Is EPHB4 p.Arg148Trp (c.442C>T) pathogenic?

EPHB4 p.Arg148Trp (c.442C>T) is classified Uncertain significance in EPHB4 (ClinVar, Multiple submitters, 2 submitters; last evaluated 2024-11-23). AlphaMissense: ambiguous (0.3727); Very rare (popmax 0.00452%, eas); Associated with Cardiovascular phenotype.

What condition is associated with EPHB4 p.Arg148Trp (c.442C>T)?

EPHB4 p.Arg148Trp (c.442C>T) is associated with Cardiovascular phenotype (ClinVar).

How common is EPHB4 p.Arg148Trp (c.442C>T) in the general population?

EPHB4 p.Arg148Trp (c.442C>T) is very rare (popmax 0.00452%, eas) (gnomAD).

What do computational predictors say about EPHB4 p.Arg148Trp (c.442C>T)?

AlphaMissense predicts ambiguous (score 0.3727) — an in-silico prediction, not a clinical call.

EPHB4 p.Arg148Trp

c.442C>T · rs774305640 · VCV1740536

Uncertain significance Multiple submitters

Classification

Uncertain significance

ClinVar

Review

Multiple submitters ★★☆☆

ClinVar · 2 submitters

AlphaMissense

ambiguous

0.3727 · ACMG-weighted

gnomAD v4.1

Rare

very rare (popmax 0.00452%, eas)

Missense predictors

0/2 damaging

REVEL, SaProt · AlphaMissense no call

Conditions

Cardiovascular phenotype

Computational evidence

Protein change
AlphaMissense	0.3727	ambiguous
REVEL	0.251	benign-leaning
SaProt	LLR -7.91	tolerated
⇒ REVEL and SaProt both call this tolerated; AlphaMissense makes no call.
Splicing
SpliceAI	—	not assessed · no allele here is in the release
Constraint at this position
Conservation	phyloP 8.5	GERP 1.1, phastCons 1
Regional constraint	o/e 0.88	unconstrained · MANE · 14 kb · p 0.00047 · regional, not allelic
Overall
CADD	28.9	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

Grpmax group 0.00452% East Asian · 2/44,296 alleles

Filtering AF 0.000748% ClinGen BA1/BS1 input FAF95, joint · FAF99 0.00028%

Overall 0.000628% 10/1,591,908 alleles · very rare

Ancestry group	Frequency	1 in
East Asiangrpmax	0.00452%	22,148
African / African-American	0.00134%	74,480
European (non-Finnish)	0.0006%	166,632

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: EPHB4
Protein: p.Arg148Trp
Coding: c.442C>T
MANE Select: NM_004444
dbSNP: rs774305640
Type: single nucleotide variant
Location: chr7:100822637 (GRCh38)
Gene constraint: LOEUF 0.645 · pLI <0.01 (gnomAD)
Structure: AlphaFold pLDDT 82.46 · 23 PDB
Residue 148: a β-strand; a disulfide bond; a UniProt-annotated variant site (in cmavm2); the eph lbd domain

Full EPHB4 gene report on Sugi Atlas → Gene function, pathways, protein structure, interactions & more

Disease context

Cardiovascular phenotype — disease report on Sugi Atlas → Associated genes, phenotypes, clinical trials & treatments

Similar variants

EPHB4 c.1870+5G>C Uncertain significance ★★ same condition
EPHB4 p.Ala262Val Uncertain significance ★★ ⚠ same condition
EPHB4 p.Ala345Gly Uncertain significance ★★ ⚠ same condition
EPHB4 p.Ala931Thr Uncertain significance ★★ ⚠ same condition
EPHB4 p.Arg310Gln Uncertain significance ★★ ⚠ same condition
EPHB4 p.Arg483Gln Uncertain significance ★★ ⚠ same condition
EPHB4 p.Arg499Gln Uncertain significance ★★ ⚠ same condition
EPHB4 p.Arg535Trp 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/ephb4-p-arg148trp (accessed [today's date]).

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