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NM_000018.4(ACADVL):c.1153C>T (p.Arg385Trp) AND Very long chain acyl-CoA dehydrogenase deficiency

Germline classification:
Conflicting interpretations of pathogenicity (8 submissions)
Last evaluated:
Mar 19, 2024
Review status:
criteria provided, conflicting classifications
Somatic classification
of clinical impact:
None
Review status:
(0/4) 0 stars out of maximum of 4 stars
no assertion criteria provided
Somatic classification
of oncogenicity:
None
Review status:
(0/4) 0 stars out of maximum of 4 stars
no assertion criteria provided
Record status:
current
Accession:
RCV000668844.23

Allele description [Variation Report for NM_000018.4(ACADVL):c.1153C>T (p.Arg385Trp)]

NM_000018.4(ACADVL):c.1153C>T (p.Arg385Trp)

Gene:
ACADVL:acyl-CoA dehydrogenase very long chain [Gene - OMIM - HGNC]
Variant type:
single nucleotide variant
Cytogenetic location:
17p13.1
Genomic location:
Preferred name:
NM_000018.4(ACADVL):c.1153C>T (p.Arg385Trp)
HGVS:
  • NC_000017.11:g.7223208C>T
  • NG_007975.1:g.8375C>T
  • NG_008391.2:g.1843G>A
  • NM_000018.4:c.1153C>TMANE SELECT
  • NM_001033859.3:c.1087C>T
  • NM_001270447.2:c.1222C>T
  • NM_001270448.2:c.925C>T
  • NP_000009.1:p.Arg385Trp
  • NP_001029031.1:p.Arg363Trp
  • NP_001257376.1:p.Arg408Trp
  • NP_001257377.1:p.Arg309Trp
  • NC_000017.10:g.7126527C>T
  • NM_000018.2:c.1153C>T
  • NM_000018.3:c.1153C>T
Protein change:
R309W
Links:
dbSNP: rs745832866
NCBI 1000 Genomes Browser:
rs745832866
Molecular consequence:
  • NM_000018.4:c.1153C>T - missense variant - [Sequence Ontology: SO:0001583]
  • NM_001033859.3:c.1087C>T - missense variant - [Sequence Ontology: SO:0001583]
  • NM_001270447.2:c.1222C>T - missense variant - [Sequence Ontology: SO:0001583]
  • NM_001270448.2:c.925C>T - missense variant - [Sequence Ontology: SO:0001583]

Condition(s)

Name:
Very long chain acyl-CoA dehydrogenase deficiency (ACADVLD)
Synonyms:
VLCAD deficiency
Identifiers:
MONDO: MONDO:0008723; MedGen: C3887523; Orphanet: 26793; OMIM: 201475

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Assertion and evidence details

Submission AccessionSubmitterReview Status
(Assertion method)
Clinical Significance
(Last evaluated)
OriginMethodCitations
SCV000793516Counsyl
criteria provided, single submitter

(Counsyl Autosomal Recessive and X-Linked Classification Criteria (2018))
Uncertain significance
(Aug 18, 2017)
unknownclinical testing

PubMed (3)
[See all records that cite these PMIDs]

Citation Link,

SCV000915778Illumina Laboratory Services, Illumina
criteria provided, single submitter

(ICSL Variant Classification Criteria 09 May 2019)
Likely pathogenic
(Nov 20, 2018)
germlineclinical testing

PubMed (4)
[See all records that cite these PMIDs]

Citation Link,

SCV001156591ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories
criteria provided, single submitter

(ARUP Molecular Germline Variant Investigation Process)
Likely pathogenic
(Jul 22, 2019)
germlineclinical testing

Citation Link,

SCV001364916Wong Mito Lab, Molecular and Human Genetics, Baylor College of Medicine
criteria provided, single submitter

(ACMG Guidelines, 2015)
Pathogenic
(Nov 1, 2019)
germlineclinical testing

PubMed (2)
[See all records that cite these PMIDs]

SCV001459250Natera, Inc.
no assertion criteria provided
Likely pathogenic
(Sep 16, 2020)
germlineclinical testing

SCV002050776Women's Health and Genetics/Laboratory Corporation of America, LabCorp
criteria provided, single submitter

(LabCorp Variant Classification Summary - May 2015)
Pathogenic
(Dec 6, 2021)
germlineclinical testing

PubMed (4)
[See all records that cite these PMIDs]

Citation Link,

SCV002164258Labcorp Genetics (formerly Invitae), Labcorp
criteria provided, single submitter

(Invitae Variant Classification Sherloc (09022015))
Pathogenic
(Dec 27, 2023)
germlineclinical testing

PubMed (6)
[See all records that cite these PMIDs]

SCV004214029Baylor Genetics
criteria provided, single submitter

(ACMG Guidelines, 2015)
Pathogenic
(Mar 19, 2024)
unknownclinical testing

PubMed (1)
[See all records that cite this PMID]

Summary from all submissions

EthnicityOriginAffectedIndividualsFamiliesChromosomes testedNumber TestedFamily historyMethod
not providedgermlineunknownnot providednot providednot providednot providednot providedclinical testing
not providedunknownunknownnot providednot providednot providednot providednot providedclinical testing

Citations

PubMed

Recurrent ACADVL molecular findings in individuals with a positive newborn screen for very long chain acyl-coA dehydrogenase (VLCAD) deficiency in the United States.

