Is ARSA p.Pro428= (c.1284G>A) pathogenic?

ARSA p.Pro428= (c.1284G>A) is classified Likely benign in ARSA (ClinVar, Single submitter, 1 submitter; last evaluated 2025-03-17). Very rare (popmax 0.00448%, eas); Associated with metachromatic leukodystrophy.

What condition is associated with ARSA p.Pro428= (c.1284G>A)?

ARSA p.Pro428= (c.1284G>A) is associated with metachromatic leukodystrophy (ClinVar).

How common is ARSA p.Pro428= (c.1284G>A) in the general population?

ARSA p.Pro428= (c.1284G>A) is very rare (popmax 0.00448%, eas) (gnomAD).

How is Metachromatic leukodystrophy inherited?

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

ARSA p.Pro428=

c.1284G>A · rs143139801 · VCV1125884

Likely benign Single submitter

Classification

Likely benign

ClinVar

Review

Single submitter ★☆☆☆

ClinVar · 1 submitter

gnomAD v4.1

Rare

very rare (popmax 0.00448%, eas)

Conditions

metachromatic leukodystrophy

Computational evidence

Protein change
Missense predictors do not apply to this variant type; conservation carries the signal.
Splicing
SpliceAI	<0.2	all four deltas below 0.2 · C>A here scores Δ0.37 · evaluated, not missing
Constraint at this position
Conservation	phyloP -12	GERP -4.7
Overall
CADD	0.96	PHRED · no single calibrated threshold — expert panels disagree

Population frequency

gnomAD v4.1 · exomes + genomes

Grpmax group 0.00448% East Asian · 2/44,630 alleles

Filtering AF 0.000743% ClinGen BA1/BS1 input FAF95, joint · FAF99 0.000278%

Overall 0.00075% 12/1,599,908 alleles · very rare exomes 11/1,447,704 · genomes 1/152,204 · joint denominator

Ancestry group	Frequency	1 in
East Asiangrpmax	0.00448%	22,315
Admixed American	0.00337%	29,683
Remaining individualsnot grpmax-eligible	0.00162%	61,752
African / African-American	0.00134%	74,636
European (non-Finnish)	0.000512%	195,155

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.Pro428=
Coding: c.1284G>A
MANE Select: NM_000487
dbSNP: rs143139801
Type: single nucleotide variant
Location: chr22:50625391 (GRCh38)
Gene constraint: LOEUF 1.166 · pLI <0.01 (gnomAD)
Structure: AlphaFold pLDDT 96.43 · 10 PDB
Residue 428: a UniProt-annotated variant site (in mld; late-infantile form); a β-strand

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.Pro428Leu Pathogenic ★★ same residue
ARSA p.Pro428Ala Likely pathogenic ★ same residue
ARSA p.Pro428Ser Likely pathogenic ★ same residue
ARSA p.Pro428Arg Likely pathogenic 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

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-pro428 (accessed [today's date]).

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