# NM_004958.4(MTOR):c.456C>T (p.Ala152=)

https://sugi.bio/variant/mtor-p-ala152

## Summary

**MTOR p.Ala152= (c.456C>T)** is classified **Uncertain significance** in MTOR (ClinVar, Single submitter, 1 submitter; last evaluated 2025-12-01). Absent from gnomAD v4.1.

**At a glance:** Uncertain significance · review: Single submitter · 1 submitter · absent from gnomAD v4.1

## For patients & families {#patients}

This is a change in the MTOR gene that is currently of uncertain significance — a definitive interpretation has not yet been established, submitted by 1 submitter.

*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.*

**Support & next steps:** [Find a genetic counselor (NSGC)](https://findageneticcounselor.nsgc.org/).

## Identity {#identity}

| Field | Value |
| --- | --- |
| Gene | [MTOR](https://sugi.bio/atlas/gene/MTOR/) |
| Protein change (HGVS p.) | p.Ala152= |
| Coding change (HGVS c.) | c.456C>T |
| MANE Select transcript | [NM_004958](https://www.ncbi.nlm.nih.gov/nuccore/NM_004958) |
| Variant type | single nucleotide variant |
| Location | chr1:11256981-11256981 (GRCh38) |
| ClinVar | [VCV4681869](https://www.ncbi.nlm.nih.gov/clinvar/variation/4681869/) |

**All HGVS expressions:** `LRG_734:g.10571C>T`, `LRG_734t1:c.456C>T`, `NC_000001.10:g.11317038G>A`, `NC_000001.11:g.11256981G>A`, `NG_033239.1:g.10571C>T`, `NM_001386500.1:c.456C>T`, `NM_001386501.1:c.-684C>T`, `NM_004958.4:c.456C>T`

## Computational & population evidence {#evidence}

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

- **Missense predictors (AlphaMissense/REVEL/SaProt) do not apply** to this variant type — they score amino-acid substitutions only. For non-missense variants the computational signal comes from conservation (below), not from a missing predictor score.
- Conservation: phyloP 3.373, GERP 0.692, phastCons 1 — highly conserved position (PP3-type support)
- CADD: **PHRED 11.8**. 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.*
- 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}

**MTOR** population constraint: LOEUF 0.268, pLI 1, missense-Z 9.505; ClinGen dosage — haploinsufficiency 0/3, triplosensitivity 0/3. *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):

- **overgrowth syndrome and/or cerebral malformations due to abnormalities in MTOR pathway genes** — Definitive (AD)

## Protein context {#protein}

Residue **152** lies in an α-helix; the 'interaction with nbn' region.

AlphaFold model confidence (whole protein): pLDDT 78.57, 11% of residues very-high.

**73 experimental structure(s)** (PDB): [1AUE](https://www.rcsb.org/structure/1AUE), [1FAP](https://www.rcsb.org/structure/1FAP), [1NSG](https://www.rcsb.org/structure/1NSG), [2FAP](https://www.rcsb.org/structure/2FAP), [2GAQ](https://www.rcsb.org/structure/2GAQ), [2NPU](https://www.rcsb.org/structure/2NPU) — incl. mutant structure 6M4U.

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

*Describes the biological roles of MTOR (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:** MTOR's established molecular role includes inositol hexakisphosphate binding. p.Ala152= falls in the interaction with nbn region. In Reactome, MTOR is annotated in disease pathway(s) including **Constitutive Signaling by AKT1 E17K in Cancer**, **Dengue virus modulates apoptosis**.

**Disease mechanism (Reactome):** MTOR loss or alteration is curated in [Constitutive Signaling by AKT1 E17K in Cancer](https://reactome.org/content/detail/R-HSA-5674400), [Dengue virus modulates apoptosis](https://reactome.org/content/detail/R-HSA-9920951).

