinct pathogenic nucleotide change producing the same amino acid or a distinct pathogenic missense substitution at residue 104.

PM1, PP2, and BP1 remain not assessed because the supplied evidence does not establish their required domain-wide or gene-level premises.

The segregation evidence supports PP1 and BS4 only at supporting strength because C104R occurs in multiple affected relatives but also in unaffected relatives and shows inconsistent phenotype correlation.

PS2 and PM6 are not assessed because no proband-specific de novo or assumed-de novo observation with parental testing information is documented.

PS3 is met at strong strength because multiple independent, variant-specific human-cell and murine functional studies with control comparisons consistently demonstrate impaired TACI function.

BS3 is not met because no reviewed study demonstrates normal C104R protein function or splicing; the available studies instead show damaging effects.

PS4 is met from the verified exact-variant familial phenotype comparison, with OR 11.43 and 95% CI 1.15-113.12 satisfying the stated >5.0 and confidence-interval criteria.

PP4 is not met because C104R has incomplete penetrance and variable clinical expression rather than a highly specific phenotype for a single genetic etiology.

PP5 and BP6 are not met because ClinVar has no exact-variant expert-panel classification; BP5 is not assessed because no alternate molecular basis is documented for the interpreted case.

The variant is missense (NM_012452.3:c.310T>C; p.(Cys104Arg)); generic PP3/BP4 therefore use REVEL only.

REVEL 0.919 meets PP3 moderate but not PP3 strong, and does not meet any BP4 threshold.

SpliceAI and uncalibrated BayesDel are excluded from these criterion decisions.

Met · 6

PS3 StrongACMG_2015Met, strong: independent human-cell and murine assays consistently showed reduced ligand binding, signaling, B-cell responses, and antibody production for C104R/C76R. Details ▾Hide ▴
Reasoning

Multiple independent, variant-specific functional studies support a damaging effect for TNFRSF13B c.310T>C (p.Cys104Arg/C104R). Human-cell assays demonstrated markedly reduced TACI surface expression, impaired BAFF/APRIL ligand binding, near-absent NF-kB or NF-AT signaling, and impaired downstream B-cell responses. Independent studies also showed absent or reduced APRIL-induced proliferation, class-switching, immunoglobulin production, and AID expression. Physiologically relevant murine models of the equivalent C76R substitution reproduced impaired antibody responses, B-cell proliferation, immunoglobulin secretion, and B-cell homeostasis. The evidence is concordant across biochemical, cellular, ex vivo, and in vivo assays and includes wild-type/control comparisons, supporting PS3 at strong strength.

Rule
Well-established in vitro or in vivo functional studies supportive of a damaging effect on the gene or gene product. ... Functional studies that have been validated and shown to be reproducible and robust in a clinical diagnostic laboratory setting are considered the most well-established.
Evidence considered
  • Salzer et al. 2005 (PMID:16007087): variant-specific patient-cell and B-cell assays showed profoundly reduced TACI surface expression, severely compromised APRIL binding, absent IgM-APRIL-induced proliferation, and impaired APRIL/BAFF-induced class-switch recombination and IgG secretion.
  • Garibyan et al. 2007 (PMID:17492055): in vitro transfection assays demonstrated that C104R and murine C76R dominantly interfered with wild-type TACI signaling.
  • Romberg et al. 2011 (PMID:20889194): transgenic mice expressing the murine equivalent C76R had impaired antibody responses, B-cell proliferation, and APRIL-induced IgG1 secretion.
  • Bacchelli et al. 2011 (PMID:21419480): 293T assays showed approximately half-normal surface expression, complete loss of BAFF binding, and failure to activate NF-kB or NF-AT by C104R; the study included co-expressed wild-type controls.
  • Häusser et al. 2011 (PMID:21458042): human assays showed diminished C104R expression and ligand binding, nearly abolished NF-kB activation, and approximately half-normal signaling at a 1:1 mutant:wild-type ratio; knock-in mice reproduced reduced surface TACI and impaired antibody responses.
  • Chaudhary et al. 2012 (PMID:23237420): patient and control B-cell studies showed reduced TACI expression, impaired APRIL binding, defective TLR9-induced upregulation, and reduced AID mRNA expression, while also documenting phenotype variability in heterozygotes.
Sources
PS4 StrongACMG_2015Met: autoimmunity was 8/15 versus 1/11 in non-carriers, giving OR 11.43 (95% CI 1.15-113.12), above 5.0 with the interval excluding 1.0. Details ▾Hide ▴
Reasoning

The verified abstract for PMID:22697072 reports the exact C104R variant in 8 of 15 heterozygous relatives with autoimmunity versus 1 of 11 non-carrier relatives. Treating these groups as affected-phenotype and control groups gives OR=(8x10)/(7x1)=11.43 and a Woolf 95% CI of 1.15-113.12. The governing PS4 comparison is OR >5.0 with a confidence interval that does not include 1.0: 11.43 > 5.0 and 1.15-113.12 excludes 1.0, so PS4 is met. The study is familial and evaluates autoimmunity rather than a narrowly defined single disease, so human review is retained.

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
  • PMID:22697072 abstract, exact C104R comparison: autoimmunity in 8/15 C104R heterozygous relatives versus 1/11 relatives without C104R.
  • Computed case-control odds ratio from the reported counts: OR=(8x10)/(7x1)=11.43; Woolf 95% CI=1.15-113.12.
  • The explicit PS4 inequality is 11.43 > 5.0? yes; the 95% CI 1.15-113.12 includes 1.0? no.
Still missing
  • The comparison is a familial relative study of autoimmunity, not a conventional independently recruited case-control study of CVID.
Sources
PM3 ModerateACMG_2015Met: one affected individual with CVID was compound heterozygous for C104R/S194X, establishing C104R in trans with the S194X stop-codon allele. Details ▾Hide ▴
Reasoning

PM3 is met for NM_012452.3:c.310T>C (p.Cys104Arg). In the seven-family study, an affected individual with CVID carried C104R/S194X, explicitly described as compound heterozygous, with C104R and S194X carried separately in the family; this establishes the queried variant in trans with the S194X stop-codon allele. The same study also reports three C104R homozygotes, but those observations are not needed for PM3. The evidence directly satisfies the generic recessive PM3 definition and includes familial phase information. No quantitative generic strength threshold was supplied, so no strength tier is assigned.

