# NM_014908.4(DOLK):c.409C>T (p.Pro137Ser)

https://sugi.bio/variant/dolk-p-pro137ser

## Summary

**DOLK p.Pro137Ser (c.409C>T)** is classified **Uncertain significance** in DOLK (ClinVar, Single submitter, 1 submitter; last evaluated 2021-10-04). AlphaMissense: likely pathogenic (0.6359); Absent from gnomAD v4.1; Associated with DK1-congenital disorder of glycosylation.

**At a glance:** Uncertain significance · review: Single submitter · rsID rs2131128759 · 1 submitter · 1 linked condition · AlphaMissense likely pathogenic · absent from gnomAD v4.1

## For patients & families {#patients}

This is a change in the DOLK gene that is currently of uncertain significance — a definitive interpretation has not yet been established, submitted by 1 submitter, and is linked to DK1-congenital disorder of glycosylation.

*Reference information, not medical advice, and not a prediction for any individual. A genetic counselor or clinician can interpret what it means for you and your family.*

|  |  |
| --- | --- |
| Typical inheritance (of this condition) | Autosomal recessive |
| Age of onset (of this condition) | Infancy, Neonatal |
| Diagnostic panels | DOLK is a diagnostic-grade gene on 17 Genomics England panels |

**Commonly reported features of DK1-CDG** (across patients with this condition; presentation varies — frequencies from Orphanet):

- Dilated cardiomyopathy — Very frequent (99-80%)
- Type I transferrin isoform profile — Very frequent (99-80%)
- Abnormal enzyme/coenzyme activity — Very frequent (99-80%)
- Cardiomyocyte hypertrophy — Very frequent (99-80%)
- Seizure — Frequent (79-30%)
- Failure to thrive — Frequent (79-30%)
- Congestive heart failure — Frequent (79-30%)
- Elevated circulating hepatic transaminase concentration — Frequent (79-30%)

**Support & next steps:** [Condition overview & support (NIH GARD)](https://rarediseases.info.nih.gov/diseases/0012393/index) · [Find a genetic counselor (NSGC)](https://findageneticcounselor.nsgc.org/).

## Identity {#identity}

| Field | Value |
| --- | --- |
| Gene | [DOLK](https://sugi.bio/atlas/gene/DOLK/) |
| Protein change (HGVS p.) | p.Pro137Ser |
| Coding change (HGVS c.) | c.409C>T |
| MANE Select transcript | [NM_014908](https://www.ncbi.nlm.nih.gov/nuccore/NM_014908) |
| dbSNP | [rs2131128759](https://www.ncbi.nlm.nih.gov/snp/rs2131128759/) |
| Variant type | single nucleotide variant |
| Location | chr9:128946895-128946895 (GRCh38) |
| ClinVar | [VCV1384400](https://www.ncbi.nlm.nih.gov/clinvar/variation/1384400/) |

**All HGVS expressions:** `LRG_744:g.5839C>T`, `NC_000009.11:g.131709174G>A`, `NC_000009.12:g.128946895G>A`, `NG_017009.1:g.5839C>T`, `NG_033111.1:g.4203G>A`, `NM_014908.4:c.409C>T`

## Computational & population evidence {#evidence}

**Concordance:** Mixed / partial computational evidence (see below).

- AlphaMissense **likely pathogenic** (0.6359)
- REVEL 0.645 (pathogenic-leaning) — agrees with AlphaMissense
- SaProt LLR -8.955 (tolerated) — differs from AlphaMissense
- → **In-silico consensus:** AlphaMissense and REVEL call this damaging; SaProt does not
- Conservation: phyloP 11.911, GERP 1.88, phastCons 1 — highly conserved (agrees)
- CADD: **PHRED 24.3**. No single ClinGen-calibrated threshold exists and the expert panels that use CADD disagree — GUCY2D/AIPL1 require ≥ 20.0 for an untranslated-region variant, ABCA4 ≥ 28.1 for a synonymous or indel variant, the Pulmonary Hypertension panel imports Pejaver 2022's missense-calibrated numbers, and the Antibody Deficiencies panel declines CADD entirely for PIK3CD. CADD v1.7 also incorporates Zoonomia phyloP, so it partly re-expresses the conservation above. *Descriptive; no threshold applied.*
- Regional missense constraint: **o/e 0.87** across the covering region of the MANE Select transcript (128,945,690–128,947,303), spanning 1,613 bp. Chi-square p 0.00089. Describes the region, not this allele; gnomAD v4.1.1's own constrained determination. *Descriptive; no ACMG code applied.*
- SpliceAI: **not assessed** — no allele at this position is in our SpliceAI release, either because it lies outside the scored MANE transcript scope or because every allele is below Δ0.2. We cannot tell which, so this claims neither; absence is not evidence against a splicing effect.
- Population frequency: **absent from gnomAD v4.1** — a rarity signal (ACMG PM2-supporting), not evidence of pathogenicity on its own.

