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Version: 3.16

ClinGen

Overview

ClinGen is a National Institutes of Health (NIH)-funded resource dedicated to building a central resource that defines the clinical relevance of genes and variants for use in precision medicine and research.

Publication

Heidi L. Rehm, Ph.D., Jonathan S. Berg, M.D., Ph.D., Lisa D. Brooks, Ph.D., Carlos D. Bustamante, Ph.D., James P. Evans, M.D., Ph.D., Melissa J. Landrum, Ph.D., David H. Ledbetter, Ph.D., Donna R. Maglott, Ph.D., Christa Lese Martin, Ph.D., Robert L. Nussbaum, M.D., Sharon E. Plon, M.D., Ph.D., Erin M. Ramos, Ph.D., Stephen T. Sherry, Ph.D., and Michael S. Watson, Ph.D., for ClinGen. ClinGen The Clinical Genome Resource. N Engl J Med 2015; 372:2235-2242 June 4, 2015 DOI: 10.1056/NEJMsr1406261.

ISCA Regions

TSV Extraction

ClinGen contains only copy number variation variants, since the coordinates in ClinGen original file follow the same rule as BED format, the coordinates had to be adjusted to [BEGIN+1, END].

#bin    chrom   chromStart      chromEnd        name    score   strand  thickStart      thickEnd        attrCount       attrTags        attrVals
nsv530705 1 564405 8597804 0 1 copy_number_loss pathogenic False Developmental delay AND/OR other significant developmental or morphological phenotypes
nsv530706 1 564424 3262790 0 1 copy_number_loss pathogenic False Abnormal facial shape,Abnormality of cardiac morphology,Global developmental delay,Muscular hypotonia HP:0001252,HP:0001263,HP:0001627,HP:0001999,MedGen:CN001147,MedGen:CN001157,MedGen:CN001482,MedGen:CN001810
nsv530707 1 564424 7068738 0 1 copy_number_loss pathogenic False Abnormality of cardiac morphology,Cleft upper lip,Failure to thrive,Global developmental delay,Intrauterine growth retardation,Microcephaly,Short stature HP:0000204,HP:0000252,HP:0001263,HP:0001508,HP:0001511,HP:0001627,HP:0004322,MedGen:C0349588,MedGen:C1845868,MedGen:C1853481,MedGen:C2364119,MedGen:CN000197,MedGen:CN001157,MedGen:CN001482
nsv533512 1 564435 649748 0 1 copy_number_loss benign False Developmental delay AND/OR other significant developmental or morphological phenotypes
nsv931338 1 714078 4958499 0 1 copy_number_loss pathogenic False Developmental delay AND/OR other significant developmental or morphological phenotypes
nsv530300 1 728138 5066371 1 0 copy_number_gain pathogenic False Abnormality of cardiac morphology,Cleft palate,Global developmental delay HP:0000175,HP:0001263,HP:0001627,MedGen:C2240378,MedGen:CN001157,MedGen:CN001482

Status levels

  • benign
  • curated benign
  • curated pathogenic
  • likely benign
  • likely pathogenic
  • path gain
  • path loss
  • pathogenic
  • uncertain

Parsing

We parse the ClinGen tsv file and extract the following:

  • chrom
  • chromStart (note this a 0-based coordinate)
  • chromEnd
  • attrTags
  • attrVals

attrTags and attrVals are comma separated lists. attrTags contains the field keys and attrVals contains the field values. We will parse the following keys from the two fields:

  • parent (this will be used as the ID in our JSON output)
  • clinical_int
  • validated
  • phenotype (this should be a string array)
  • phenotype_id (this should be a string array)

Observed losses and observed gains will be calculated from entries that share a common parent ID.

  • variants with a common parent ID and same coordinates are grouped
    • calculated observed losses, observed gains for each group
    • Clinical significance and validation status are collapsed using the priority strategy described below
  • Variants with the same parent ID can have different coordinates (mapped to hg38)
    • nsv491508 : chr14:105583663-106881350 and chr14:105605043-106766076 (only one example)
    • we kept both variants

Conflict Resolution

Clinical significance priority

When there are a mixture of variants belonging to the same parent ID, we will choose the most pathogenic clinical significance from the available values. i.e. if 3 samples were deemed pathogenic and 2 samples were likely pathogenic, we would list the variant as pathogenic.

Priority (high to low)

  • Priority
  • Pathogenic
  • Likely pathogenic
  • Benign
  • Likely benign
  • Uncertain significance

Validation Priority

When there are a mixture of variants belonging to same parent ID, we will set the validation status to true if any of the variants were validated.