Rule
For recessive disorders, detected in trans with a pathogenic variant ... Note: This requires testing of parents (or offspring) to determine phase.
Evidence considered
  • Martinez-Gallo et al. 2013, Table I, Family E: affected patient E.I is listed as C104R/S194X, while relatives carry C104R or S194X separately.
  • Martinez-Gallo et al. 2013, Results, 'Impaired TACI upregulation after TLR9 activation': the patient with CVID is described as having compound heterozygous C104R/S194X mutations.
  • The study examined patients with CVID and first-degree relatives, providing familial inheritance information relevant to phase; S194X is reported as a stop-codon allele in Table I and the surrounding results.
Sources
PP1 SupportingACMG_2015Met at supporting: multiple affected relatives carried C104R, but seven-member familial data showed inconsistent phenotype correlation and reduced penetrance. Details ▾Hide ▴
Reasoning

The exact C104R variant is reported in familial studies with multiple affected relatives. PMID:22983507 describes a seven-member family carrying the variant, including an index patient with CVID and SLE, while the paper reports that the variant did not correlate consistently with clinical phenotype. The literature bundle also reports the exact variant in two of three index children with CVID and in relatives with selective IgA deficiency or recurrent infections. This supports cosegregation with disease in multiple affected family members, but reduced penetrance and marked intrafamilial variability limit the evidence to supporting strength.

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
  • Clinical variability of family members with the C104R mutation reports a seven-member family with four C104R/wild-type heterozygotes and one C104R homozygote; the index patient had CVID and SLE, and the authors state that C104R did not correlate consistently with clinical phenotype.
  • The literature evidence for TACI mutations and disease susceptibility reports the exact C104R variant in two of three index children with CVID and in relatives with selective IgA deficiency or recurrent infections, while also reporting a healthy grandfather carrying the variant; this supports familial transmission but indicates incomplete penetrance.
Still missing
  • A complete pedigree with phenotype definitions and genotype results for every informative meiosis is not available.
  • Penetrance, phenocopy, and possible contribution of additional variants require human review before any stronger PP1 level.
Sources
PP3 ModerateACMGMet at moderate strength: REVEL 0.919 meets the >=0.773 PP3 threshold but remains below the >=0.932 strong threshold. Details ▾Hide ▴
Reasoning

The variant is a missense substitution, p.(Cys104Arg), so the governing generic rule selects the REVEL path only; SpliceAI and BayesDel are not used for PP3. REVEL is 0.919, meeting the supplied PP3 moderate threshold of >=0.773 but not the strong threshold of >=0.932. The threshold is the ClinGen SVI REVEL calibration of Pejaver et al. 2022 (PMID:36413997).

Rule
PP3: Multiple lines of computational evidence support a deleterious effect on the gene or gene product (conservation, evolutionary, splicing impact, etc.). ... PP3/BP4 take evidence from exactly ONE path, selected by the variant's own consequence type, never from both. ... Missense variant -> REVEL only.
Evidence considered
  • Generic consequence-path rule: p.(Cys104Arg) is missense, therefore REVEL is the sole PP3/BP4 predictor path and SpliceAI is excluded.
  • Local REVEL predictor lookup: REVEL score 0.919 for NM_012452.3:c.310T>C.
  • ClinGen SVI REVEL calibration (Pejaver et al. 2022, PMID:36413997): PP3 moderate threshold >=0.773 and strong threshold >=0.932.
  • BayesDel score 0.52845 was not used because no generic ACMG-strength calibration is established for BayesDel.
Sources
revel
BS4 SupportingACMG_2015Met at supporting: affected and unaffected relatives showed inconsistent C104R phenotype correlation, including an affected CVID child reported without the variant. Details ▾Hide ▴
Reasoning

Non-segregation is documented in familial C104R reports. PMID:22983507 describes affected and unaffected members within the same family and states that C104R did not correlate consistently with clinical phenotype; the literature bundle additionally reports a CVID index child who lacked the variant despite other affected relatives carrying it. This supports lack of segregation in affected family members, but the finding is confounded by incomplete penetrance, variable clinical expression, and the possibility of phenocopy or additional genetic contributors.

Rule
Lack of segregation in affected members of a family.
Evidence considered
  • Clinical variability of family members with the C104R mutation reports four heterozygotes and one homozygote with variable or absent disease manifestations and explicitly states that the variant did not correlate consistently with clinical phenotype.
  • The literature evidence for TACI mutations and disease susceptibility reports a third index child with CVID who did not carry C104R despite the variant being present in two other index children and affected relatives.
Still missing
  • The full genotype and phenotype status of every affected relative in the non-segregating family is not available.
  • Phenocopy, incomplete penetrance, and additional pathogenic variants have not been fully excluded.
Sources

Not met · 10 · evaluated, threshold not reached

PS1 ACMG_2015Not met: reviewed records report Cys104Arg as c.310T>C, with no established pathogenic alternate nucleotide change producing the same amino-acid substitution. Details ▾Hide ▴
Reasoning

The variant is NP_036584.1:p.(Cys104Arg) (C104R), and the reviewed reports describe this same c.310T>C/C104R change. No previously established pathogenic variant producing Cys104Arg through a different nucleotide substitution was identified in the available ClinVar and literature records; therefore the PS1 same-amino-acid criterion is not met.

