Submissions for variant NM_000527.5(LDLR):c.665G>A (p.Cys222Tyr)

dbSNP: rs730882086

Total submissions: 4

Submitter	RCV	SCV	Clinical significance	Condition	Last evaluated	Review status	Method	Comment
LDLR-LOVD, British Heart Foundation	RCV000238340	SCV000294870	likely pathogenic	Hypercholesterolemia, familial, 1	2016-03-25	criteria provided, single submitter	literature only
Fundacion Hipercolesterolemia Familiar	RCV000238340	SCV000607484	likely pathogenic	Hypercholesterolemia, familial, 1	2016-03-01	criteria provided, single submitter	research
Ambry Genetics	RCV002362855	SCV002663276	pathogenic	Cardiovascular phenotype	2021-03-19	criteria provided, single submitter	clinical testing	The p.C222Y pathogenic mutation (also known as c.665G>A), located in coding exon 4 of the LDLR gene, results from a G to A substitution at nucleotide position 665. The cysteine at codon 222, is replaced by tyrosine, an amino acid with highly dissimilar properties. This alteration impacts a residue in the conserved cluster of acidic amino acids at the C-terminal end of LDLR class A repeat 5 (Jeon H and Blacklow C. Annu. Rev. Biochem. 2005;74:535-62). Pathogenic LDLR mutations that result in the substitution or generation of cysteine residues within the cysteine-rich LDLR class A repeats and EGF-like domains are common in familial hypercholesterolemia (FH) (Villéger L. Hum Mutat. 2002;20(2):81-7). This alteration (also referred to as p.C201Y) has been reported in patients from several FH and myocardial infarction cohorts (Koivisto UM et al. Am J Hum Genet, 1995 Oct;57:789-97; Bertolini S et al. Arterioscler Thromb Vasc Biol, 2000 Sep;20:E41-52; Alonso R et al. Clin Biochem, 2009 Jun;42:899-903; Chmara M et al. J Appl Genet, 2010;51:95-106; Thormaehlen AS et al. PLoS Genet, 2015 Feb;11:e1004855; Do R et al. Nature, 2015 Feb;518:102-6). In in vitro assays from one group, this variant was indicated to disrupt protein function (Thormaehlen AS et al. PLoS Genet, 2015 Feb;11:e1004855). Internal structural analysis indicates this alteration eliminates a disulfide bond critical for the structural integrity of (the) LDLR class A repeat 5 (Ambry internal data). Another variant affecting this codon (p.C222R, c.664T>C) has also been reported in association with FH (Damgaard D et al. Atherosclerosis. 2005;180:155-60). The p.C222Y allele was reported in one heterozygous individual in population-based cohorts in the Genome Aggregation Database (gnomAD). This amino acid position is highly conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. Based on the supporting evidence, this alteration is interpreted as a disease-causing mutation.
Dept. of Genetics and Pharmacogenomics, Merck Research Labs	RCV000161963	SCV000189538	not provided	not provided		no assertion provided	in vitro