Download URL

https://cirm.ucsc.edu/cgi-bin/hgTrackUi?db=hg19&g=iscaComposite

JSON Output

"clingen":[
{
"chromosome":"17",
"begin":525,
"end":14667519,
"variantType":"copy_number_gain",
"id":"nsv996083",
"clinicalInterpretation":"pathogenic",
"observedGains":1,
"validated":true,
"phenotypes":[
"Intrauterine growth retardation"
],
"phenotypeIds":[
"HP:0001511",
"MedGen:C1853481"
],
"reciprocalOverlap":0.00131
},
{
"chromosome":"17",
"begin":45835,
"end":7600330,
"variantType":"copy_number_loss",
"id":"nsv869419",
"clinicalInterpretation":"pathogenic",
"observedLosses":1,
"validated":true,
"phenotypes":[
"Developmental delay AND/OR other significant developmental or morphological phenotypes"
],
"reciprocalOverlap":0.00254
}
]
FieldTypeNotes
clingenobject array
chromosomestringEnsembl-style chromosome names
begininteger1-based position
endinteger1-based position
variantTypestringAny of the sequence alterations defined here.
idstringIdentifier from the data source. Alternatively a VID
clinicalInterpretationstringsee possible values below
observedGainsintegerRange: 0 - (231 - 1). Only used if copy_number_variation, copy_number_loss, or copy_number_gain.
observedLossesintegerRange: 0 - (231 - 1). Only used if copy_number_variation, copy_number_loss, or copy_number_gain.
validatedboolean
phenotypesstring arrayDescription of the phenotype.
phenotypeIdsstring arrayDescription of the phenotype IDs.
reciprocalOverlapfloating pointRange: 0 - 1. E.g. 0.57 would indicate a 57% reciprocal overlap. Specified up to 5 decimal places (Not reported for Insertions).

clinicalInterpretation

  • benign
  • curated benign
  • curated pathogenic
  • likely benign
  • likely pathogenic
  • path gain
  • path loss
  • pathogenic
  • uncertain

Dosage Sensitivity Map

The Clinical Genome Resource (ClinGen) consortium is curating genes and regions of the genome to assess whether there is evidence to support that these genes/regions are dosage sensitive and should be targeted on a cytogenomic array. Nirvana reports these annotations for overlapping SVs.

Publication

Riggs ER, Nelson T, Merz A, Ackley T, Bunke B, Collins CD, Collinson MN, Fan YS, Goodenberger ML, Golden DM, Haglund-Hazy L, Krgovic D, Lamb AN, Lewis Z, Li G, Liu Y, Meck J, Neufeld-Kaiser W, Runke CK, Sanmann JN, Stavropoulos DJ, Strong E, Su M, Tayeh MK, Kokalj Vokac N, Thorland EC, Andersen E, Martin CL. Copy number variant discrepancy resolution using the ClinGen dosage sensitivity map results in updated clinical interpretations in ClinVar. Hum Mutat. 2018 Nov;39(11):1650-1659. doi: 10.1002/humu.23610. PMID: 30095202; PMCID: PMC7374944.

TSV Source files

Regions

#ClinGen Region Curation Results
#07 May,2019
#Genomic Locations are reported on GRCh38 (hg38): GCF_000001405.36
#https://www.ncbi.nlm.nih.gov/projects/dbvar/clingen
#to create link: https://www.ncbi.nlm.nih.gov/projects/dbvar/clingen/clingen_region.cgi?id=key
#ISCA ID ISCA Region Name cytoBand Genomic Location Haploinsufficiency Score Haploinsufficiency Description Haploinsufficiency PMID1 Haploinsufficiency PMID2 Haploinsufficiency PMID3 Triplosensitivity Score Triplosensitivity Description Triplosensitivity PMID1 Triplosensitivity PMID2 Triplosensitivity PMID3 Date Last Evaluated Loss phenotype OMIM ID Triplosensitive phenotype OMIM ID
ISCA-46299 Xp11.22 region (includes HUWE1) Xp11.22 tbd 0 No evidence available 3 Sufficient evidence for dosage pathogenicity 22840365 20655035 26692240 2018-11-19
ISCA-46295 15q13.3 recurrent region (D-CHRNA7 to BP5) (includes CHRNA7 and OTUD7A) 15q13.3 chr15:31727418-32153204 3 Sufficient evidence for dosage pathogenicity 19898479 20236110 22775350 40 Dosage sensitivity unlikely 26968334 22420048 2018-05-10
ISCA-46291 7q11.23 recurrent distal region (includes HIP1, YWHAG) 7q11.23 chr7:75528718-76433859 2 Some evidence for dosage pathogenicity 21109226 16971481 1 Little evidence for dosage pathogenicity 21109226 27867344 2018-12-31
ISCA-46290 Xp11.22p11.23 recurrent region (includes SHROOM4) Xp11.22-p11.23 chrX: 48447780-52444264 0 No evidence available 3 Sufficient evidence for dosage pathogenicity 19716111 21418194 25425167 2017-12-14 300801

