# NM_012154.5(AGO2):c.1805C>G (p.Pro602Arg)

https://sugi.bio/variant/ago2-p-pro602arg

## Summary

**AGO2 p.Pro602Arg (c.1805C>G)** is classified **Uncertain significance** in AGO2 (ClinVar, Multiple submitters, 3 submitters; last evaluated 2024-01-19). AlphaMissense: likely pathogenic (0.9833); Very rare (popmax 8.52e-05%, nfe); Associated with Inborn genetic diseases.

**At a glance:** Uncertain significance · review: Multiple submitters · rsID rs2072852147 · 3 submitters · 2 linked conditions · AlphaMissense likely pathogenic · very rare (popmax 8.52e-05%, nfe)

## For patients & families {#patients}

This is a change in the AGO2 gene that is currently of uncertain significance — a definitive interpretation has not yet been established, submitted by 3 submitters, and is linked to Inborn genetic diseases.

*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 | [AGO2](https://sugi.bio/atlas/gene/AGO2/) |
| Protein change (HGVS p.) | p.Pro602Arg |
| Coding change (HGVS c.) | c.1805C>G |
| MANE Select transcript | [NM_012154](https://www.ncbi.nlm.nih.gov/nuccore/NM_012154) |
| dbSNP | [rs2072852147](https://www.ncbi.nlm.nih.gov/snp/rs2072852147/) |
| Variant type | single nucleotide variant |
| Location | chr8:140544247-140544247 (GRCh38) |
| ClinVar | [VCV2405612](https://www.ncbi.nlm.nih.gov/clinvar/variation/2405612/) |

**All HGVS expressions:** `NC_000008.10:g.141554346G>C`, `NC_000008.11:g.140544247G>C`, `NM_001164623.3:c.1805C>G`, `NM_012154.5:c.1805C>G`

## Computational & population evidence {#evidence}

**Concordance:** ClinVar classifies this **uncertain**; the computational predictors unanimously lean **damaging** — a triage signal, not a reclassification.

- AlphaMissense **likely pathogenic** (0.9833)
- REVEL 0.404 (indeterminate)
- SaProt LLR -13.51 (damaging) — agrees with AlphaMissense
- → **In-silico consensus:** AlphaMissense and SaProt both call this damaging; REVEL makes no call
- Conservation: phyloP 11.525, GERP 1.89, phastCons 1 — highly conserved (agrees)
- CADD: **PHRED 24.8**. 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 0.42** across the covering region of the MANE Select transcript (140,532,047–140,557,095), spanning 25,048 bp. Chi-square p 1.2e-55. 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 **8.52e-05%** (nfe) · 1/1,173,428 in the highest group · 1/1,444,628 alleles overall — very rare (popmax 8.52e-05%, 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}

**AGO2** population constraint: LOEUF 0.102, pLI 1, missense-Z 6.9835. *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):

- **Lessel-Kreienkamp syndrome** — Definitive (AD)

## Protein context {#protein}

Residue **602** lies in an α-helix; the piwi domain.

AlphaFold model confidence (whole protein): pLDDT 92.82, 86% of residues very-high.

**71 experimental structure(s)** (PDB): [10BE](https://www.rcsb.org/structure/10BE), [11GI](https://www.rcsb.org/structure/11GI), [11GJ](https://www.rcsb.org/structure/11GJ), [11GK](https://www.rcsb.org/structure/11GK), [3LUC](https://www.rcsb.org/structure/3LUC), [3LUD](https://www.rcsb.org/structure/3LUD) — incl. mutant structure 4Z4H.

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

*Describes the biological roles of AGO2 (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:** AGO2's established molecular role includes RNA 7-methylguanosine cap binding. p.Pro602Arg falls in the piwi domain. In Reactome, AGO2 is annotated in disease pathway(s) including **Nuclear events stimulated by ALK signaling in cancer**.

**Disease mechanism (Reactome):** AGO2 loss or alteration is curated in [Nuclear events stimulated by ALK signaling in cancer](https://reactome.org/content/detail/R-HSA-9725371).

### Pathways affected {#pathways}

AGO2 participates in **25 Reactome pathways** (⚕ = disease pathway):