Rule
Same amino acid change as a previously established pathogenic variant regardless of nucleotide change.
Evidence considered
  • ClinVar variation 5302 exactly matches NM_012452.3(TNFRSF13B):c.310T>C (p.Cys104Arg).
  • Salzer et al. 2005 (PMID:16007087) reports C104R, using the study's coding notation 323T-C, as the Cys104Arg variant; it does not establish a different nucleotide change for the same amino-acid substitution.
  • Reports by family and functional studies (PMIDs 22983507 and 23237420) likewise identify the queried C104R variant rather than a distinct nucleotide substitution producing Cys104Arg.
Sources
PM2 ACMGNot met: non-cancer AF is 0.00335751 and gnomAD v4.1 filtering FAF is 0.0065711, both above the PM2 threshold of 0.0001. Details ▾Hide ▴
Reasoning

PM2 is not met because C104R is substantially more frequent than the generic supporting threshold in both all-comers and non-cancer population data. The lowest relevant total allele frequency is 0.00335751 in gnomAD v2.1 non-cancer data, and the highest filtering FAF is 0.0065711 in gnomAD v4.1; all exceed 0.0001. Homozygotes are also observed (4 in gnomAD v2.1 and 32 in gnomAD v4.1), so the variant is neither absent nor at an extremely low frequency compatible with the supplied PM2 threshold.

Rule
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=0.00347485, 983/282890 alleles, 4 homozygotes; grpmax FAF=0.00508582.
  • gnomAD v2.1 non-cancer exomes: AF=0.00336352, 797/236954 exome alleles, 3 homozygotes; total AF=0.00335751 after the included genome data, with grpmax FAF=0.00494465.
  • gnomAD v4.1 all-comers: AF=0.005441, 8783/1614226 alleles, 32 homozygotes; grpmax FAF=0.0065711.
  • gnomAD v3.1 non-cancer genomes: AF=0.00387911, 574/147972 alleles, 4 homozygotes; grpmax FAF=0.00604868.
Sources
PM5 ACMG_2015Not met: no reviewed record documents a different pathogenic missense substitution at residue Cys104; reported comparators affect other residues. Details ▾Hide ▴
Reasoning

The queried variant changes Cys104 to Arg. The reviewed TNFRSF13B reports describe C104R and other missense variants at different residues, including Y79C, but do not document a different pathogenic missense substitution at residue 104. The required same-residue pathogenic comparator is therefore absent from the reviewed evidence.

Rule
Novel missense change at an amino acid residue where a different missense change determined to be pathogenic has been seen before.
Evidence considered
  • Vallurupalli et al. 2011 (PMID:21419480) reports C104R and other TACI missense variants such as Y79C and L171R, but those are different residues and no alternate residue-104 pathogenic missense change is reported.
  • Salzer et al. 2005 (PMID:16007087), the family study (PMID:22983507), and the B-cell study (PMID:23237420) report C104R itself and do not establish a different pathogenic missense substitution at residue 104.
Sources
PP4 ACMG_2015Not met: C104R occurs in affected and healthy relatives with variable penetrance, so the phenotype is not highly specific for a single genetic etiology. Details ▾Hide ▴
Reasoning

The available phenotype evidence is not highly specific for a disease with a single genetic etiology. C104R is reported in CVID-affected individuals, clinically healthy heterozygotes, and individuals with variable or incomplete phenotypes; TNFRSF13B-related antibody deficiency is also genetically heterogeneous. Therefore the PP4 specificity requirement is not met.

Rule
Patient’s phenotype or family history is highly specific for a disease with a single genetic etiology.
Evidence considered
  • Clinical variability study PMID:22983507: C104R heterozygotes ranged from healthy to mildly symptomatic, the index patient had CVID/SLE, and the authors state the variant did not correlate consistently with phenotype.
  • Seven-family study PMID:23237420: C104R occurred in affected individuals and clinically healthy relatives; one homozygous sibling was clinically unaffected.
  • These observations do not support a highly specific phenotype attributable to a single genetic etiology.
Sources
PP5 ACMG_2015Not met: ClinVar has no exact-variant expert-panel classification, only laboratory submissions with conflicting aggregate labels. Details ▾Hide ▴
Reasoning

ClinVar contains Pathogenic and Likely pathogenic laboratory submissions for the exact variant, but the record reports zero expert-panel submissions and conflicting classifications. Under the specified generic rule, ordinary laboratory submissions and aggregate ClinVar labels do not trigger 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 5302 exact match: Pathogenic and Likely pathogenic laboratory submissions are present, but expert_panels is empty and expert_panel_submissions=0.
  • The ClinVar record is reported as criteria provided, conflicting classifications; laboratory submissions and aggregate labels are excluded by the specified PP5 rule.
Sources
BA1 ACMGNot met: the highest filtering FAF is 0.0065711, well below the BA1 stand-alone threshold of 0.05. Details ▾Hide ▴
Reasoning

BA1 is not met. The applicable filtering allele-frequency values are far below the stand-alone threshold: gnomAD v4.1 grpmax FAF=0.0065711 and gnomAD v2.1 grpmax FAF=0.00508582; the non-cancer subsets are also below threshold (v2.1 exomes grpmax FAF=0.00494465; v3.1 non-cancer genomes grpmax FAF=0.00604868). These are filtering FAF values rather than popmax point estimates, and the relevant observed-allele counts exceed 2000 for the grpmax populations. The maximum observed filtering FAF is 0.0065711, below 0.05.

