Is CTRC p.Arg254Pro (c.761G>C) pathogenic?

CTRC p.Arg254Pro (c.761G>C) is classified Uncertain significance in CTRC (ClinVar, Multiple submitters, 3 submitters; last evaluated 2024-07-17). AlphaMissense: likely pathogenic (0.9848); Very rare (popmax 0.000424%, nfe); Associated with hereditary chronic pancreatitis.

What condition is associated with CTRC p.Arg254Pro (c.761G>C)?

CTRC p.Arg254Pro (c.761G>C) is associated with hereditary chronic pancreatitis (ClinVar).

How common is CTRC p.Arg254Pro (c.761G>C) in the general population?

CTRC p.Arg254Pro (c.761G>C) is very rare (popmax 0.000424%, nfe) (gnomAD).

What do computational predictors say about CTRC p.Arg254Pro (c.761G>C)?

AlphaMissense predicts likely pathogenic (score 0.9848) — an in-silico prediction, not a clinical call.

CTRC p.Arg254Pro

Q: How is Autosomal dominant hereditary chronic pancreatitis inherited?

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

c.761G>C · rs755811899 · VCV827156

Uncertain significance Multiple submitters

Classification

Uncertain significance

ClinVar

Review

Multiple submitters ★★☆☆

ClinVar · 3 submitters

AlphaMissense

likely pathogenic

0.9848 · ACMG-weighted

gnomAD v4.1

Rare

very rare (popmax 0.000424%, nfe)

Missense predictors

3/3 damaging

AlphaMissense, REVEL, SaProt

Conditions

hereditary chronic pancreatitis

Computational evidence

Protein change
AlphaMissense	0.9848	likely pathogenic · top 5% in CTRC
REVEL	0.9	moderately pathogenic-leaning
SaProt	LLR -15.26	damaging
⇒ AlphaMissense, REVEL and SaProt all call this damaging.
Splicing
SpliceAI	—	not assessed · no allele here is in the release
Constraint at this position
Conservation	phyloP 7.3	GERP 1.6, phastCons 1
Regional constraint	o/e 0.90	unconstrained · MANE · 8,121 bp · p 0.049 · regional, not allelic
Overall
CADD	26.7	PHRED · no single calibrated threshold — expert panels disagree

ClinVar classifies this uncertain; the computational predictors unanimously lean damaging — 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 0.000424% European (non-Finnish) · 5/1,180,032 alleles

Filtering AF 0.000124% ClinGen BA1/BS1 input FAF95, joint · FAF99 9e-05%

Overall 0.00031% 5/1,614,042 alleles · very rare

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: CTRC
Protein: p.Arg254Pro
Coding: c.761G>C
MANE Select: NM_007272
dbSNP: rs755811899
Type: single nucleotide variant
Location: chr1:15445718 (GRCh38)
Gene constraint: LOEUF 1.147 · pLI <0.01 (gnomAD)
Structure: AlphaFold pLDDT 94.03 · 1 PDB
Residue 254: the peptidase s1 domain; a UniProt-annotated variant site (in pctt; results in reduced protein secretion and loss of activity); a UniProt-annotated variant site (found in a patient with chronic pancreatitis; uncertain significance; mutant protein secretion, activity and trypsin-mediated degradation are comparable to those of wild-type); a UniProt-annotated variant site (in pctt; results in reduced secretion; normal activity; the mutant undergoes proteolytic degradation during trypsin-mediated activation); a β-strand

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

Disease context

hereditary chronic pancreatitis — disease report on Sugi Atlas → Associated genes, phenotypes, clinical trials & treatments

For Autosomal dominant hereditary chronic pancreatitis (Orphanet):

Inheritance: Autosomal dominant
Onset: Adolescent, Childhood
Prevalence: 1-9 / 1 000 000 (France)

Similar variants

CTRC p.Arg254Gln Uncertain significance ★★ ⚠ same residue
CTRC p.Arg254= Likely benign ★ same residue
CTRC c.494-1G>C Pathogenic/Likely pathogenic ★★ same condition
CTRC p.Arg29Ter Pathogenic/Likely pathogenic ★★ same condition
CTRC p.Gln174Ter Pathogenic/Likely pathogenic ★★ same condition
CTRC c.356+1G>A Uncertain significance ★★ same condition
CTRC c.40+4A>G Uncertain significance ★★ same condition
CTRC c.40+6C>T 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/ctrc-p-arg254pro (accessed [today's date]).

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