| Pathway (Reactome) | Evidence |
| --- | --- |
| ⚕ [Nuclear events stimulated by ALK signaling in cancer](https://reactome.org/content/detail/R-HSA-9725371) | curated |
| [Ca2+ pathway](https://reactome.org/content/detail/R-HSA-4086398) | curated |
| [Competing endogenous RNAs (ceRNAs) regulate PTEN translation](https://reactome.org/content/detail/R-HSA-8948700) | curated |
| [Estrogen-dependent gene expression](https://reactome.org/content/detail/R-HSA-9018519) | curated |
| [MAPK6/MAPK4 signaling](https://reactome.org/content/detail/R-HSA-5687128) | curated |
| [MTOR signalling](https://reactome.org/content/detail/R-HSA-165159) | curated |
| [MicroRNA (miRNA) biogenesis](https://reactome.org/content/detail/R-HSA-203927) | curated |
| [NR1H3 & NR1H2 regulate gene expression linked to cholesterol transport and efflux](https://reactome.org/content/detail/R-HSA-9029569) | curated |
| [Post-transcriptional silencing by small RNAs](https://reactome.org/content/detail/R-HSA-426496) | curated |
| [Pre-NOTCH Transcription and Translation](https://reactome.org/content/detail/R-HSA-1912408) | curated |
| [Regulation of CDH1 mRNA translation by microRNAs](https://reactome.org/content/detail/R-HSA-9764562) | curated |
| [Regulation of MITF-M-dependent genes involved in apoptosis](https://reactome.org/content/detail/R-HSA-9824594) | curated |
| [Regulation of NPAS4 mRNA translation](https://reactome.org/content/detail/R-HSA-9768778) | curated |
| [Regulation of PD-L1(CD274) translation](https://reactome.org/content/detail/R-HSA-9909620) | curated |
| [Regulation of PTEN mRNA translation](https://reactome.org/content/detail/R-HSA-8943723) | curated |
| [Regulation of RUNX1 Expression and Activity](https://reactome.org/content/detail/R-HSA-8934593) | curated |
| [Small interfering RNA (siRNA) biogenesis](https://reactome.org/content/detail/R-HSA-426486) | curated |
| [TGFBR3 expression](https://reactome.org/content/detail/R-HSA-9839394) | curated |
| [TP53 Regulates Metabolic Genes](https://reactome.org/content/detail/R-HSA-5628897) | curated |
| [Transcriptional regulation by small RNAs](https://reactome.org/content/detail/R-HSA-5578749) | curated |
| [Transcriptional regulation of multiciliogenesis](https://reactome.org/content/detail/R-HSA-9945556) | curated |
| [M-decay: degradation of maternal mRNAs by maternally stored factors](https://reactome.org/content/detail/R-HSA-9820841) | electronic |
| [Regulation of CDH11 mRNA translation by microRNAs](https://reactome.org/content/detail/R-HSA-9759811) | electronic |
| [Regulation of MECP2 expression and activity](https://reactome.org/content/detail/R-HSA-9022692) | electronic |
| [Transcriptional Regulation by MECP2](https://reactome.org/content/detail/R-HSA-8986944) | electronic |

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

**Molecular function:** RNA 7-methylguanosine cap binding, RNA polymerase II complex binding, core promoter sequence-specific DNA binding, RNA binding, double-stranded RNA binding, single-stranded RNA binding.

**Biological process:** pre-miRNA processing, P-body assembly, miRNA processing, miRNA-mediated gene silencing by inhibition of translation, miRNA-mediated gene silencing by mRNA destabilization, positive regulation of translation.

## Clinical significance {#significance}

**Uncertain significance** — review status Multiple submitters *(criteria provided, multiple submitters, no conflicts)*, last evaluated 2024-01-19.

**Submitter consensus:** conflicting (2 Uncertain significance, 1 Likely pathogenic).

**Submission history:** 3 submissions (2021–2024); classifications have differed over time.

### Submitter classifications {#submitters}

| Submitter | Classification | Review | Method | Date |
| --- | --- | --- | --- | --- |
| Molecular Genetics laboratory, Necker Hospital | Likely pathogenic | no assertion criteria provided | clinical testing | 2022-03-30 |
| Ambry Genetics | Uncertain significance | criteria provided, single submitter | clinical testing | 2021-10-04 |
| 3billion | Uncertain significance | criteria provided, single submitter | clinical testing | 2024-01-19 |

## Associated conditions {#conditions}

[Inborn genetic diseases](https://sugi.bio/atlas/disease/inborn-genetic-diseases/), [Lessel-Kreienkamp syndrome](https://sugi.bio/atlas/disease/lessel-kreienkamp-syndrome/).

**Reported phenotype names (ClinVar):** Inborn genetic diseases, not provided, Lessel-Kreienkamp syndrome, none provided, RECLASSIFIED - ADRA2C POLYMORPHISM, RECLASSIFIED - ADRB1 POLYMORPHISM.

## Similar variants {#similar}

Related AGO2 variant pages (same residue, condition, or type): [AGO2 p.Pro602=](/variant/ago2-p-pro602), [AGO2 p.Cys751Tyr](/variant/ago2-p-cys751tyr), [AGO2 p.Gly201Val](/variant/ago2-p-gly201val), [AGO2 p.Gly604Arg](/variant/ago2-p-gly604arg), [AGO2 p.Thr357Met](/variant/ago2-p-thr357met), [AGO2 p.Arg630His](/variant/ago2-p-arg630his), [AGO2 p.Asp89Glu](/variant/ago2-p-asp89glu), [AGO2 p.Glu46Lys](/variant/ago2-p-glu46lys).

### 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 2405612). 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.*