Rule
Allele frequency is above 5% in Exome Sequencing Project, 1000 Genomes or Exome Aggregation Consortium. ... BA1 (stand-alone): >= 0.05 — ACMG/AMP 2015 stand-alone benign allele frequency (PMID:25741868)
Evidence considered
  • gnomAD v2.1 all-comers: total AF=0.00347485 from 983/282890 alleles; grpmax FAF=0.00508582 in European (non-Finnish), with 129190 observed alleles.
  • gnomAD v4.1 all-comers: total AF=0.005441 from 8783/1614226 alleles; grpmax FAF=0.0065711 in European (non-Finnish), with 1180028 observed alleles.
  • gnomAD v2.1 non-cancer exomes: AF=0.00336352 from 797/236954 alleles; grpmax FAF=0.00494465.
  • gnomAD v3.1 non-cancer genomes: AF=0.00387911 from 574/147972 alleles; grpmax FAF=0.00604868. The HGDP:FRENCH popmax point estimate of 0.0185185 is based on only 54 observed alleles and is not used.
Sources
BS3 ACMG_2015Not met: every variant-specific functional study reviewed showed impaired TACI expression, ligand binding, signaling, B-cell function, or antibody responses rather than normal function. Details ▾Hide ▴
Reasoning

The reviewed variant-specific functional evidence does not show a lack of damaging effect. Instead, independent human-cell, patient-cell, ex vivo, and murine studies consistently demonstrate loss or reduction of TACI expression, ligand binding, signaling, B-cell proliferation, class switching, immunoglobulin production, or antibody responses. No well-established assay showing normal protein function or splicing for C104R was identified.

Rule
Well-established in vitro or in vivo functional studies show no damaging effect on protein function or splicing.
Evidence considered
  • The available variant-specific functional studies consistently reported impaired TACI biology and therefore provide no support for BS3; heterozygous phenotype variability does not constitute evidence of normal protein function.
  • No assay in the reviewed sources demonstrated normal C104R protein function or normal splicing relative to appropriate controls.
Still missing
  • No well-established benign functional assay demonstrating normal TACI protein function or splicing for C104R was identified.
Sources
BP2 ACMG_2015Not met: C104R was observed in trans with S194X, but no cis pathogenic-variant observation exists and the disorder is not a fully penetrant dominant condition. Details ▾Hide ▴
Reasoning

BP2 is not met. The available study documents C104R in trans with S194X in an affected individual, but the governing BP2 trans path requires a pathogenic variant in a fully penetrant dominant gene/disorder; TNFRSF13B-related antibody deficiency is reported with variable penetrance and both recessive and dominant-risk patterns, so that trans observation does not qualify. No observation of C104R in cis with another pathogenic variant was identified. The compound-heterozygous observation therefore supports PM3, not BP2.

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
  • Martinez-Gallo et al. 2013, Table I and Results: C104R/S194X is a compound-heterozygous genotype, not a cis genotype.
  • Martinez-Gallo et al. 2013, Abstract and Discussion: TACI mutation-bearing relatives can be clinically healthy while affected individuals have CVID, documenting variable penetrance rather than a fully penetrant dominant disorder.
  • No cis configuration of C104R with a pathogenic variant was reported in the reviewed family and functional literature.
Sources
BP4 ACMGNot met: REVEL 0.919 exceeds the <=0.29 BP4 supporting threshold, while SpliceAI is excluded for this missense variant. Details ▾Hide ▴
Reasoning

The variant is a missense substitution, p.(Cys104Arg), so the governing generic rule selects the REVEL path only; the SpliceAI max delta of 0.011 cannot be used for BP4. REVEL is 0.919, which exceeds the supplied BP4 supporting threshold of <=0.29, so BP4 is not met. BayesDel is not usable because no generic ACMG-strength calibration is established.

Rule
BP4: Multiple lines of computational evidence suggest no impact on gene or gene product (conservation, evolutionary, splicing impact, etc) ... PP3/BP4 take evidence from exactly ONE path, selected by the variant's own consequence type, never from both. ... Missense variant -> REVEL only.
Evidence considered
  • Generic consequence-path rule: p.(Cys104Arg) is missense, therefore REVEL is the sole PP3/BP4 predictor path; the SpliceAI max delta 0.011 is not evidence for BP4.
  • Local REVEL predictor lookup: REVEL score 0.919 for NM_012452.3:c.310T>C.
  • ClinGen SVI REVEL calibration (Pejaver et al. 2022, PMID:36413997): BP4 supporting threshold <=0.29.
  • BayesDel score 0.52845 was not used because no generic ACMG-strength calibration is established for BayesDel.
Sources
revel
BP6 ACMG_2015Not met: no exact-variant expert-panel benign classification is present; the only Likely benign assertion is a laboratory submission. Details ▾Hide ▴
Reasoning

ClinVar has one Likely benign laboratory submission for the exact variant, but no expert-panel submission and conflicting classifications overall. Under the specified generic rule, this does not qualify for 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 5302 exact match: one Likely benign clinical-laboratory submission is reported, while expert_panels is empty and expert_panel_submissions=0.
  • The record has conflicting classifications, so neither the laboratory assertion nor the aggregate label satisfies the specified BP6 requirement.
Sources

Not assessed · 7 · no assessment recorded

PS2 ACMG_2015Not assessed: no documented proband trio testing confirms both maternity and paternity for this variant. Details ▾Hide ▴
Reasoning

No case-specific evidence documents that NM_012452.3:c.310T>C arose de novo in the proband. The available evidence does not establish both maternity and paternity, does not document a negative family history, and does not provide a trio or parental testing result. Therefore PS2 cannot be assessed.

Rule
De novo (both maternity and paternity confirmed) in a patient with the disease and no family history.
Evidence considered
  • The case evidence identifies TNFRSF13B c.310T>C (p.Cys104Arg) and reports familial heterozygous and homozygous observations, but provides no proband de novo analysis or confirmed maternity/paternity result.
Still missing
  • Proband and parental genotypes with confirmed maternity and paternity are not documented.
  • A relevant negative family history is not documented.
PM1 ACMG_2015Not assessed: Cys104 lies in functional CRD2, but no complete evidence establishes absence of benign variation across that domain. Details ▾Hide ▴
Reasoning

Cys104 is described as a conserved extracellular cysteine forming a disulfide bond with Cys93 and maintaining the second cysteine-rich domain; functional studies show impaired ligand binding and signaling. However, no VCEP domain table applies, and the available evidence does not establish that the complete relevant domain lacks benign variation, which is required for generic PM1.

