Is CPE p.Val445Ala (c.1334T>C) pathogenic?

CPE p.Val445Ala (c.1334T>C) is classified Uncertain significance in CPE (ClinVar, No assertion criteria, 1 submitter; last evaluated 2024-09-03). AlphaMissense: likely benign (0.1786); Very rare (popmax 0.0013%, sas); Associated with CPE-related disorder.

What condition is associated with CPE p.Val445Ala (c.1334T>C)?

CPE p.Val445Ala (c.1334T>C) is associated with CPE-related disorder (ClinVar).

How common is CPE p.Val445Ala (c.1334T>C) in the general population?

CPE p.Val445Ala (c.1334T>C) is very rare (popmax 0.0013%, sas) (gnomAD).

What do computational predictors say about CPE p.Val445Ala (c.1334T>C)?

AlphaMissense predicts likely benign (score 0.1786) — an in-silico prediction, not a clinical call.

CPE p.Val445Ala

c.1334T>C · VCV3354966

Uncertain significance No assertion criteria

Classification

Uncertain significance

ClinVar

Review

No assertion criteria ☆☆☆☆

ClinVar · 1 submitter

AlphaMissense

likely benign

0.1786 · ACMG-weighted

gnomAD v4.1

Rare

very rare (popmax 0.0013%, sas)

Missense predictors

0/3 damaging

AlphaMissense, REVEL, SaProt

Conditions

CPE-related disorder

Computational evidence

Protein change
AlphaMissense	0.1786	likely benign
REVEL	0.269	benign-leaning
SaProt	LLR -9.01	tolerated
⇒ AlphaMissense, REVEL and SaProt all call this tolerated.
Splicing
SpliceAI	—	not assessed · no allele here is in the release
Constraint at this position
Conservation	phyloP 6.1	GERP 2, phastCons 1
Regional constraint	o/e 0.85	unconstrained · MANE · 118 kb · p 0.00025 · regional, not allelic
Overall
CADD	25.6	PHRED · no single calibrated threshold — expert panels disagree

ClinVar classifies this uncertain; the computational predictors unanimously lean tolerated — a triage signal, not a reclassification

AlphaMissense carries the ACMG weight for missense; REVEL and SaProt are independent agreement signals.

Population frequency

gnomAD v4.1 · exomes + genomes

Grpmax group 0.0013% South Asian · 1/77,134 alleles

Filtering AF 8.2e-05% ClinGen BA1/BS1 input FAF95, joint · FAF99 5.5e-05%

Overall 0.000326% 5/1,535,680 alleles · very rare

Ancestry group	Frequency	1 in
South Asiangrpmax	0.0013%	77,134
European (non-Finnish)	0.00035%	285,510

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: CPE
Protein: p.Val445Ala
Coding: c.1334T>C
MANE Select: NM_001873
Type: single nucleotide variant
Location: chr4:165497513 (GRCh38)
Gene constraint: LOEUF 0.565 · pLI 0.83 (gnomAD)
Structure: AlphaFold pLDDT 90.83
Residue 445: a UniProt-annotated variant site (in bdvs)

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

Disease context

CPE-related disorder

Similar variants

CPE p.Arg121Ter Pathogenic ★★ same condition
CPE c.974-3C>T Uncertain significance ★ same condition
CPE p.Ile415Met Uncertain significance ★ ⚠ same condition
CPE p.Pro30Ala Uncertain significance ★ ⚠ same condition
CPE c.673-2A>G Uncertain significance same condition
CPE p.Ala231Gly Uncertain significance ⚠ same condition
CPE p.Ala266Ser Uncertain significance ⚠ same condition
CPE p.Ala389Val Uncertain significance ⚠ 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/cpe-p-val445ala (accessed [today's date]).

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