# NM_001719.3(BMP7):c.866G>A (p.Arg289His)

https://sugi.bio/variant/bmp7-p-arg289his

## Summary

**BMP7 p.Arg289His (c.866G>A)** is classified **Uncertain significance** in BMP7 (ClinVar, Single submitter, 1 submitter; last evaluated 2024-03-25). AlphaMissense: ambiguous (0.4907); Very rare (popmax 0.000169%, nfe); Associated with nephrotic syndrome, type 12.

**At a glance:** Uncertain significance · review: Single submitter · rsID rs2515997277 · 1 submitter · 1 linked condition · AlphaMissense ambiguous · very rare (popmax 0.000169%, nfe)

## For patients & families {#patients}

This is a change in the BMP7 gene that is currently of uncertain significance — a definitive interpretation has not yet been established, submitted by 1 submitter, and is linked to nephrotic syndrome, type 12.

*Reference information, not medical advice, and not a prediction for any individual. A genetic counselor or clinician can interpret what it means for you and your family.*

|  |  |
| --- | --- |
| Typical inheritance (of this condition) | Autosomal dominant, Autosomal recessive |
| Age of onset (of this condition) | Adolescent, Adult, Antenatal, Childhood, Infancy, Neonatal |

**Commonly reported features of Hereditary steroid-resistant nephrotic syndrome** (across patients with this condition; presentation varies — frequencies from Orphanet):

- Proteinuria — Obligate (100%)
- Edema — Very frequent (99-80%)
- Focal segmental glomerulosclerosis — Frequent (79-30%)
- Stage 5 chronic kidney disease — Frequent (79-30%)
- Chronic kidney disease — Frequent (79-30%)
- Periorbital edema — Frequent (79-30%)
- Irritability — Occasional (29-5%)
- Fever — Occasional (29-5%)

**Support & next steps:** [Condition overview & support (NIH GARD)](https://rarediseases.info.nih.gov/diseases/0016166/index) · [Find a genetic counselor (NSGC)](https://findageneticcounselor.nsgc.org/).

## Identity {#identity}

| Field | Value |
| --- | --- |
| Gene | [BMP7](https://sugi.bio/atlas/gene/BMP7/) |
| Protein change (HGVS p.) | p.Arg289His |
| Coding change (HGVS c.) | c.866G>A |
| MANE Select transcript | [NM_001719](https://www.ncbi.nlm.nih.gov/nuccore/NM_001719) |
| dbSNP | [rs2515997277](https://www.ncbi.nlm.nih.gov/snp/rs2515997277/) |
| Variant type | single nucleotide variant |
| Location | chr20:57183814-57183814 (GRCh38) |
| ClinVar | [VCV3064817](https://www.ncbi.nlm.nih.gov/clinvar/variation/3064817/) |

**All HGVS expressions:** `NC_000020.10:g.55758870C>T`, `NC_000020.11:g.57183814C>T`, `NG_032771.1:g.87838G>A`, `NG_143565.1:g.686C>T`, `NG_143566.1:g.163C>T`, `NM_001719.3:c.866G>A`

## Computational & population evidence {#evidence}

**Concordance:** AlphaMissense and REVEL make no call here — the available evidence is described below.

- AlphaMissense **ambiguous** (0.4907) — no call either way
- REVEL 0.609 (indeterminate)
- SaProt LLR -10.219 (damaging)
- Conservation: phyloP 7.453, GERP 2.56, phastCons 1 — highly conserved
- CADD: **PHRED 26.6**. No single ClinGen-calibrated threshold exists and the expert panels that use CADD disagree — GUCY2D/AIPL1 require ≥ 20.0 for an untranslated-region variant, ABCA4 ≥ 28.1 for a synonymous or indel variant, the Pulmonary Hypertension panel imports Pejaver 2022's missense-calibrated numbers, and the Antibody Deficiencies panel declines CADD entirely for PIK3CD. CADD v1.7 also incorporates Zoonomia phyloP, so it partly re-expresses the conservation above. *Descriptive; no threshold applied.*
- Regional missense constraint: **o/e 0.84** across the covering region of the MANE Select transcript (57,173,308–57,266,122), spanning 92,814 bp. Chi-square p 0.00035. Describes the region, not this allele; gnomAD v4.1.1's own constrained determination. *Descriptive; no ACMG code applied.*
- SpliceAI: **not assessed** — no allele at this position is in our SpliceAI release, either because it lies outside the scored MANE transcript scope or because every allele is below Δ0.2. We cannot tell which, so this claims neither; absence is not evidence against a splicing effect.
- Population frequency (gnomAD v4.1): grpmax **0.000169%** (nfe) · FAF95 2.8e-05% · FAF99 1.1e-05% · 2/1,180,044 in the highest group · 2/1,461,854 alleles overall — very rare (popmax 0.000169%, nfe).