*Computational predictors are not independent (ClinGen Variant Classification guidance): AlphaMissense (Cheng et al. 2023) carries the ACMG weight for missense and conservation (phyloP/GERP/phastCons) for non-missense; REVEL (Pejaver-2022 calibrated strength bands) and SaProt (Su et al. 2023, structure-aware, ClinVar-independent protein language model, raw LLR) are shown as orthogonal agreement signals, not additive. For frequency, the gnomAD v4.1 grpmax filtering allele frequency (FAF95) is ClinGen's designated BA1/BS1 input (gnomAD v4 guidance v3.0, June 2025); BA1/BS1 thresholds are disease-specific, not a blanket 5%. Predictions, not a clinical determination.*

## Gene constraint & dosage {#gene-context}

**DOLK** population constraint: LOEUF 0.858, pLI 0.00023739, missense-Z 1.6948. *Lower LOEUF and higher pLI indicate a gene that tolerates loss-of-function poorly; ClinGen dosage is the curated haploinsufficiency call.*

Curated gene–disease validity (ClinGen):

- **DK1-congenital disorder of glycosylation** — Definitive (AR)

## Protein context {#protein}


AlphaFold model confidence (whole protein): pLDDT 90.37, 74% of residues very-high.

## What this gene does {#gene-function}

*Describes the biological roles of DOLK (the gene this variant disrupts) — not effects measured for this specific variant. A damaging variant is expected to affect these functions and pathways; the degree depends on the variant.*

**How this variant is thought to act:** DOLK's established molecular role includes dolichol kinase activity. In Reactome, DOLK is annotated in disease pathway(s) including **Defective DOLK causes DOLK-CDG**.

**Disease mechanism (Reactome):** DOLK loss or alteration is curated in [Defective DOLK causes DOLK-CDG](https://reactome.org/content/detail/R-HSA-4755583).

### Pathways affected {#pathways}

DOLK participates in **2 Reactome pathways** (⚕ = disease pathway):

| Pathway (Reactome) | Evidence |
| --- | --- |
| ⚕ [Defective DOLK causes DOLK-CDG](https://reactome.org/content/detail/R-HSA-4755583) | curated |
| [Synthesis of dolichyl-phosphate](https://reactome.org/content/detail/R-HSA-446199) | curated |

### Molecular function & processes (GO — experimentally supported) {#go}

**Molecular function:** dolichol kinase activity.

**Biological process:** dolichyl monophosphate biosynthetic process.

## Clinical significance {#significance}

**Uncertain significance** — review status Single submitter *(criteria provided, single submitter)*, last evaluated 2021-10-04.

**Submitter consensus:** unanimous (1/1 Uncertain significance).

### Submitter classifications {#submitters}

| Submitter | Classification | Review | Method | Date |
| --- | --- | --- | --- | --- |
| Labcorp Genetics (formerly Invitae), Labcorp | Uncertain significance | criteria provided, single submitter | clinical testing | 2021-10-04 |

## Associated conditions {#conditions}

[DK1-congenital disorder of glycosylation](https://sugi.bio/atlas/disease/dk1-congenital-disorder-of-glycosylation/).

**Reported phenotype names (ClinVar):** DK1-congenital disorder of glycosylation, CONGENITAL DISORDER OF GLYCOSYLATION, TYPE Im, DK1-CDG, DOLK-congenital disorder of glycosylation, Carbohydrate deficient glycoprotein syndrome type 1m, CDG Im, DK1 DEFICIENCY, DOLICHOL KINASE DEFICIENCY.

## Similar variants {#similar}

Related DOLK variant pages (same residue, condition, or type): [DOLK p.His408Asp](/variant/dolk-p-his408asp), [DOLK p.Met1Ile](/variant/dolk-p-met1ile), [DOLK p.Met1Thr](/variant/dolk-p-met1thr), [DOLK c.-194G>T](/variant/dolk-c-minus-194g-t), [DOLK c.-22G>A](/variant/dolk-c-minus-22g-a), [DOLK c.-269G>T](/variant/dolk-c-minus-269g-t), [DOLK p.Ala115Val](/variant/dolk-p-ala115val), [DOLK p.Ala129Ser](/variant/dolk-p-ala129ser).

### Data sources & attribution {#sources}

ClinVar (NCBI — public domain, built 2026-10-11); gnomAD v4.1 (Broad Institute, built 2026-10-06); AlphaMissense (Cheng et al. 2023, © Google DeepMind — CC BY 4.0, built 2026-01-27); REVEL (Ioannidis et al. 2016 — ODbL, built 2026-07-13); SaProt (Su et al. 2023 — MIT, built 2026-07-14); SpliceAI (Illumina — free for non-commercial use, built 2026-10-13); CADD (Rentzsch et al. 2019, University of Washington — free for non-commercial use, built 2026-10-10); Conservation (phyloP/phastCons/GERP) (UCSC hg38 470-way mammal (Hiller Lab) + Ensembl Compara, built 2026-07-12); gnomAD Non-coding Constraint (Gnocchi) (Chen et al. 2024, Broad Institute — CC0, built 2026-10-11); gnomAD Regional Missense Constraint (Broad Institute — CC0, built 2026-10-13); Pangolin (Zeng & Li 2022 — CC BY 4.0, built 2026-10-11); Repeat regions (UCSC — RepeatMasker, TRF, segmental duplications, built 2026-10-11); ClinGen (ClinGen, built 2026-09-22); UniProt (CC BY 4.0); Reactome / GO (CC BY 4.0, built 2026-09-23); MaveDB (per-record license, built 2026-10-11); CIViC (CC0, built 2026-09-22); Orphanet (Orphanet, built 2026-06-12)

*Primary record: NCBI ClinVar (variation 1384400). Classifications reflect these databases as of the page's build date and may change. Free reference use — not medical advice; consult the primary submitters and a clinician.*