Is AIPL1 p.Arg46Gln (c.137G>A) pathogenic?

AIPL1 p.Arg46Gln (c.137G>A) is classified Uncertain significance in AIPL1 (ClinVar, Multiple submitters, 2 submitters; last evaluated 2022-12-07). AlphaMissense: likely benign (0.1012); Ultra-rare (popmax 0.0423%, eas); Associated with Leber congenital amaurosis 4.

What condition is associated with AIPL1 p.Arg46Gln (c.137G>A)?

AIPL1 p.Arg46Gln (c.137G>A) is associated with Leber congenital amaurosis 4 (ClinVar).

How common is AIPL1 p.Arg46Gln (c.137G>A) in the general population?

AIPL1 p.Arg46Gln (c.137G>A) is ultra-rare (popmax 0.0423%, eas) (gnomAD).

How is Cone rod dystrophy inherited?

Typically Autosomal dominant, Autosomal recessive (Orphanet). A genetic counselor can assess individual risk for a family.

What do computational predictors say about AIPL1 p.Arg46Gln (c.137G>A)?

AlphaMissense predicts likely benign (score 0.1012) — an in-silico prediction, not a clinical call.

AIPL1 p.Arg46Gln

c.137G>A · rs755639765 · VCV962856

Uncertain significance Multiple submitters

Classification

Uncertain significance

ClinVar

Review

Multiple submitters ★★☆☆

ClinVar · 2 submitters

AlphaMissense

likely benign

0.1012 · ACMG-weighted

gnomAD v4.1

Rare

ultra-rare (popmax 0.0423%, eas)

Missense predictors

0/2 damaging

AlphaMissense, SaProt · REVEL no call

Conditions

Leber congenital amaurosis 4

Computational evidence

Protein change
AlphaMissense	0.1012	likely benign
REVEL	0.513	indeterminate
SaProt	LLR -9.81	tolerated
⇒ AlphaMissense and SaProt both call this tolerated; REVEL makes no call.
Splicing
SpliceAI	Δ0.25	acceptor gain · deltas
Pangolin	Δ0.21	gain · loss 0.03 · agrees with SpliceAI · independent
Constraint at this position
Conservation	phyloP 0.8	GERP -3.1, phastCons 0.97
Regional constraint	o/e 0.96	unconstrained · MANE · 9,641 bp · p 0.35 · regional, not allelic
Overall
CADD	24.1	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 0.0423% East Asian · 19/44,888 alleles

Filtering AF 0.0277% ClinGen BA1/BS1 input FAF95, joint · FAF99 0.023%

Overall 0.00384% 62/1,613,990 alleles · ultra-rare

Ancestry group	Frequency	1 in
East Asiangrpmax	0.0423%	2,363
African / African-American	0.00401%	24,968
European (non-Finnish)	0.00314%	31,893
Finnishnot grpmax-eligible	0.00312%	32,010
Remaining individualsnot grpmax-eligible	0.0016%	62,488

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: AIPL1
Protein: p.Arg46Gln
Coding: c.137G>A
MANE Select: NM_014336
dbSNP: rs755639765
Type: single nucleotide variant
Location: chr17:6434058 (GRCh38)
Gene constraint: LOEUF 1.01 · pLI <0.01 (gnomAD)
Structure: AlphaFold pLDDT 83.42 · 6 PDB

Full AIPL1 gene report on Sugi Atlas → Gene function, pathways, protein structure, interactions & more

Disease context

Leber congenital amaurosis 4 — disease report on Sugi Atlas → Associated genes, phenotypes, clinical trials & treatments

For Cone rod dystrophy (Orphanet):

Inheritance: Autosomal dominant, Autosomal recessive, X-linked recessive
Onset: Adolescent, Adult, Childhood
Prevalence: 1-9 / 100 000 (Europe)

Similar variants

AIPL1 p.Arg46Pro Uncertain significance ★★ ⚠ same residue
AIPL1 p.Arg46Trp Uncertain significance ★ ⚠ same residue
AIPL1 p.Arg46= Likely benign ★ same residue
AIPL1 c.276+1G>A Pathogenic ★★★ same condition
AIPL1 c.277-2A>G Pathogenic ★★★ same condition
AIPL1 p.Ala197Pro Pathogenic ★★★ same condition
AIPL1 p.Arg270His Pathogenic ★★★ same condition
AIPL1 p.Arg32Ter Pathogenic ★★★ same condition

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/aipl1-p-arg46gln (accessed [today's date]).

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