Is ARSA p.Ala191= (c.573G>A) pathogenic?

ARSA p.Ala191= (c.573G>A) is classified Likely benign in ARSA (ClinVar, Single submitter, 1 submitter; last evaluated 2025-09-21). Ultra-rare (popmax 0.0173%, afr); Associated with metachromatic leukodystrophy.

What condition is associated with ARSA p.Ala191= (c.573G>A)?

ARSA p.Ala191= (c.573G>A) is associated with metachromatic leukodystrophy (ClinVar).

How common is ARSA p.Ala191= (c.573G>A) in the general population?

ARSA p.Ala191= (c.573G>A) is ultra-rare (popmax 0.0173%, afr) (gnomAD).

How is Metachromatic leukodystrophy inherited?

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

ARSA p.Ala191=

c.573G>A · rs376834935 · VCV1148562

Likely benign Single submitter

Classification

Likely benign

ClinVar

Review

Single submitter ★☆☆☆

ClinVar · 1 submitter

gnomAD v4.1

Rare

ultra-rare (popmax 0.0173%, afr)

Conditions

metachromatic leukodystrophy

Computational evidence

Protein change
Missense predictors do not apply to this variant type; conservation carries the signal.
Splicing
SpliceAI	—	not assessed · no allele here is in the release
Constraint at this position
Conservation	phyloP -11	GERP -4.3
Overall
CADD	0.45	PHRED · no single calibrated threshold — expert panels disagree

Population frequency

gnomAD v4.1 · exomes + genomes

Grpmax group 0.0173% African / African-American · 13/75,062 alleles

Filtering AF 0.0102% ClinGen BA1/BS1 input FAF95, joint · FAF99 0.00811%

Overall 0.00198% 32/1,613,108 alleles · ultra-rare exomes 28/1,460,778 · genomes 4/152,330 · joint denominator

Ancestry group	Frequency	1 in
African / African-Americangrpmax	0.0173%	5,774
Admixed American	0.00666%	15,007
South Asian	0.00329%	30,361
Remaining individualsnot grpmax-eligible	0.0032%	31,239
European (non-Finnish)	0.000847%	117,997

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: ARSA
Protein: p.Ala191=
Coding: c.573G>A
MANE Select: NM_000487
dbSNP: rs376834935
Type: single nucleotide variant
Location: chr22:50626945 (GRCh38)
Gene constraint: LOEUF 1.166 · pLI <0.01 (gnomAD)
Structure: AlphaFold pLDDT 96.43 · 10 PDB
Residue 191: a β-strand; a UniProt-annotated variant site (in mld; juvenile-onset)

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

Disease context

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

For Metachromatic leukodystrophy (Orphanet):

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

Similar variants

ARSA p.Ala191Thr Uncertain significance ★ same residue
ARSA p.Ala191Val Uncertain significance ★ same residue
ARSA c.1107+1G>A Pathogenic/Likely pathogenic ★★ same condition
ARSA c.1107+1G>T Pathogenic ★★ same condition
ARSA c.1108-2A>G Pathogenic ★★ same condition
ARSA c.1108-3C>G Pathogenic/Likely pathogenic ★★ same condition
ARSA c.1210+1G>A Pathogenic ★★ same condition
ARSA c.224+1G>A 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/arsa-p-ala191 (accessed [today's date]).

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