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
  • Salzer et al. 2005, Results on family B characterization: Cys104 forms a disulfide bond with Cys93 and participates in maintenance of the second cysteine-rich domain of TACI.
  • Vallurupalli et al. 2011, functional-analysis results: C104R is in ligand-binding CRD2; C104R showed approximately half-normal surface expression, complete loss of BAFF binding, and failure to activate NF-kB or NF-AT.
  • CVID cohort and B-cell functional study (PMID:23237420): C104R disrupts the second CRD and impairs BAFF and APRIL binding.
  • gnomAD v4.1 reports the queried C104R allele at AF 0.005441, including 32 homozygotes; this population observation makes the required absence of benign variation across the domain unresolved rather than established.
Still missing
  • A comprehensive assessment of benign variation across the relevant TNFRSF13B cysteine-rich domain is unavailable.
Sources
PM6 ACMG_2015Not assessed: the available reports describe familial transmission, not an assumed de novo proband variant without parental confirmation. Details ▾Hide ▴
Reasoning

No case-specific evidence establishes that the variant was assumed to be de novo in the proband. The literature instead describes inherited familial transmission and unaffected carriers, and no proband parental testing or de novo observation is documented. Therefore PM6 cannot be assessed.

Rule
Assumed de novo, but without confirmation of paternity and maternity.
Evidence considered
  • Clinical variability of family members with the C104R mutation reports a family with four heterozygotes and one homozygote, demonstrating inherited familial occurrence rather than a proband-specific assumed de novo observation.
Still missing
  • A proband-specific assumed de novo observation is not documented.
  • Parental testing and inheritance status for the proband are not documented.
Sources
PP2 ACMG_2015Not assessed: missense disease involvement is documented, but the required gene-level low benign-missense rate is not established; gnomAD AF is 0.005441. Details ▾Hide ▴
Reasoning

The evidence shows that TNFRSF13B has disease-associated missense variants, including C104R, and that C104R is relatively common in population data (gnomAD v4.1 AF 0.005441 with 32 homozygotes). It does not establish the required gene-level low rate of benign missense variation, so PP2 cannot be adjudicated from the supplied evidence.

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
  • TNFRSF13B studies report disease-associated missense variants and functional effects for C104R, including loss of ligand binding and impaired signaling (PMIDs 16007087, 21419480, and 23237420).
  • gnomAD v4.1 reports C104R at AF 0.005441, with 8783/1614226 alleles and 32 homozygotes; this is evidence relevant to benign variation but does not by itself establish the required gene-level missense-variation rate.
Still missing
  • A validated gene-level assessment demonstrating a low rate of benign TNFRSF13B missense variation is unavailable.
Sources
BS1 ACMGNot assessed: filtering FAF is 0.0065711, but variable penetrance and missing prevalence inputs prevent a defensible maximum-credible-frequency comparison. Details ▾Hide ▴
Reasoning

BS1 is not assessed rather than applied from the generic 1% default. The highest filtering FAF is 0.0065711, below 1%, but C104R is a known TNFRSF13B risk-associated allele observed in healthy heterozygotes and in a disorder with incomplete and variable penetrance. A publication reports C104R in approximately 0.5%-1% of reportedly healthy subjects, and another study reports clinically healthy carriers and an unaffected homozygous sibling. A maximum-credible-frequency calculation cannot be completed because disease prevalence, penetrance, allelic heterogeneity, and the fraction of disease attributable to this allele are not quantitatively specified in the case evidence. Therefore the frequency does not establish BS1, and the default alone is insufficient.

Rule
Allele frequency is greater than expected for the disorder. ... BS1 (strong): >= 0.01 — Generic SVI default; per-gene derivation preferred (Whiffin et al. 2017) (PMID:28518168)
Evidence considered
  • gnomAD v4.1 all-comers: grpmax FAF=0.0065711, below the generic 0.01 default; gnomAD v2.1 all-comers grpmax FAF=0.00508582.
  • gnomAD v2.1 non-cancer exomes: grpmax FAF=0.00494465; gnomAD v3.1 non-cancer genomes: grpmax FAF=0.00604868.
  • PMID:21458042, abstract: C104R is reported in 0.5% to 1% of reportedly healthy subjects; this supports reduced or variable penetrance rather than a simple fully penetrant early-onset model.
  • PMID:23237420: C104R occurred in clinically healthy relatives and in one clinically unaffected homozygous sibling, while affected and unaffected carriers showed variable immunologic phenotypes.
Still missing
  • Quantitative disease prevalence, penetrance, allelic heterogeneity, and allele-attributable fraction needed for a maximum-credible-frequency calculation.
Sources
BP1 ACMG_2015Not assessed: TNFRSF13B disease literature includes missense and truncating variants, without evidence that disease is primarily truncation-driven. Details ▾Hide ▴
Reasoning

The supplied literature documents both missense and truncating TNFRSF13B variants and supports disease relevance for missense variation, including C104R. It does not establish that disease in this gene is caused primarily by truncating variants, so the BP1 gene-level premise cannot be confirmed.

Rule
Missense variant in a gene for which primarily truncating variants are known to cause disease.
Evidence considered
  • Salzer et al. 2005 (PMID:16007087) reports disease-associated missense C104R and a truncating S144X variant in TNFRSF13B.
  • The seven-family B-cell study (PMID:23237420) reports missense C104R and truncating S194X in affected families, while the functional variant study (PMID:21419480) evaluates multiple missense variants including C104R, Y79C, and L171R.
  • These records demonstrate a mixed variant spectrum but do not quantify or establish that truncating variants are the primary disease mechanism.
Still missing
  • A gene-level variant-spectrum analysis establishing that TNFRSF13B disease is primarily caused by truncating variants is unavailable.
Sources
BP5 ACMG_2015Not assessed: no case-specific alternate molecular basis is documented for a patient carrying this exact variant. Details ▾Hide ▴
Reasoning

No case-specific evidence establishes that this exact variant was found in a patient with an alternate molecular basis for disease. The available literature describes variable TNFRSF13B phenotypes and functional findings but does not document the required alternate molecular diagnosis for the interpreted case.

