Is COL4A4 p.Ala592= (c.1776T>C) pathogenic?

COL4A4 p.Ala592= (c.1776T>C) is classified Conflicting classifications of pathogenicity in COL4A4 (ClinVar, Conflicting submitters, 4 submitters; last evaluated 2026-02-01). Rare (popmax 0.327%, afr); Associated with Alport syndrome.

What condition is associated with COL4A4 p.Ala592= (c.1776T>C)?

COL4A4 p.Ala592= (c.1776T>C) is associated with Alport syndrome (ClinVar).

How common is COL4A4 p.Ala592= (c.1776T>C) in the general population?

COL4A4 p.Ala592= (c.1776T>C) is rare (popmax 0.327%, afr) (gnomAD).

How is Alport syndrome inherited?

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

COL4A4 p.Ala592=

c.1776T>C · rs188655353 · VCV593863

Conflicting classifications of pathogenicity Conflicting submitters

Classification

Conflicting classifications of pathogenicity

ClinVar

Review

Conflicting submitters ★☆☆☆

ClinVar · 4 submitters

gnomAD v4.1

Rare

rare (popmax 0.327%, afr)

Conditions

Alport syndrome

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 2.8	GERP 0.64, phastCons 0.98
Overall
CADD	6.053	PHRED · no single calibrated threshold — expert panels disagree

Population frequency

gnomAD v4.1 · exomes + genomes

Grpmax group 0.327% African / African-American · 245/75,028 alleles

Filtering AF 0.293% ClinGen BA1/BS1 input FAF95, joint · FAF99 0.28%

Overall 0.0165% 266/1,614,124 alleles · rare

Ancestry group	Frequency	1 in
African / African-Americangrpmax	0.327%	306
Remaining individualsnot grpmax-eligible	0.0176%	5,682
Admixed American	0.0117%	8,574
European (non-Finnish)	0.000254%	393,338

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: COL4A4
Protein: p.Ala592=
Coding: c.1776T>C
MANE Select: NM_000092
dbSNP: rs188655353
Type: single nucleotide variant
Location: chr2:227080470 (GRCh38)
Gene constraint: LOEUF 0.607 · pLI <0.01 (gnomAD)
Structure: AlphaFold pLDDT 49.03 · 2 PDB
Residue 592: the 'triple-helical region' region; the 'disordered' region

Full COL4A4 gene report on Sugi Atlas → Gene function, pathways, protein structure, interactions & more

Disease context

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

For Alport syndrome (Orphanet):

Inheritance: Autosomal dominant, Autosomal recessive, X-linked dominant
Onset: Adolescent, Adult, Childhood, Elderly

Similar variants

COL4A4 p.Ala592Pro Uncertain significance ★ ⚠ same residue
COL4A4 p.Ala592Gly Uncertain significance ⚠ same residue
COL4A4 c.1030-2A>C Likely pathogenic ★★ same condition
COL4A4 c.1369+1G>A Pathogenic/Likely pathogenic ★★ same condition
COL4A4 c.1370-2A>C Likely pathogenic ★★ same condition
COL4A4 c.1696+1G>A Likely pathogenic ★★ same condition
COL4A4 c.1696+1G>T Likely pathogenic ★★ same condition
COL4A4 c.1697-1G>A 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/col4a4-p-ala592 (accessed [today's date]).

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