Miller MJ, Burrage LC, Gibson JB, Strenk ME, Lose EJ, Bick DP, Elsea SH, Sutton VR, Sun Q, Graham BH, Craigen WJ, Zhang VW, Wong LJ.

Mol Genet Metab. 2015 Nov;116(3):139-45. doi: 10.1016/j.ymgme.2015.08.011. Epub 2015 Sep 2.

PubMed [citation]
PMID:
26385305
PMCID:
PMC4790081

VLCAD deficiency: pitfalls in newborn screening and confirmation of diagnosis by mutation analysis.

Boneh A, Andresen BS, Gregersen N, Ibrahim M, Tzanakos N, Peters H, Yaplito-Lee J, Pitt JJ.

Mol Genet Metab. 2006 Jun;88(2):166-70. Epub 2006 Feb 20.

PubMed [citation]
PMID:
16488171
See all PubMed Citations (11)

Details of each submission

From Counsyl, SCV000793516.1

#EthnicityIndividualsChromosomes TestedFamily HistoryMethodCitations
1not providednot providednot providednot providedclinical testing PubMed (3)
#SampleMethodObservation
OriginAffectedNumber testedTissuePurposeMethodIndividualsAllele frequencyFamiliesCo-occurrences
1unknownunknownnot providednot providednot providednot providednot providednot providednot provided

From Illumina Laboratory Services, Illumina, SCV000915778.1

#EthnicityIndividualsChromosomes TestedFamily HistoryMethodCitations
1not providednot providednot providednot providedclinical testing PubMed (4)

Description

The ACADVL c.1156C>T (p.Arg385Trp) is a missense variant that has been reported in at least five studies and found in at least five individuals with VLCAD deficiency, including a sibling pair, in a compound heterozygous state with a unique missense variant in each case (Boneh et al. 2006; Wasibren et al. 2013; Yamamoto et al. 2015; Evans et al. 2016; Merinero et al. 2017). This variant was inherited from the unaffected mother in a heterozygous state (Merinero et al. 2017) and is reported at a frequency of 0.000208 in the Latino population of the Genome Aggregation Database. Based on the collective evidence, the p.Arg386Cys variant is classified as likely pathogenic for VLCAD deficiency. This variant was observed by ICSL as part of a predisposition screen in an ostensibly healthy population.

#SampleMethodObservation
OriginAffectedNumber testedTissuePurposeMethodIndividualsAllele frequencyFamiliesCo-occurrences
1germlineunknownnot providednot providednot providednot providednot providednot providednot provided

From ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories, SCV001156591.2

#EthnicityIndividualsChromosomes TestedFamily HistoryMethodCitations
1not providednot providednot providednot providedclinical testingnot provided

Description

The ACADVL c.1153C>T; p.Arg385Trp variant (rs745832866), also reported as Arg345Trp, has been described in multiple individuals in association with very long-chain acyl-CoA dehydrogenase deficiency (VLCADD; Boneh 2006, Merinero 2018, Ohashi 2004, Yamamoto 2015). It contains an entry in ClinVar (Variation ID: 193786), and is observed at a low overall frequency of 0.004% (10/251484 alleles) in the Genome Aggregation Database. The arginine at codon 385 is moderately conserved, and computational algorithms (PolyPhen-2, SIFT) predict that this variant is deleterious. Additionally, recombinant ACADVL protein harboring the p.Arg385Trp substitution showed a reduction in enzyme activity comparted to wildtype (Ohashi 2004). Based on available information, this variant is considered likely pathogenic. REFERENCES Boneh et al. VLCAD deficiency: pitfalls in newborn screening and confirmation of diagnosis by mutation analysis. Mol. Genet. Metab. 2006; 88(2): 166-170. Merinero B et al. Four Years' Experience in the Diagnosis of Very Long-Chain Acyl-CoA Dehydrogenase Deficiency in Infants Detected in Three Spanish Newborn Screening Centers. JIMD Rep. 2018;39:63-74. Ohashi et al. A new diagnostic test for VLCAD deficiency using immunohistochemistry. Neurology. 2004; 62(12): 2209-2213. Yamamoto H et al. Successful management of pregnancy with very-long-chain acyl-coenzyme A dehydrogenase deficiency. J Obstet Gynaecol Res. 2015 Jul;41(7):1126-8.