Rule
Variant found in a case with an alternate molecular basis for disease.
Evidence considered
  • Reviewed exact-variant clinical and literature evidence; none documents the required alternate molecular basis in the interpreted patient.
Still missing
  • A case report or clinical record documenting the exact variant together with a confirmed alternate molecular diagnosis is needed.
Sources
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_012452.3:c.310T>C in TNFRSF13B is a missense substitution predicted to produce NP_036584.1:p.(Cys104Arg). 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 TNFRSF13B, 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_012452.3:c.310T>C in TNFRSF13B is a missense substitution predicted to produce NP_036584.1:p.(Cys104Arg). 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 TNFRSF13B, 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: C104R has variable penetrance, so homozygotes in gnomAD or one unaffected sibling cannot satisfy the full-penetrance early-age BS2 condition. Details ▾Hide ▴
Reasoning

BS2 is not applicable under its stated generic condition because the TNFRSF13B C104R phenotype is variably penetrant and clinically heterogeneous rather than a disorder for which full penetrance at an early age is established. gnomAD reports homozygotes (v2.1: 4; v4.1: 32), and PMID:23237420 describes an apparently unaffected homozygous sibling, but these observations cannot satisfy a full-penetrance early-age healthy-adult criterion for this disorder.

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 4 homozygotes and gnomAD v4.1 reports 32 homozygotes for C104R, but these datasets do not establish that each carrier is a healthy adult assessed for the relevant phenotype.
  • PMID:23237420: one homozygous sibling was clinically unaffected, while two other homozygous siblings had CVID; the study therefore documents variable clinical expression rather than full early-age penetrance.
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_012452.3:c.310T>C in TNFRSF13B is a missense substitution predicted to produce NP_036584.1:p.(Cys104Arg). 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 TNFRSF13B, 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_012452.3:c.310T>C in TNFRSF13B is a missense substitution predicted to produce NP_036584.1:p.(Cys104Arg). 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 TNFRSF13B, 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
TNFRSF13B
Transcript
NM_012452.3
Coding (HGVS c.)
NM_012452.3:c.310T>C
Protein (HGVS p.)
NP_036584.1:p.(Cys104Arg)
GRCh38
chr17:16948873 A>G
GRCh37
chr17:16852187 A>G
Location and type
Exon 3 · missense
ClinVar
5302, 645207
COSMIC
COSV55430181

Gene diagram

Every interpreted variant in TNFRSF13B, mapped onto the exon structure of NM_012452.3. Select a row to find it on the plot.

TNFRSF13BNM_012452.3
Fetching transcript structure from UCSC…
gnomAD v4.1 8,783 / 1,614,226 alleles AF 0.00544 · 32 homozygotes · FAF 0.00657
gnomAD v2.1 983 / 282,890 alleles AF 0.00347 · 4 homozygotes · FAF 0.00509
gnomAD-Canada v1.0 Allele count data not recorded

By genetic ancestry

gnomAD v4.1

AF 0.0054 · 8783 / 1,614,226 alleles · 32 hom · FAF 0.0066
European (non-Finnish)7900 / 1,180,028 0.006729 hom
Admixed American295 / 60,022 0.00492 hom
Remaining individuals301 / 62,512 0.00481 hom
Ashkenazi Jewish80 / 29,606 0.0027
Middle Eastern13 / 6,062 0.0021
African/African American96 / 75,064 0.0013
European (Finnish)72 / 64,048 0.0011
South Asian26 / 91,086 0.00029
0 alternate alleles recorded in 2 other groups: Amish, East Asian.

gnomAD v2.1

AF 0.0035 · 983 / 282,890 alleles · 4 hom · FAF 0.0051
European (non-Finnish)697 / 129,190 0.00543 hom
Remaining individuals31 / 7,228 0.0043
Admixed American151 / 35,440 0.00431 hom
Ashkenazi Jewish25 / 10,370 0.0024
African/African American42 / 24,970 0.0017
European (Finnish)29 / 25,122 0.0012
South Asian8 / 30,616 0.00026
0 alternate alleles recorded in 1 other group: East Asian.

Statements

gnomAD v4.1

This variant is present in gnomAD v4.1 (AF= 0.005441; MAF= 0.54410%, 8783/1614226 alleles, homozygotes = 32) and has highest observed frequency in the European (non-Finnish) population (AF= 0.00669476; MAF= 0.66948%, 7900/1180028 alleles, homozygotes = 29); grpmax FAF= 0.0065711.

gnomAD v2.1

This variant is present in gnomAD v2.1 (AF= 0.00347485; MAF= 0.34748%, 983/282890 alleles, homozygotes = 4) and has highest observed frequency in the European (non-Finnish) population (AF= 0.00539515; MAF= 0.53952%, 697/129190 alleles, homozygotes = 3); grpmax FAF= 0.00508582.

gnomAD-Canada

Not available in gnomAD-Canada v1.0.

SpliceAI and Pangolin

SpliceAI acceptor lossat +100 bp
0.001
SpliceAI acceptor gainat +110 bp
0.005
SpliceAI donor lossat -417 bp
0.001
SpliceAI donor gainat -135 bp
0.011
Pangolin splice lossmagnitude shown
-0.001
Pangolin splice gain
0.011

Other predictors

REVEL
0.919
BayesDel
0.528

How the predictions were used

PP3 ModerateACMGMet at moderate strength: REVEL 0.919 meets the >=0.773 PP3 threshold but remains below the >=0.932 strong threshold. Details ▾Hide ▴
Reasoning

The variant is a missense substitution, p.(Cys104Arg), so the governing generic rule selects the REVEL path only; SpliceAI and BayesDel are not used for PP3. REVEL is 0.919, meeting the supplied PP3 moderate threshold of >=0.773 but not the strong threshold of >=0.932. The threshold is the ClinGen SVI REVEL calibration of Pejaver et al. 2022 (PMID:36413997).

