Is ALPL p.Ala443Ser (c.1327G>T) pathogenic?

ALPL p.Ala443Ser (c.1327G>T) is classified Conflicting classifications of pathogenicity in ALPL (ClinVar, Conflicting submitters, 5 submitters; last evaluated 2025-08-29). AlphaMissense: likely benign (0.1649); Absent from gnomAD v4.1; Associated with hypophosphatasia.

What condition is associated with ALPL p.Ala443Ser (c.1327G>T)?

ALPL p.Ala443Ser (c.1327G>T) is associated with hypophosphatasia, adult hypophosphatasia, childhood hypophosphatasia (ClinVar).

How common is ALPL p.Ala443Ser (c.1327G>T) in the general population?

ALPL p.Ala443Ser (c.1327G>T) is absent from gnomAD v4.1 (gnomAD).

How is Hypophosphatasia inherited?

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

What do computational predictors say about ALPL p.Ala443Ser (c.1327G>T)?

AlphaMissense predicts likely benign (score 0.1649) — an in-silico prediction, not a clinical call.

ALPL p.Ala443Ser

c.1327G>T · rs2545350189 · VCV3252040

Conflicting classifications of pathogenicity Conflicting submitters

Classification

Conflicting classifications of pathogenicity

ClinVar

Review

Conflicting submitters ★☆☆☆

ClinVar · 5 submitters

AlphaMissense

likely benign

0.1649 · ACMG-weighted

gnomAD v4.1

Absent

absent from gnomAD v4.1

Missense predictors

0/2 damaging

AlphaMissense, SaProt · REVEL no call

Conditions

hypophosphatasia

Computational evidence

Protein change
AlphaMissense	0.1649	likely benign
REVEL	0.572	indeterminate
SaProt	LLR -8.08	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 12	GERP 0.45, phastCons 1
Regional constraint	o/e 0.83	unconstrained · MANE · 24 kb · p 6.1e-06 · regional, not allelic
Overall
CADD	24.4	PHRED · no single calibrated threshold — expert panels disagree

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

Population frequency

gnomAD v4.1 · exomes + genomes

Absent from gnomAD v4.1. Not observed in any sequenced alleles — a rarity signal (ACMG PM2-supporting), not evidence of pathogenicity on its own.

Variant & gene context

Gene: ALPL
Protein: p.Ala443Ser
Coding: c.1327G>T
MANE Select: NM_000478
dbSNP: rs2545350189
Type: single nucleotide variant
Location: chr1:21577400 (GRCh38)
Gene constraint: LOEUF 0.987 · pLI <0.01 (gnomAD)
Structure: AlphaFold pLDDT 93.74 · 5 PDB

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

Disease context

hypophosphatasia — disease report on Sugi Atlas → Associated genes, phenotypes, clinical trials & treatments

Also linked: adult hypophosphatasia childhood hypophosphatasia infantile hypophosphatasia

For Hypophosphatasia (Orphanet):

Inheritance: Autosomal dominant, Autosomal recessive
Onset: All ages

Similar variants

ALPL p.Ala443Gly Likely pathogenic ★★ ⚠ same residue
ALPL p.Ala443Thr Likely pathogenic ★★ ⚠ same residue
ALPL p.Ala443Val Pathogenic/Likely pathogenic ★★ ⚠ same residue
ALPL p.Ala443Glu Likely pathogenic ★ ⚠ same residue
ALPL p.Ala443= Likely benign ★ same residue
ALPL c.1190-2A>T Pathogenic ★★ same condition
ALPL c.182-1G>A Pathogenic/Likely pathogenic ★★ same condition
ALPL c.182-2A>G Pathogenic/Likely 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/alpl-p-ala443ser (accessed [today's date]).

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