Genes

#ClinGen Gene Curation Results
#24 May,2019
#Genomic Locations are reported on GRCh37 (hg19): GCF_000001405.13
#https://www.ncbi.nlm.nih.gov/projects/dbvar/clingen
#to create link: https://www.ncbi.nlm.nih.gov/projects/dbvar/clingen/clingen_gene.cgi?sym=Gene Symbol
#Gene Symbol Gene ID cytoBand Genomic Location Haploinsufficiency Score Haploinsufficiency Description Haploinsufficiency PMID1 Haploinsufficiency PMID2 Haploinsufficiency PMID3 Triplosensitivity Score Triplosensitivity Description Triplosensitivity PMID1 Triplosensitivity PMID2 Triplosensitivity PMID3 Date Last Evaluated Loss phenotype OMIM ID Triplosensitive phenotype OMIM ID
A4GALT 53947 22q13.2 chr22:43088121-43117307 30 Gene associated with autosomal recessive phenotype 0 No evidence available 2014-12-11 111400
AAGAB 79719 15q23 chr15:67493013-67547536 3 Sufficient evidence for dosage pathogenicity 23064416 23000146 0 No evidence available 2013-02-28 148600

Dosage Rating System

RatingPossible Clinical Interpretation
0No evidence to suggest that dosage sensitivity is associated with clinical phenotype
1Little evidence suggesting dosage sensitivity is associated with clinical phenotype
2Emerging evidence suggesting dosage sensitivity is associated with clinical phenotype
3Sufficient evidence suggesting dosage sensitivity is associated with clinical phenotype
30Gene associated with autosomal recessive phenotype
40Dosage sensitivity unlikely

Reference: https://www.ncbi.nlm.nih.gov/projects/dbvar/clingen/help.shtml

Download URL

ftp://ftp.clinicalgenome.org/

JSON Output

"clingenDosageSensitivityMap": [{
"chromosome": "15",
"begin": 30900686,
"end": 32153204,
"haploinsufficiency": "sufficient evidence suggesting dosage sensitivity is associated with clinical phenotype",
"triplosensitivity": "little evidence suggesting dosage sensitivity is associated with clinical phenotype",
"reciprocalOverlap": 0.00147,
"annotationOverlap": 0.33994
},
{
"chromosome": "15",
"begin": 31727418,
"end": 32153204,
"haploinsufficiency": "sufficient evidence suggesting dosage sensitivity is associated with clinical phenotype",
"triplosensitivity": "dosage sensitivity unlikely",
"reciprocalOverlap": 0.00147,
"annotationOverlap": 1
}]
FieldTypeNotes
clingenDosageSensitivityMapobject array
chromosomestringEnsembl-style chromosome names
begininteger1-based position
endinteger1-based position
haploinsufficiencystringsee possible values below
triplosensitivitystring(same as haploinsufficiency) 
reciprocalOverlapfloating pointRange: 0 - 1. E.g. 0.57 would indicate a 57% reciprocal overlap. Specified up to 5 decimal places (Not reported for Insertions).
annotationOverlapfloating pointRange: 0 - 1. E.g. 0.57 would indicate a 57% reciprocal overlap. Specified up to 5 decimal places (Not reported for Insertions).

haploinsufficiency and triplosensitivity

  • no evidence to suggest that dosage sensitivity is associated with clinical phenotype
  • little evidence suggesting dosage sensitivity is associated with clinical phenotype
  • emerging evidence suggesting dosage sensitivity is associated with clinical phenotype
  • sufficient evidence suggesting dosage sensitivity is associated with clinical phenotype
  • gene associated with autosomal recessive phenotype
  • dosage sensitivity unlikely

Gene-Disease Validity

The ClinGen Gene-Disease Clinical Validity curation process involves evaluating the strength of evidence supporting or refuting a claim that variation in a particular gene causes a particular disease. Nirvana reports these annotations for genes in the genes section of the JSON.