#SampleMethodObservation
OriginAffectedNumber testedTissuePurposeMethodIndividualsAllele frequencyFamiliesCo-occurrences
1germlineunknownnot providednot providednot providednot providednot providednot providednot provided

From Wong Mito Lab, Molecular and Human Genetics, Baylor College of Medicine, SCV001364916.2

#EthnicityIndividualsChromosomes TestedFamily HistoryMethodCitations
1not providednot providednot providednot providedclinical testing PubMed (2)

Description

The NM_000018.3:c.1153C>T (NP_000009.1:p.Arg385Trp) [GRCH38: NC_000017.11:g.7223208C>T] variant in ACADVL gene is interpretated to be Pathogenic based on ACMG guidelines (PMID: 25741868). This variant has been reported in PMID: 15210884. This variant meets the following evidence codes reported in the ACMG guidelines: PS1, PS3

#SampleMethodObservation
OriginAffectedNumber testedTissuePurposeMethodIndividualsAllele frequencyFamiliesCo-occurrences
1germlineunknownnot providednot providednot providednot providednot providednot providednot provided

From Natera, Inc., SCV001459250.1

#EthnicityIndividualsChromosomes TestedFamily HistoryMethodCitations
1not providednot providednot providednot providedclinical testingnot provided
#SampleMethodObservation
OriginAffectedNumber testedTissuePurposeMethodIndividualsAllele frequencyFamiliesCo-occurrences
1germlineunknownnot providednot providednot providednot providednot providednot providednot provided

From Women's Health and Genetics/Laboratory Corporation of America, LabCorp, SCV002050776.1

#EthnicityIndividualsChromosomes TestedFamily HistoryMethodCitations
1not providednot providednot providednot providedclinical testing PubMed (4)

Description

Variant summary: ACADVL c.1153C>T (p.Arg385Trp) results in a non-conservative amino acid change located in the Acyl-CoA dehydrogenase/oxidase C-terminal domain (IPR009075) of the encoded protein sequence. Five of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 4e-05 in 251484 control chromosomes. This frequency is not significantly higher than expected for a pathogenic variant in ACADVL causing Very Long Chain Acyl-CoA Dehydrogenase Deficiency (4e-05 vs 0.0029), allowing no conclusion about variant significance. c.1153C>T has been reported in the literature as a compound heterozygous genotype in individuals affected with Very Long Chain Acyl-CoA Dehydrogenase Deficiency (example Ohashi_2004, Merinero_2018, Musumeci_2020, Chen_2020). These data indicate that the variant is likely to be associated with disease. At least one publication reports experimental evidence evaluating an impact on protein function (Ohashi_2004, Chen_2020). The most pronounced variant effect results in a reduction in enzyme activity compared to wild type. Consistently, another recent study utilized this variant as a positive control to demonstrate a barely detectable level of fatty acid oxidation (FAO) activity as determined by overexpression of the recombinant HAtagged mutant proteins in HEK293T cell lines (Chen_2020). Seven clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 without evidence for independent evaluation. Multiple laboratories reported the variant with conflicting assessments (likely pathogenic/pathogenic, n=4; VUS, n=3). Based on the evidence outlined above, the variant was classified as pathogenic.

#SampleMethodObservation
OriginAffectedNumber testedTissuePurposeMethodIndividualsAllele frequencyFamiliesCo-occurrences
1germlineunknownnot providednot providednot providednot providednot providednot providednot provided

From Labcorp Genetics (formerly Invitae), Labcorp, SCV002164258.3

#EthnicityIndividualsChromosomes TestedFamily HistoryMethodCitations
1not providednot providednot providednot providedclinical testing PubMed (6)

Description

This sequence change replaces arginine, which is basic and polar, with tryptophan, which is neutral and slightly polar, at codon 385 of the ACADVL protein (p.Arg385Trp). This variant is present in population databases (rs745832866, gnomAD 0.02%). This missense change has been observed in individual(s) with very long-chain acyl-CoA dehydrogenase deficiency (PMID: 23798014, 25655073, 28755359, 32655480). This variant is also known as R345W. ClinVar contains an entry for this variant (Variation ID: 193786). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is expected to disrupt ACADVL protein function with a positive predictive value of 95%. Experimental studies have shown that this missense change affects ACADVL function (PMID: 15210884). For these reasons, this variant has been classified as Pathogenic.

#SampleMethodObservation
OriginAffectedNumber testedTissuePurposeMethodIndividualsAllele frequencyFamiliesCo-occurrences
1germlineunknownnot providednot providednot providednot providednot providednot providednot provided

From Baylor Genetics, SCV004214029.2

#EthnicityIndividualsChromosomes TestedFamily HistoryMethodCitations
1not providednot providednot providednot providedclinical testing PubMed (1)
#SampleMethodObservation
OriginAffectedNumber testedTissuePurposeMethodIndividualsAllele frequencyFamiliesCo-occurrences
1unknownunknownnot providednot providednot providednot providednot providednot providednot provided

Last Updated: Oct 13, 2024