# NM_000124.4(ERCC6):c.5del (p.Pro2fs)

https://sugi.bio/variant/ercc6-p-pro2fs

## Summary

**ERCC6 p.Pro2fs (c.5del)** is classified **Pathogenic** in ERCC6 (ClinVar, Single submitter, 1 submitter; last evaluated 2026-01-19). No gnomAD frequency available for this variant.

**At a glance:** Pathogenic · review: Single submitter · rsID rs2496175498 · 1 submitter · no gnomAD frequency available for this variant

## For patients & families {#patients}

This is a change in the ERCC6 gene that is reported as disease-causing, but on limited review, submitted by 1 submitter.

*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.*

**Support & next steps:** [Find a genetic counselor (NSGC)](https://findageneticcounselor.nsgc.org/).

## Identity {#identity}

| Field | Value |
| --- | --- |
| Gene | [ERCC6](https://sugi.bio/atlas/gene/ERCC6/) |
| Protein change (HGVS p.) | p.Pro2fs |
| Coding change (HGVS c.) | c.5del |
| MANE Select transcript | [NM_000124](https://www.ncbi.nlm.nih.gov/nuccore/NM_000124) |
| dbSNP | [rs2496175498](https://www.ncbi.nlm.nih.gov/snp/rs2496175498/) |
| Variant type | Deletion |
| Location | chr10:49532960-49532960 (GRCh38) |
| ClinVar | [VCV1997329](https://www.ncbi.nlm.nih.gov/clinvar/variation/1997329/) |

**All HGVS expressions:** `LRG_465:g.11142del`, `LRG_465t1:c.4del`, `NC_000010.10:g.50741007del`, `NC_000010.11:g.49532961del`, `NG_009442.1:g.11142del`, `NM_000124.4:c.5del`, `NM_001277058.2:c.5del`, `NM_001277059.2:c.5del`, `NM_001346440.2:c.5del`

## Computational & population evidence {#evidence}

**Concordance:** Mixed / partial computational evidence (see below).

- **Missense predictors (AlphaMissense/REVEL/SaProt) do not apply** to this variant type — they score amino-acid substitutions only. For non-missense variants the computational signal comes from conservation (below), not from a missing predictor score.
- Conservation: phyloP -0.354, GERP -3.24 — not a conserved position (phyloP < 0.1, ACGS BP7 cut)
- Molecular consequence: **frameshift** — a predicted loss-of-function variant. Gene population constraint: LOEUF 0.803, pLI 1.2087e-23. *Descriptive; not an applied PVS1 code.*
- Nonsense-mediated decay: the premature termination codon is **in exon 2 of 21**, so the transcript is predicted to undergo NMD.
- SpliceAI: **not assessed** — the release is built from a substitutions-only source, so it holds no deletion variants. That is a property of the dataset, not of the variant, and is not evidence against a splicing effect.
- Population frequency: **no gnomAD frequency available for this variant** — rarity (ACMG PM2) and BA1/BS1 cannot be assessed for this variant.

*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}

**ERCC6** population constraint: LOEUF 0.803, pLI 1.2087e-23, missense-Z 1.7245. *Lower LOEUF and higher pLI indicate a gene that tolerates loss-of-function poorly; ClinGen dosage is the curated haploinsufficiency call.*

Curated gene–disease validity (ClinGen):

- **Cockayne spectrum with or without cerebrooculofacioskeletal syndrome** — Definitive (AR)

## Protein context {#protein}

Residue **2** lies in the 'disordered' region; the 'n-terminal domain; essential for its chromatin remodeling activity' region.

AlphaFold model confidence (whole protein): pLDDT 70.12, 32% of residues very-high.

**12 experimental structure(s)** (PDB): [4CVO](https://www.rcsb.org/structure/4CVO), [7OO3](https://www.rcsb.org/structure/7OO3), [7OOB](https://www.rcsb.org/structure/7OOB), [7OOP](https://www.rcsb.org/structure/7OOP), [7OPC](https://www.rcsb.org/structure/7OPC), [7OPD](https://www.rcsb.org/structure/7OPD).

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

*Describes the biological roles of ERCC6 (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:** ERCC6's established molecular role includes sequence-specific DNA binding. p.Pro2fs falls in the disordered region.


### Pathways affected {#pathways}

ERCC6 participates in **7 Reactome pathways** (⚕ = disease pathway):

| Pathway (Reactome) | Evidence |
| --- | --- |
| [B-WICH complex positively regulates rRNA expression](https://reactome.org/content/detail/R-HSA-5250924) | curated |
| [Dual incision in TC-NER](https://reactome.org/content/detail/R-HSA-6782135) | curated |
| [Formation of TC-NER Pre-Incision Complex](https://reactome.org/content/detail/R-HSA-6781823) | curated |
| [Gap-filling DNA repair synthesis and ligation in TC-NER](https://reactome.org/content/detail/R-HSA-6782210) | curated |
| [RNA Polymerase I Transcription Initiation](https://reactome.org/content/detail/R-HSA-73762) | curated |
| [Transcription-Coupled Nucleotide Excision Repair (TC-NER)](https://reactome.org/content/detail/R-HSA-6781827) | curated |
| [ERCC6 (CSB) and EHMT2 (G9a) positively regulate rRNA expression](https://reactome.org/content/detail/R-HSA-427389) | electronic |

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

**Molecular function:** sequence-specific DNA binding, DNA binding, chromatin binding, ATP binding, ATP-dependent activity, acting on DNA, protein tyrosine kinase activator activity.

**Biological process:** positive regulation of defense response to virus by host, positive regulation of gene expression, positive regulation of peptidyl-serine phosphorylation of STAT protein, positive regulation of DNA repair, single strand break repair, DNA damage checkpoint signaling.

## Clinical significance {#significance}

**Pathogenic** — review status Single submitter *(criteria provided, single submitter)*, last evaluated 2026-01-19.

**Submitter consensus:** unanimous (1/1 Pathogenic).

### Submitter classifications {#submitters}

| Submitter | Classification | Review | Method | Date |
| --- | --- | --- | --- | --- |
| Labcorp Genetics (formerly Invitae), Labcorp | Pathogenic | criteria provided, single submitter | clinical testing | 2026-01-19 |

**Reported phenotype names (ClinVar):** not provided, none provided.

## Similar variants {#similar}

Related ERCC6 variant pages (same residue, condition, or type): [ERCC6 p.Ala1167fs](/variant/ercc6-p-ala1167fs), [ERCC6 p.Arg1318fs](/variant/ercc6-p-arg1318fs), [ERCC6 p.Gly270fs](/variant/ercc6-p-gly270fs), [ERCC6 p.Gly347fs](/variant/ercc6-p-gly347fs), [ERCC6 p.Ile931fs](/variant/ercc6-p-ile931fs), [ERCC6 p.Lys506fs](/variant/ercc6-p-lys506fs), [ERCC6 p.Ser49fs](/variant/ercc6-p-ser49fs), [ERCC6 p.Tyr1179fs](/variant/ercc6-p-tyr1179fs).

### 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 1997329). 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.*