# NM_014391.3(ANKRD1):c.764del (p.Pro255fs)

https://sugi.bio/variant/ankrd1-p-pro255fs

## Summary

**ANKRD1 p.Pro255fs (c.764del)** is classified **Uncertain significance** in ANKRD1 (ClinVar, Multiple submitters, 2 submitters; last evaluated 2025-12-05). Very rare (popmax 0.00119%, nfe); Associated with ANKRD1-related dilated cardiomyopathy.

**At a glance:** Uncertain significance · review: Multiple submitters · rsID rs753476942 · 2 submitters · 1 linked condition · very rare (popmax 0.00119%, nfe)

## For patients & families {#patients}

This is a change in the ANKRD1 gene that is currently of uncertain significance — a definitive interpretation has not yet been established, submitted by 2 submitters, and is linked to ANKRD1-related dilated cardiomyopathy.

*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 | [ANKRD1](https://sugi.bio/atlas/gene/ANKRD1/) |
| Protein change (HGVS p.) | p.Pro255fs |
| Coding change (HGVS c.) | c.764del |
| MANE Select transcript | [NM_014391](https://www.ncbi.nlm.nih.gov/nuccore/NM_014391) |
| dbSNP | [rs753476942](https://www.ncbi.nlm.nih.gov/snp/rs753476942/) |
| Variant type | Deletion |
| Location | chr10:90915628-90915628 (GRCh38) |
| ClinVar | [VCV664045](https://www.ncbi.nlm.nih.gov/clinvar/variation/664045/) |

**All HGVS expressions:** `LRG_379:g.10648del`, `LRG_379t1:c.764del`, `NC_000010.10:g.92675388del`, `NC_000010.11:g.90915631del`, `NG_023227.1:g.10648del`, `NM_014391.2:c.764delC`, `NM_014391.3:c.764del`

## Computational & population evidence {#evidence}

**Concordance:** Mixed / partial computational evidence (see below).

- **Missense predictors (AlphaMissense/REVEL/SaProt) do not apply** to this variant type — they score amino-acid substitutions only. For non-missense variants the computational signal comes from conservation (below), not from a missing predictor score.
- Conservation: phyloP -8.237, GERP -4.99 — fast-evolving / accelerated position
- Molecular consequence: **frameshift** — a predicted loss-of-function variant. Gene population constraint: LOEUF 1.038, pLI 7.6168e-09. *Descriptive; not an applied PVS1 code.*
- Nonsense-mediated decay: the premature termination codon is **in exon 8 of 9**, so the transcript is predicted to undergo NMD.
- SpliceAI: **not assessed** — the release is built from a substitutions-only source, so it holds no deletion variants. That is a property of the dataset, not of the variant, and is not evidence against a splicing effect.
- Population frequency (gnomAD v4.1): grpmax **0.00119%** (nfe) · FAF95 0.000688% · FAF99 0.000539% · 14/1,179,968 in the highest group · 14/1,461,746 alleles overall — very rare (popmax 0.00119%, 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}

**ANKRD1** population constraint: LOEUF 1.038, pLI 7.6168e-09, missense-Z 0.80164. *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):

- **dilated cardiomyopathy** — Limited (AD)
- **hypertrophic cardiomyopathy** — Disputed (AD)
- **congenital heart disease** — Limited (AD)

## Protein context {#protein}


AlphaFold model confidence (whole protein): pLDDT 82.64, 54% of residues very-high.

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

*Describes the biological roles of ANKRD1 (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:** ANKRD1's established molecular role includes p53 binding.


### Pathways affected {#pathways}

ANKRD1 participates in **1 Reactome pathway** (⚕ = disease pathway):

| Pathway (Reactome) | Evidence |
| --- | --- |
| [PPARA activates gene expression](https://reactome.org/content/detail/R-HSA-1989781) | curated |

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

**Molecular function:** p53 binding, DNA binding, transcription coactivator activity, titin binding, histone deacetylase binding, RNA polymerase II-specific DNA-binding transcription factor binding.

**Biological process:** response to muscle stretch, positive regulation of apoptotic process, positive regulation of DNA damage response, signal transduction by p53 class mediator, positive regulation of protein secretion, cardiac muscle tissue morphogenesis, cellular response to lipopolysaccharide.

## Clinical significance {#significance}

**Uncertain significance** — review status Multiple submitters *(criteria provided, multiple submitters, no conflicts)*, last evaluated 2025-12-05.

**Submitter consensus:** unanimous (2/2 Uncertain significance).

**Submission history:** 2 submissions (2025); classifications have been stable.

### Submitter classifications {#submitters}

| Submitter | Classification | Review | Method | Date |
| --- | --- | --- | --- | --- |
| Ambry Genetics | Uncertain significance | criteria provided, single submitter | clinical testing | 2025-12-05 |
| Labcorp Genetics (formerly Invitae), Labcorp | Uncertain significance | criteria provided, single submitter | clinical testing | 2025-10-21 |

## Associated conditions {#conditions}

[ANKRD1-related dilated cardiomyopathy](https://sugi.bio/atlas/disease/ankrd1-related-dilated-cardiomyopathy/).

**Reported phenotype names (ClinVar):** ANKRD1-related dilated cardiomyopathy, Cardiovascular phenotype.

## Similar variants {#similar}

Related ANKRD1 variant pages (same residue, condition, or type): [ANKRD1 p.Pro255Leu](/variant/ankrd1-p-pro255leu), [ANKRD1 p.Pro255=](/variant/ankrd1-p-pro255), [ANKRD1 p.Pro52fs](/variant/ankrd1-p-pro52fs), [ANKRD1 c.345+17del](/variant/ankrd1-c-345-plus-17del), [ANKRD1 c.346-14_346-9del](/variant/ankrd1-c-346-minus-14-346-minus-9del), [ANKRD1 c.346-17_346-12del](/variant/ankrd1-c-346-minus-17-346-minus-12del), [ANKRD1 c.346-18_346-9del](/variant/ankrd1-c-346-minus-18-346-minus-9del), [ANKRD1 c.346-21_346-12del](/variant/ankrd1-c-346-minus-21-346-minus-12del).

### 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 664045). 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.*