Is CBS p.His65Leu (c.194A>T) pathogenic?

CBS p.His65Leu (c.194A>T) is classified Likely pathogenic in CBS (ClinVar, Single submitter, 1 submitter; last evaluated 2024-10-28). AlphaMissense: ambiguous (0.5009); Absent from gnomAD v4.1; Associated with HYPERHOMOCYSTEINEMIA, THROMBOTIC, CBS-RELATED.

What condition is associated with CBS p.His65Leu (c.194A>T)?

CBS p.His65Leu (c.194A>T) is associated with HYPERHOMOCYSTEINEMIA, THROMBOTIC, CBS-RELATED (ClinVar).

How common is CBS p.His65Leu (c.194A>T) in the general population?

CBS p.His65Leu (c.194A>T) is absent from gnomAD v4.1 (gnomAD).

What do computational predictors say about CBS p.His65Leu (c.194A>T)?

AlphaMissense predicts ambiguous (score 0.5009) — an in-silico prediction, not a clinical call.

CBS p.His65Leu

c.194A>T · rs1191141364 · VCV2878068

Likely pathogenic Single submitter

Classification

Likely pathogenic

ClinVar

Review

Single submitter ★☆☆☆

ClinVar · 1 submitter

AlphaMissense

ambiguous

0.5009 · ACMG-weighted

gnomAD v4.1

Absent

absent from gnomAD v4.1

Missense predictors

1/2 damaging

REVEL, SaProt · AlphaMissense no call

Conditions

HYPERHOMOCYSTEINEMIA, THROMBOTIC, CBS-RELATED

Computational evidence

Protein change
AlphaMissense	0.5009	ambiguous
REVEL	0.739	pathogenic-leaning
SaProt	LLR -6.65	tolerated
⇒ REVEL calls this damaging; SaProt does not; AlphaMissense makes no call.
Splicing
SpliceAI	—	not assessed · no allele here is in the release
Constraint at this position
Conservation	phyloP 7.6	GERP 1.5, phastCons 1
Regional constraint	o/e 0.63	unconstrained · MANE · 5,845 bp · p 0.12 · regional, not allelic
Overall
CADD	23.7	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: CBS
Protein: p.His65Leu
Coding: c.194A>T
MANE Select: NM_000071
dbSNP: rs1191141364
Type: single nucleotide variant
Location: chr21:43072000 (GRCh38)
Structure: AlphaFold pLDDT 90.15 · 28 PDB
Residue 65: a UniProt-annotated variant site (in cbsd; decreased cystathionine beta-synthase activity; inhibited by adomet and adohcy; decreased homotetramer formation); the 'disordered' region; a binding site

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

Disease context

HYPERHOMOCYSTEINEMIA, THROMBOTIC, CBS-RELATED — disease report on Sugi Atlas → Associated genes, phenotypes, clinical trials & treatments

Similar variants

CBS p.His65Arg Pathogenic ★★ ⚠ same residue
CBS p.His65Pro Likely pathogenic ★ same residue
CBS c.1145+1G>A Pathogenic/Likely pathogenic ★★ same condition
CBS c.1223+1G>T Pathogenic ★★ same condition
CBS c.1552+1G>A Pathogenic/Likely pathogenic ★★ same condition
CBS c.451+1G>T Likely pathogenic ★★ same condition
CBS c.531+1G>A Likely pathogenic ★★ same condition
CBS c.736+2T>G 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/cbs-p-his65leu (accessed [today's date]).

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