Publication

Strande NT, Riggs ER, Buchanan AH, et al. Evaluating the Clinical Validity of Gene-Disease Associations: An Evidence-Based Framework Developed by the Clinical Genome Resource. Am J Hum Genet. 2017;100(6):895-906. doi:10.1016/j.ajhg.2017.04.015

Source TSV

The source data comes in a CSV file that we convert to a TSV as follows:

CLINGEN GENE VALIDITY CURATIONS
FILE CREATED: 2019-05-28
WEBPAGE: https://search.clinicalgenome.org/kb/gene-validity
+++++++++++,++++++++++++++,+++++++++++++,++++++++++++++++++,+++++++++,++++++++++++++,+++++++++++++,+++++++++++++++++++
GENE SYMBOL,GENE ID (HGNC),DISEASE LABEL,DISEASE ID (MONDO),SOP,CLASSIFICATION,ONLINE REPORT,CLASSIFICATION DATE
+++++++++++,++++++++++++++,+++++++++++++,++++++++++++++++++,+++++++++,++++++++++++++,+++++++++++++,+++++++++++++++++++
A2ML1,HGNC:23336,Noonan syndrome with multiple lentigines,MONDO_0007893,SOP5,No Reported Evidence,https://search.clinicalgenome.org/kb/gene-validity/59b87033-dd91-4f1e-aec1-c9b1f5124b16--2018-06-07T14:37:47,2018-06-07T14:37:47.175Z
A2ML1,HGNC:23336,cardiofaciocutaneous syndrome,MONDO_0015280,SOP5,No Reported Evidence,https://search.clinicalgenome.org/kb/gene-validity/fc3c41d8-8497-489b-a350-c9e30016bc6a--2018-06-07T14:31:03,2018-06-07T14:31:03.696Z
A2ML1,HGNC:23336,Costello syndrome,MONDO_0009026,SOP5,No Reported Evidence,https://search.clinicalgenome.org/kb/gene-validity/ea72ba8d-cf62-44bc-86be-da64e3848eba--2018-06-07T14:34:05,2018-06-07T14:34:05.324Z

Download URL

https://search.clinicalgenome.org/kb/gene-validity.csv

Conflict Resolution

Multiple Classifications

Here is an example of multiple classifications.

$ grep MONDO_0010192 ClinGen-Gene-Disease-Summary-2019-12-02.csv  | grep EDNRB
EDNRB,HGNC:3180,Waardenburg syndrome type 4A,MONDO_0010192,SOP6,Moderate,https://search.clinicalgenome.org/kb/gene-validity/d7abbd45-7915-437b-849b-dea876bfc2f5--2018-05-08T04:00:00,2018-05-08T04:00:00.000Z
EDNRB,HGNC:3180,Waardenburg syndrome type 4A,MONDO_0010192,SOP6,Limited,https://search.clinicalgenome.org/kb/gene-validity/73ee9727-60c1-40fd-830f-08c2b513d2ee--2018-05-08T04:00:00,2018-05-08T04:00:00.000Z

In such cases, we select the more severe classification.

Multiple Dates

$ grep MONDO_0016419 ClinGen-Gene-Disease-Summary-2019-12-02.csv  | grep MUTYH
MUTYH,HGNC:7527,hereditary breast carcinoma,MONDO_0016419,SOP4,No Reported Evidence,https://search.clinicalgenome.org/kb/gene-validity/9904,2017-05-24T00:00:00
MUTYH,HGNC:7527,hereditary breast carcinoma,MONDO_0016419,SOP4,No Reported Evidence,https://search.clinicalgenome.org/kb/gene-validity/9902,2017-05-25T00:00:00

If the classifications are the same, we should select the latest classification date.

JSON Output

"clingenGeneValidity":[
{
"diseaseId":"MONDO_0007893",
"disease":"Noonan syndrome with multiple lentigines",
"classification":"no reported evidence",
"classificationDate":"2018-06-07"
},
{
"diseaseId":"MONDO_0015280",
"disease":"cardiofaciocutaneous syndrome",
"classification":"no reported evidence",
"classificationDate":"2018-06-07"
}
]
FieldTypeNotes
clingenGeneValidityobject
diseaseIdstringMonarch Disease Ontology ID (MONDO)
diseasestringdisease label
classificationstringsee below for possible values
classificationDatestringyyyy-MM-dd

classification

  • no reported evidence
  • disputed
  • limited
  • moderate
  • definitive
  • strong
  • refuted