### Pathways affected {#pathways}

MTOR participates in **15 Reactome pathways** (⚕ = disease pathway):

| Pathway (Reactome) | Evidence |
| --- | --- |
| ⚕ [Constitutive Signaling by AKT1 E17K in Cancer](https://reactome.org/content/detail/R-HSA-5674400) | curated |
| ⚕ [Dengue virus modulates apoptosis](https://reactome.org/content/detail/R-HSA-9920951) | curated |
| [Amino acids regulate mTORC1](https://reactome.org/content/detail/R-HSA-9639288) | curated |
| [CD28 dependent PI3K/Akt signaling](https://reactome.org/content/detail/R-HSA-389357) | curated |
| [Energy dependent regulation of mTOR by LKB1-AMPK](https://reactome.org/content/detail/R-HSA-380972) | curated |
| [HSF1-dependent transactivation](https://reactome.org/content/detail/R-HSA-3371571) | curated |
| [High laminar flow shear stress activates signaling by PIEZO1 and PECAM1:CDH5:KDR in endothelial cells](https://reactome.org/content/detail/R-HSA-9856530) | curated |
| [MTOR signalling](https://reactome.org/content/detail/R-HSA-165159) | curated |
| [Macroautophagy](https://reactome.org/content/detail/R-HSA-1632852) | curated |
| [PIP3 activates AKT signaling](https://reactome.org/content/detail/R-HSA-1257604) | curated |
| [Regulation of PTEN gene transcription](https://reactome.org/content/detail/R-HSA-8943724) | curated |
| [Regulation of TP53 Degradation](https://reactome.org/content/detail/R-HSA-6804757) | curated |
| [TP53 Regulates Metabolic Genes](https://reactome.org/content/detail/R-HSA-5628897) | curated |
| [VEGFR2 mediated vascular permeability](https://reactome.org/content/detail/R-HSA-5218920) | curated |
| [mTORC1-mediated signalling](https://reactome.org/content/detail/R-HSA-166208) | curated |

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

**Molecular function:** inositol hexakisphosphate binding, RNA polymerase III type 1 promoter sequence-specific DNA binding, RNA polymerase III type 2 promoter sequence-specific DNA binding, RNA polymerase III type 3 promoter sequence-specific DNA binding, TFIIIC-class transcription factor complex binding, protein kinase activity.

**Biological process:** regulation of cell growth, protein phosphorylation, regulation of cell size, cellular response to starvation, negative regulation of autophagy, positive regulation of epithelial to mesenchymal transition.

## Clinical significance {#significance}

**Uncertain significance** — review status Single submitter *(criteria provided, single submitter)*, last evaluated 2025-12-01.

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

### Submitter classifications {#submitters}

| Submitter | Classification | Review | Method | Date |
| --- | --- | --- | --- | --- |
| CeGaT Center for Human Genetics Tuebingen | Uncertain significance | criteria provided, single submitter | clinical testing | 2025-12-01 |

**Reported phenotype names (ClinVar):** not provided, none provided.

## Similar variants {#similar}

Related MTOR variant pages (same residue, condition, or type): [MTOR p.Ala152Val](/variant/mtor-p-ala152val), [MTOR p.Ala1669Ser](/variant/mtor-p-ala1669ser), [MTOR p.Cys1483Arg](/variant/mtor-p-cys1483arg), [MTOR p.Cys1483Tyr](/variant/mtor-p-cys1483tyr), [MTOR p.Leu1460Pro](/variant/mtor-p-leu1460pro), [MTOR p.Leu2427Pro](/variant/mtor-p-leu2427pro), [MTOR p.Ser2215Phe](/variant/mtor-p-ser2215phe), [MTOR p.Ser2215Tyr](/variant/mtor-p-ser2215tyr).

### Data sources & attribution {#sources}

ClinVar (NCBI — public domain, built 2026-10-14); gnomAD v4.1 (Broad Institute, built 2026-10-14); 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 2026-10-14); 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 4681869). 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.*