Pathogenicity: Alzheimer's Disease : Likely Pathogenic
ACMG/AMP Pathogenicity Criteria: PS3, PS4, PM1, PM2, PP2, PP3
Clinical Phenotype: Alzheimer's Disease
Reference Assembly: GRCh37/hg19
Position: Chr14:73664748 C>T
dbSNP ID: rs63751420
Coding/Non-Coding: Coding
DNA Change: Substitution
Expected RNA Consequence: Substitution
Expected Protein Consequence: Missense
Codon Change: GCT to GTT
Reference Isoform: PSEN1 Isoform 1 (467 aa)
Genomic Region: Exon 8


This mutation was originally reported in two families of Japanese origin (Rogaev et al., 1995; Ikeda et al., 1996; Poorkaj et al., 1998). In the more well-characterized family, at least 10 members, across three generations, suffered from AD symptoms, usually beginning with personality changes and memory loss at a mean age of 40 years (Ikeda et al., 1996). The mutation was present in all four affected members who were tested, and absent from 140 Japanese and 200 white controls.

The mutation has also been found in several non-Asian families. It was identified in an AD patient in the U.K. with six family members across two generations presenting with AD symptoms beginning at ages 40–42 (Janssen et al., 2003). Moreover, it was found in a woman from the Iberian peninsula who developed AD symptoms at age 30 and had a family history of dementia emerging before age 40 (Guerreiro et al., 2010). The mutation was also found in a member of a French family with six affected individuals with age of onset ranging between 34 and 38 years (Wallon et al., 2012). 

This variant was absent from the gnomAD variant database (gnomAD v2.1.1, July 2021).

In three cases from the Japanese pedigree, neuropathology was consistent with AD, including widespread senile plaques, neurofibrillary tangles, and neuronal loss. In addition, abundant perivascular amyloid deposits were found in the subpial regions of Virchow-Robin spaces and Pick-like intraneuronal inclusions were observed in the dentate gyrus (Ikeda et al., 1996).

Biological Effect
In the conditioned media of COS-1 cells transfected with cDNAs encoding APP695 and the A260V mutant, the Aβ42/Aβ ratio was increased relative to controls (Murayama et al., 1999). Consistent with this finding, an in vitro assay using the APP-C99 substrate revealed an approximately 18-fold increase in the Aβ42/Aβ40 ratio (Sun et al., 2017). The mutant produced less of both Aβ42 and Aβ40, but the drop in Aβ40 production was greater. Decreased Aβ production was also reported in PC12D transfected cells (Kametani et al., 2004). Moreover, a reduction in Rab8, a GTPase involved in vesicular transport, and disruption of the intracellular distribution of the APP C-terminal fragment was observed in these cells.

Several in silico algorithms (SIFT, Polyphen-2, LRT, MutationTaster, MutationAssessor, FATHMM, PROVEAN, CADD, REVEL, and Reve in the VarCards database) predicted this variant is damaging (Xiao et al., 2021). These authors classified the variant as pathogenic using the ACMG-AMP guidelines (Richards et al., 2015).


Alzheimer's Disease : Likely Pathogenic

This variant fulfilled the following criteria based on the ACMG/AMP guidelines. See a full list of the criteria in the Methods page.


Well-established in vitro or in vivo functional studies supportive of a damaging effect on the gene or gene product. A260V: Aβ42/Aβ40 ratio increased and APP-CTF localization was altered, but production of both Ab peptides decreased.


The prevalence of the variant in affected individuals is significantly increased compared to the prevalence in controls. A260V: The variant was reported in 3 or more unrelated patients with the same phenotype, and absent from controls.


Located in a mutational hot spot and/or critical and well-established functional domain (e.g. active site of an enzyme) without benign variation.


Absent from controls (or at extremely low frequency if recessive) in Exome Sequencing Project, 1000 Genomes Project, or Exome Aggregation Consortium. *Alzforum uses the gnomAD variant database.


Missense variant in a gene that has a low rate of benign missense variation and where missense variants are a common mechanism of disease.


Multiple lines of computational evidence support a deleterious effect on the gene or gene product (conservation, evolutionary, splicing impact, etc.). *In most cases, Alzforum applies this criterion when the variant’s PHRED-scaled CADD score is greater than or equal to 20.

Pathogenic (PS, PM, PP) Benign (BA, BS, BP)
Criteria Weighting Strong (-S) Moderate (-M) Supporting (-P) Supporting (-P) Strong (-S) Strongest (BA)

Last Updated: 22 Feb 2022


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Paper Citations

  1. . Familial Alzheimer's disease in kindreds with missense mutations in a gene on chromosome 1 related to the Alzheimer's disease type 3 gene. Nature. 1995 Aug 31;376(6543):775-8. PubMed.
  2. . The clinical phenotype of two missense mutations in the presenilin I gene in Japanese patients. Ann Neurol. 1996 Dec;40(6):912-7. PubMed.
  3. . Missense mutations in the chromosome 14 familial Alzheimer's disease presenilin 1 gene. Hum Mutat. 1998;11(3):216-21. PubMed.
  4. . Early onset familial Alzheimer's disease: Mutation frequency in 31 families. Neurology. 2003 Jan 28;60(2):235-9. PubMed.
  5. . Genetic screening of Alzheimer's disease genes in Iberian and African samples yields novel mutations in presenilins and APP. Neurobiol Aging. 2010 May;31(5):725-31. Epub 2008 Jul 30 PubMed.
  6. . The French series of autosomal dominant early onset Alzheimer's disease cases: mutation spectrum and cerebrospinal fluid biomarkers. J Alzheimers Dis. 2012 Jan 1;30(4):847-56. PubMed.
  7. . Enhancement of amyloid beta 42 secretion by 28 different presenilin 1 mutations of familial Alzheimer's disease. Neurosci Lett. 1999 Apr 9;265(1):61-3. PubMed.
  8. . Analysis of 138 pathogenic mutations in presenilin-1 on the in vitro production of Aβ42 and Aβ40 peptides by γ-secretase. Proc Natl Acad Sci U S A. 2017 Jan 24;114(4):E476-E485. Epub 2016 Dec 5 PubMed.
  9. . Mutant presenilin (A260V) affects Rab8 in PC12D cell. Neurochem Int. 2004 Apr;44(5):313-20. PubMed.
  10. . APP, PSEN1, and PSEN2 Variants in Alzheimer's Disease: Systematic Re-evaluation According to ACMG Guidelines. Front Aging Neurosci. 2021;13:695808. Epub 2021 Jun 18 PubMed.
  11. . Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Genet Med. 2015 May;17(5):405-24. Epub 2015 Mar 5 PubMed.

External Citations

  1. gnomAD v2.1.1

Further Reading


  1. . Human wild presenilin-1 mimics the effect of the mutant presenilin-1 on the processing of Alzheimer's amyloid precursor protein in PC12D cells. J Neurol Sci. 2001 Jul 15;188(1-2):27-31. PubMed.

Protein Diagram

Primary Papers

  1. . Familial Alzheimer's disease in kindreds with missense mutations in a gene on chromosome 1 related to the Alzheimer's disease type 3 gene. Nature. 1995 Aug 31;376(6543):775-8. PubMed.
  2. . The clinical phenotype of two missense mutations in the presenilin I gene in Japanese patients. Ann Neurol. 1996 Dec;40(6):912-7. PubMed.

Other mutations at this position


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