Rule
PP3: Multiple lines of computational evidence support a deleterious effect on the gene or gene product (conservation, evolutionary, splicing impact, etc.). ... PP3/BP4 take evidence from exactly ONE path, selected by the variant's own consequence type, never from both. ... Missense variant -> REVEL only.
Evidence considered
  • Generic consequence-path rule: p.(Cys104Arg) is missense, therefore REVEL is the sole PP3/BP4 predictor path and SpliceAI is excluded.
  • Local REVEL predictor lookup: REVEL score 0.919 for NM_012452.3:c.310T>C.
  • ClinGen SVI REVEL calibration (Pejaver et al. 2022, PMID:36413997): PP3 moderate threshold >=0.773 and strong threshold >=0.932.
  • BayesDel score 0.52845 was not used because no generic ACMG-strength calibration is established for BayesDel.
Sources
revel
BP4 ACMGNot met: REVEL 0.919 exceeds the <=0.29 BP4 supporting threshold, while SpliceAI is excluded for this missense variant. Details ▾Hide ▴
Reasoning

The variant is a missense substitution, p.(Cys104Arg), so the governing generic rule selects the REVEL path only; the SpliceAI max delta of 0.011 cannot be used for BP4. REVEL is 0.919, which exceeds the supplied BP4 supporting threshold of <=0.29, so BP4 is not met. BayesDel is not usable because no generic ACMG-strength calibration is established.

Rule
BP4: Multiple lines of computational evidence suggest no impact on gene or gene product (conservation, evolutionary, splicing impact, etc) ... PP3/BP4 take evidence from exactly ONE path, selected by the variant's own consequence type, never from both. ... Missense variant -> REVEL only.
Evidence considered
  • Generic consequence-path rule: p.(Cys104Arg) is missense, therefore REVEL is the sole PP3/BP4 predictor path; the SpliceAI max delta 0.011 is not evidence for BP4.
  • Local REVEL predictor lookup: REVEL score 0.919 for NM_012452.3:c.310T>C.
  • ClinGen SVI REVEL calibration (Pejaver et al. 2022, PMID:36413997): BP4 supporting threshold <=0.29.
  • BayesDel score 0.52845 was 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_012452.3:c.310T>C in TNFRSF13B is a missense substitution predicted to produce NP_036584.1:p.(Cys104Arg). 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 TNFRSF13B, 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 = 0.919. BayesDel score = 0.52845.

10 paper records listed. 7 cited in the classification.

Cited in the classification

  • Mutations in TNFRSF13B encoding TACI are associated with common variable immunodeficiency in humans.
    Salzer U et al. · 2005 Aug
    The study reports TNFRSF13B C104R in CVID families and sporadic cases. Cys104 forms a disulfide bond with Cys93 and maintains the second cysteine-rich domain; homozygous C104R showed reduced surface expression, severely compromised APRIL binding, absent APRIL-induced proliferation, and impaired class-switching and IgG production.
    → PS3 · strong Names this variant
    PMID 16007087 ↗
    Source detail
    The mutation in family B affects a conserved cysteine residue (C104R) in the extracellular domain of TACI. Cys104 forms a disulfide bond with Cys93 and participates in the maintenance of the second cysteine-rich domain of TACI21.

    Location Results: family B characterization; Figure 1a-b; Table 1; Figure 2a; Figure 3a-c

    Context Study of 162 unrelated individuals with CVID, including multiplex families and sporadic cases, with EBV-transformed B-cell expression and ligand-binding assays, B-cell proliferation assays, and PBMC class-switch and IgG assays.

  • Dominant-negative effect of the heterozygous C104R TACI mutation in common variable immunodeficiency (CVID).
    Garibyan L et al. · 2007 Jun
    In vitro transfection assays specifically studied TACI C104R and the equivalent murine C76R, demonstrating loss of ligand binding and dominant interference with wild-type TACI signaling.
    → PS3 · strong Names this variant
    PMID 17492055 ↗
    Source detail
    B cells from patients with common variable immunodeficiency (CVID) who are heterozygous for transmembrane activator and CAML interactor (TACI) mutation C104R, which abolishes ligand binding, fail to produce Igs in response to TACI ligand.

    Location Abstract and in vitro transfection assay results

    Context Patient B cells and in vitro transfection assays evaluating human C104R and murine C76R TACI signaling with wild-type TACI comparison.

  • The C104R mutant impairs the function of transmembrane activator and calcium modulator and cyclophilin ligand interactor (TACI) through haploinsufficiency.
    The paper identifies murine TACI C76R as equivalent to human C104R and reports impaired antibody responses, B-cell proliferation, and APRIL-induced IgG1 secretion in transgenic mice expressing the mutant.
    → PS3 · strong Names this variant
    PMID 20889194 ↗
    Source detail
    The murine TACI mutant C76R is the equivalent of the human TACI mutant C104R.

    Location Abstract; Results sections on TNP-Ficoll responses and APRIL-induced proliferation and immunoglobulin production; Discussion

    Context Murine transgenic TACI C76R expression on a TACI-heterozygous background; in vivo immunization and ex vivo APRIL-induced B-cell assays.