*Computational predictors are not independent (ClinGen Variant Classification guidance): AlphaMissense (Cheng et al. 2023) carries the ACMG weight for missense and conservation (phyloP/GERP/phastCons) for non-missense; REVEL (Pejaver-2022 calibrated strength bands) and SaProt (Su et al. 2023, structure-aware, ClinVar-independent protein language model, raw LLR) are shown as orthogonal agreement signals, not additive. For frequency, the gnomAD v4.1 grpmax filtering allele frequency (FAF95) is ClinGen's designated BA1/BS1 input (gnomAD v4 guidance v3.0, June 2025); BA1/BS1 thresholds are disease-specific, not a blanket 5%. Predictions, not a clinical determination.*

## Gene constraint & dosage {#gene-context}

**BMP7** population constraint: LOEUF 0.523, pLI 0.95879, missense-Z 1.806. *Lower LOEUF and higher pLI indicate a gene that tolerates loss-of-function poorly; ClinGen dosage is the curated haploinsufficiency call.*

## Protein context {#protein}


AlphaFold model confidence (whole protein): pLDDT 76.50, 51% of residues very-high.

**4 experimental structure(s)** (PDB): [1BMP](https://www.rcsb.org/structure/1BMP), [1LX5](https://www.rcsb.org/structure/1LX5), [1LXI](https://www.rcsb.org/structure/1LXI), [1M4U](https://www.rcsb.org/structure/1M4U).

## What this gene does {#gene-function}

*Describes the biological roles of BMP7 (the gene this variant disrupts) — not effects measured for this specific variant. A damaging variant is expected to affect these functions and pathways; the degree depends on the variant.*

**How this variant is thought to act:** BMP7's established molecular role includes growth factor activity.


### Pathways affected {#pathways}

BMP7 participates in **2 Reactome pathways** (⚕ = disease pathway):

| Pathway (Reactome) | Evidence |
| --- | --- |
| [Molecules associated with elastic fibres](https://reactome.org/content/detail/R-HSA-2129379) | curated |
| [Transcriptional regulation of brown and beige adipocyte differentiation by EBF2](https://reactome.org/content/detail/R-HSA-9844594) | electronic |

### Molecular function & processes (GO — experimentally supported) {#go}

**Molecular function:** growth factor activity, BMP receptor binding.

**Biological process:** osteoblast differentiation, metanephros development, mesonephros development, positive regulation of gene expression, positive regulation of bone mineralization, BMP signaling pathway.

## Clinical significance {#significance}

**Uncertain significance** — review status Single submitter *(criteria provided, single submitter)*, last evaluated 2024-03-25.

**Submitter consensus:** unanimous (1/1 Uncertain significance).

### Submitter classifications {#submitters}

| Submitter | Classification | Review | Method | Date |
| --- | --- | --- | --- | --- |
| Genomic Medicine Center of Excellence, King Faisal Specialist Hospital and Research Centre | Uncertain significance | criteria provided, single submitter | clinical testing | 2024-03-25 |

## Associated conditions {#conditions}

[nephrotic syndrome, type 12](https://sugi.bio/atlas/disease/nephrotic-syndrome-type-12/).

**Reported phenotype names (ClinVar):** Nephrotic syndrome, type 12.

## Similar variants {#similar}

Related BMP7 variant pages (same residue, condition, or type): [BMP7 p.Arg289=](/variant/bmp7-p-arg289), [BMP7 p.Arg150His](/variant/bmp7-p-arg150his), [BMP7 p.Arg267Gln](/variant/bmp7-p-arg267gln), [BMP7 p.His241Tyr](/variant/bmp7-p-his241tyr), [BMP7 p.Ile386Val](/variant/bmp7-p-ile386val), [BMP7 p.Leu160Phe](/variant/bmp7-p-leu160phe), [BMP7 p.Pro116Ser](/variant/bmp7-p-pro116ser), [BMP7 p.Ser248Leu](/variant/bmp7-p-ser248leu).

### Data sources & attribution {#sources}

ClinVar (NCBI — public domain, built 2026-10-11); gnomAD v4.1 (Broad Institute, built 2026-10-06); AlphaMissense (Cheng et al. 2023, © Google DeepMind — CC BY 4.0, built 2026-01-27); REVEL (Ioannidis et al. 2016 — ODbL, built 2026-07-13); SaProt (Su et al. 2023 — MIT, built 2026-07-14); SpliceAI (Illumina — free for non-commercial use, built 2026-10-13); CADD (Rentzsch et al. 2019, University of Washington — free for non-commercial use, built 2026-10-10); Conservation (phyloP/phastCons/GERP) (UCSC hg38 470-way mammal (Hiller Lab) + Ensembl Compara, built 2026-07-12); gnomAD Non-coding Constraint (Gnocchi) (Chen et al. 2024, Broad Institute — CC0, built 2026-10-11); gnomAD Regional Missense Constraint (Broad Institute — CC0, built 2026-10-13); Pangolin (Zeng & Li 2022 — CC BY 4.0, built 2026-10-11); Repeat regions (UCSC — RepeatMasker, TRF, segmental duplications, built 2026-10-11); ClinGen (ClinGen, built 2026-09-22); UniProt (CC BY 4.0); Reactome / GO (CC BY 4.0, built 2026-09-23); MaveDB (per-record license, built 2026-10-11); CIViC (CC0, built 2026-09-22); Orphanet (Orphanet, built 2026-06-12)

*Primary record: NCBI ClinVar (variation 3064817). Classifications reflect these databases as of the page's build date and may change. Free reference use — not medical advice; consult the primary submitters and a clinician.*