Is ACACB p.Arg1033Trp (c.3097C>T) pathogenic?

ACACB p.Arg1033Trp (c.3097C>T) is classified Uncertain significance in ACACB (ClinVar, Single submitter, 1 submitter; last evaluated 2024-05-20). AlphaMissense: likely benign (0.1579); Ultra-rare (popmax 0.0343%, mid).

How common is ACACB p.Arg1033Trp (c.3097C>T) in the general population?

ACACB p.Arg1033Trp (c.3097C>T) is ultra-rare (popmax 0.0343%, mid) (gnomAD).

What do computational predictors say about ACACB p.Arg1033Trp (c.3097C>T)?

AlphaMissense predicts likely benign (score 0.1579) — an in-silico prediction, not a clinical call.

ACACB p.Arg1033Trp

c.3097C>T · VCV3260404

Uncertain significance Single submitter

Classification

Uncertain significance

ClinVar

Review

Single submitter ★☆☆☆

ClinVar · 1 submitter

AlphaMissense

likely benign

0.1579 · ACMG-weighted

gnomAD v4.1

Rare

ultra-rare (popmax 0.0343%, mid)

Missense predictors

0/2 damaging

AlphaMissense, SaProt · REVEL no call

Computational evidence

Protein change
AlphaMissense	0.1579	likely benign
REVEL	0.401	indeterminate
SaProt	LLR -9.82	tolerated
⇒ AlphaMissense and SaProt both call this tolerated; REVEL makes no call.
Splicing
SpliceAI	—	not assessed · no allele here is in the release
Constraint at this position
Conservation	phyloP 2.2	GERP -0.23, phastCons 0.98
Regional constraint	o/e 0.88	unconstrained · MANE · 111 kb · p 4.8e-09 · regional, not allelic
Overall
CADD	28.2	PHRED · no single calibrated threshold — expert panels disagree

ClinVar classifies this uncertain; the computational predictors unanimously lean tolerated — a triage signal, not a reclassification

AlphaMissense carries the ACMG weight for missense; REVEL and SaProt are independent agreement signals.

Population frequency

gnomAD v4.1 · exomes + genomes

Grpmax group 0.0343% Middle Eastern · 2/5,828 alleles

Filtering AF 0.00603% ClinGen BA1/BS1 input FAF95, joint · FAF99 0.00475%

Overall 0.00597% 96/1,607,132 alleles · ultra-rare

Ancestry group	Frequency	1 in
Middle Easterngrpmax	0.0343%	2,914
East Asian	0.0112%	8,949
South Asian	0.0111%	8,974
European (non-Finnish)	0.00637%	15,704
Admixed American	0.00338%	29,578
Remaining individualsnot grpmax-eligible	0.00161%	62,190
African / African-American	0.00134%	74,842

Rarity supports pathogenicity (ACMG PM2); frequency above a disease-specific BA1/BS1 threshold argues against it. A variant frequent in one ancestry group can be near-absent in others, so a single global figure can mislead.

Variant & gene context

Gene: ACACB
Protein: p.Arg1033Trp
Coding: c.3097C>T
MANE Select: NM_001093
Type: single nucleotide variant
Location: chr12:109209201 (GRCh38)
Gene constraint: LOEUF 0.843 · pLI <0.01 (gnomAD)
Structure: AlphaFold pLDDT 79.29 · 11 PDB

Full ACACB gene report on Sugi Atlas → Gene function, pathways, protein structure, interactions & more

Similar variants

ACACB p.Val958Met Uncertain significance ★★ ⚠ same type
ACACB c.6942+9C>T Benign ★★ same type
ACACB c.6943-8G>A Benign ★★ same type
ACACB c.7113+7C>T Benign/Likely benign ★★ same type
ACACB p.Ala650= Likely benign ★★ same type
ACACB p.Arg1786Gln Likely benign ★★ ⚠ same type
ACACB p.Asp1481Val Benign/Likely benign ★★ ⚠ same type
ACACB p.Gln1257Glu Benign ★★ same type

Built on 18 open, versioned datasets — ClinVar, gnomAD, AlphaMissense, REVEL, ClinGen & more — plus Sugi Variant's own cross-source analysis. Source data 2026-01–2026-10, ClinVar 2026-10. Full sources & versions →

Cite Sugi Variant

Gür T. Sugi Variant: A Deterministic Per-Variant Germline Reference from a Knowledge Graph for Humans and AI Agents. 2026. doi:10.5281/zenodo.21509445. This variant: https://sugi.bio/variant/acacb-p-arg1033trp (accessed [today's date]).

Preprint & method: sugi.bio/variant/method Machine-readable: this page as Markdown