  • Functional analysis of transmembrane activator and calcium-modulating cyclophilin ligand interactor (TACI) mutations associated with common variable immunodeficiency.
    The functional study evaluates TNFRSF13B/TACI C104R and other missense variants. C104R is in ligand-binding CRD2, has approximately half-normal surface expression, loses BAFF binding, and fails to activate NF-kB or NF-AT; the other reported missense variants are at different residues.
    → PS3 · strong Names this variant
    PMID 21419480 ↗
    Source detail
    The most common TACI variants in CVID are C104R, in the ligand binding cysteine-rich domain 2 (CRD2), and A181E, in the transmembrane (TM) domain of TACI. ... Surface expression of the CRD2 mutants Y79C and C104R was modestly decreased to ~ half of WT, while that of the L171R mutant was reduced ~8 fold.

    Location Results, paragraphs describing Figure 1B-C and Figure 2A-C; discussion of the C76R murine equivalent

    Context 293T transfectant assays of surface expression, BAFF binding, APRIL-induced NF-kB and NF-AT reporter activity, and co-transfection testing for dominant-negative effects.

  • The C76R transmembrane activator and calcium modulator cyclophilin ligand interactor mutation disrupts antibody production and B-cell homeostasis in heterozygous and homozygous mice.
    Human C104R assays showed diminished expression and ligand binding, nearly abolished NF-kB activation, and approximately half-normal signaling at a 1:1 mutant:wild-type ratio; knock-in mice carrying equivalent C76R showed reduced surface TACI and impaired antibody responses.
    → PS3 · strong Names this variant
    PMID 21458042 ↗
    Source detail
    A knock-in mouse with the equivalent mutation murine TACI (mTACI) C76R was generated as a physiologically relevant model of human disease.

    Location Abstract, Background and Methods; Results sections on NF-kB activation and C76R knock-in mice

    Context Human TACI expression, ligand-binding, and NF-kB assays plus C57BL/6 knock-in mice with murine C76R studied in heterozygous and homozygous states.

  • Clinical variability of family members with the C104R mutation in transmembrane activator and calcium modulator and cyclophilin ligand interactor (TACI).
    The family study identifies TNFRSF13B c.310T>C as p.C104R and reports variable clinical findings among heterozygotes and a homozygote. It describes disruption of the cysteine disulfide bridge and loss of BAFF and APRIL binding, but does not report a different pathogenic missense substitution at residue 104.
    → PP1 · supporting → BS4 · supporting Names this variant
    PMID 22983507 ↗
    Source detail
    A 310T→C nucleotide substitution in the TNFRSF13B gene leads to C104R (cysteine 104→arginine) mutation in the transmembrane activator and calcium-modulator cyclophilin and ligand interactor (TACI) protein [5].

    Location Introduction, paragraph describing the TNFRSF13B nucleotide substitution and C104R; Results, Molecular Studies and Flow Cytometry Analysis; Discussion

    Context Family segregation study of seven related individuals with exon 3 sequencing, flow-cytometric TACI expression, immunoglobulin measurements, vaccine-response testing, and lymphocyte proliferation assays.

  • TACI mutations and impaired B-cell function in subjects with CVID and healthy heterozygotes.
    The study explicitly describes C104R as an extracellular mutation disrupting the second cysteine-rich domain and impairing BAFF and APRIL binding. C104R occurred in affected individuals and healthy relatives, including heterozygous and homozygous states, with variable clinical and functional consequences.
    → PS3 · strong → PM3 Names this variant
    PMID 23237420 ↗
    Source detail
    The extracellular mutation (C104R) leads to a disruption of the second CRD, impairing BAFF and APRIL binding.

    Location Introduction, p. 469; Table I, Families D, E, and F; Results, 'Heterozygous and homozygous mutations impair APRIL binding'

    Context Seven-family study of CVID patients, mutation-bearing relatives, and healthy controls using EBV-transformed B-cell lines and peripheral blood B cells, ligand-binding assays, TLR9 activation, AID mRNA quantification, and APRIL-induced immunoglobulin production assays.

Other recorded publications

  • Relevance of biallelic versus monoallelic TNFRSF13B mutations in distinguishing disease-causing from risk-increasing TNFRSF13B variants in antibody deficiency syndromes.
    Salzer U et al. · 2009
    No paper-specific finding is recorded.
    PMID 18981294 ↗
  • Specific guidelines for assessing and improving the methodological quality of economic evaluations of newborn screening.
    No paper-specific finding is recorded.
    PMID 22947299 ↗
  • ACOG Committee Opinion No. 778 Summary: Newborn Screening and the Role of the Obstetrician-Gynecologist.
    No paper-specific finding is recorded.
    PMID 31022120 ↗

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= 0.005441; MAF= 0.54410%, 8783/1614226 alleles, homozygotes = 32) and has highest observed frequency in the European (non-Finnish) population (AF= 0.00669476; MAF= 0.66948%, 7900/1180028 alleles, homozygotes = 29); grpmax FAF= 0.0065711.

gnomAD v2.1

This variant is present in gnomAD v2.1 (AF= 0.00347485; MAF= 0.34748%, 983/282890 alleles, homozygotes = 4) and has highest observed frequency in the European (non-Finnish) population (AF= 0.00539515; MAF= 0.53952%, 697/129190 alleles, homozygotes = 3); grpmax FAF= 0.00508582.

gnomAD-Canada

Not available in gnomAD-Canada v1.0.

ClinVar

This variant has been reported in ClinVar as Pathogenic (23 clinical laboratories) and as Likely pathogenic (21 clinical laboratories) and as Uncertain significance (5 clinical laboratories) and as Likely benign (1 clinical laboratory) and as risk factor (1 clinical laboratory). (ClinVarID = 5302)

In silico

SpliceAI predicts no significant splice impact for this variant (max delta score = 0.01). REVEL score = 0.919. BayesDel score = 0.52845.

Somatic

This variant does not lie in a statistically significant hotspot. This variant has previously been reported in somatic cancers (COSMIC; COSV55430181, n = 2 times).

Cancer Hotspots

This variant does not lie in a statistically significant hotspot.