# NM_000062.3(SERPING1):c.135C>T (p.Val45=)

https://sugi.bio/variant/serping1-p-val45

## Summary

**SERPING1 p.Val45= (c.135C>T)** is classified **Uncertain significance** in SERPING1 (ClinVar, Single submitter, 1 submitter; last evaluated 2018-01-12). Very rare (popmax 0.00267%, afr); Associated with hereditary angioedema type 1.

**At a glance:** Uncertain significance · review: Single submitter · rsID rs886048399 · 1 submitter · 1 linked condition · very rare (popmax 0.00267%, afr)

## For patients & families {#patients}

This is a change in the SERPING1 gene that is currently of uncertain significance — a definitive interpretation has not yet been established, submitted by 1 submitter, and is linked to hereditary angioedema type 1.

*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) | Not applicable |
| Age of onset (of this condition) | Adult, Elderly |
| Clinical trials | 7 registered for this condition — see ClinicalTrials.gov |
| Diagnostic panels | SERPING1 is a diagnostic-grade gene on 3 Genomics England panels |

**Commonly reported features of Hereditary angioedema with C1Inh deficiency** (across patients with this condition; presentation varies — frequencies from Orphanet):

- Facial edema — Frequent (79-30%)
- Skin rash — Frequent (79-30%)
- Joint swelling — Frequent (79-30%)
- Diarrhea — Frequent (79-30%)
- Nausea and vomiting — Frequent (79-30%)
- Abdominal pain — Frequent (79-30%)
- Pharyngeal edema — Frequent (79-30%)
- Laryngeal edema — Frequent (79-30%)

**Support & next steps:** [Condition overview & support (NIH GARD)](https://rarediseases.info.nih.gov/diseases/0016933/index) · [Find a genetic counselor (NSGC)](https://findageneticcounselor.nsgc.org/).

## Identity {#identity}

| Field | Value |
| --- | --- |
| Gene | [SERPING1](https://sugi.bio/atlas/gene/SERPING1/) |
| Protein change (HGVS p.) | p.Val45= |
| Coding change (HGVS c.) | c.135C>T |
| MANE Select transcript | [NM_000062](https://www.ncbi.nlm.nih.gov/nuccore/NM_000062) |
| dbSNP | [rs886048399](https://www.ncbi.nlm.nih.gov/snp/rs886048399/) |
| Variant type | single nucleotide variant |
| Location | chr11:57599962-57599962 (GRCh38) |
| ClinVar | [VCV305019](https://www.ncbi.nlm.nih.gov/clinvar/variation/305019/) |

**All HGVS expressions:** `LRG_105:g.7409C>T`, `LRG_105t1:c.135C>T`, `NC_000011.10:g.57599962C>T`, `NC_000011.9:g.57367435C>T`, `NG_009625.1:g.7409C>T`, `NM_000062.3:c.135C>T`, `NM_001032295.2:c.135C>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 -0.48, GERP -4.31 — not a conserved position (phyloP < 0.1, ACGS BP7 cut)
- CADD: **PHRED 2.122**. 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: **no splice effect predicted**. SpliceAI outputs four numbers per variant, not one: acceptor loss, donor loss, acceptor gain, donor gain (DS_AL / DS_DL / DS_AG / DS_DG). A loss score is an existing splice site weakened or destroyed; a gain score is a new site created or an existing one strengthened. The release publishes its own filter rule, which we read from the dataset rather than assume: an allele is reported only if the largest of its four deltas reaches 0.2. No allele at this position is in the release, so all four are under 0.2 for every alternate allele here. No figure is shown because none was read: the bound is deduced from that absence. It is a result, not a gap in our data, because the release scores every possible substitution across the transcripts it covers (Ensembl MANE v1.4) before it filters, so what survives for a gene is one continuous stretch. What is measured is that this position sits inside the stretch covered for SERPING1 (352 scored positions, the nearest 6 bases away); what is taken from the release's own description, rather than measured, is that coverage inside that stretch is continuous. On that, SpliceAI did score it. *ClinGen's SVI treats the largest of the four as evidence against a splicing effect at or below 0.1, where it may support BP4, and as uninformative between 0.1 and 0.2. We cannot tell which applies here, so these SpliceAI data support neither BP4 nor PP3; that is a statement about this evidence alone, not about the variant's other evidence.*
- Population frequency (gnomAD v4.1): grpmax **0.00267%** (afr) · FAF95 0.000443% · FAF99 0.000166% · 2/74,920 in the highest group · 11/1,614,072 alleles overall — very rare (popmax 0.00267%, afr).

| Ancestry group | Allele frequency | 1 in |
| --- | --- | --- |
| Remaining individuals (not grpmax-eligible) | 0.0032% | 31,244 |
| African / African-American (grpmax) | 0.00267% | 37,460 |
| South Asian | 0.0011% | 91,084 |
| European (non-Finnish) | 0.000508% | 196,674 |

Remaining individuals shows a higher raw frequency than the grpmax group. gnomAD excludes bottlenecked groups — Finnish, Ashkenazi Jewish, Amish and "Remaining individuals" — from grpmax, because founder effects make their frequencies unrepresentative for filtering. The table is sorted by frequency, so an excluded group can sit above the grpmax row.

*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}

**SERPING1** population constraint: LOEUF 0.278, pLI 0.99999, missense-Z 1.8596. *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):

- **hereditary angioedema with C1Inh deficiency** — Definitive (AD)

## Protein context {#protein}


AlphaFold model confidence (whole protein): pLDDT 80.63, 68% of residues very-high.

**5 experimental structure(s)** (PDB): [2OAY](https://www.rcsb.org/structure/2OAY), [5DU3](https://www.rcsb.org/structure/5DU3), [5DUQ](https://www.rcsb.org/structure/5DUQ), [7AKV](https://www.rcsb.org/structure/7AKV), [8W18](https://www.rcsb.org/structure/8W18).

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

*Describes the biological roles of SERPING1 (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:** SERPING1's established molecular role includes serine-type endopeptidase inhibitor activity. In Reactome, SERPING1 is annotated in disease pathway(s) including **Defective SERPING1 causes hereditary angioedema**.

**Disease mechanism (Reactome):** SERPING1 loss or alteration is curated in [Defective SERPING1 causes hereditary angioedema](https://reactome.org/content/detail/R-HSA-9657689).

### Pathways affected {#pathways}

SERPING1 participates in **6 Reactome pathways** (⚕ = disease pathway):

| Pathway (Reactome) | Evidence |
| --- | --- |
| ⚕ [Defective SERPING1 causes hereditary angioedema](https://reactome.org/content/detail/R-HSA-9657689) | curated |
| [Platelet degranulation ](https://reactome.org/content/detail/R-HSA-114608) | curated |
| [Regulation of Complement cascade](https://reactome.org/content/detail/R-HSA-977606) | curated |
| [Regulation of FXIIa and plasma kallikrein activity](https://reactome.org/content/detail/R-HSA-9855719) | curated |
| [Regulation of clotting cascade](https://reactome.org/content/detail/R-HSA-9769739) | curated |
| [None](https://reactome.org/content/detail/R-HSA-140837) | other |

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

**Molecular function:** serine-type endopeptidase inhibitor activity.

**Biological process:** negative regulation of complement activation, lectin pathway.

## Clinical significance {#significance}

**Uncertain significance** — review status Single submitter *(criteria provided, single submitter)*, last evaluated 2018-01-12.

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

### Submitter classifications {#submitters}

| Submitter | Classification | Review | Method | Date |
| --- | --- | --- | --- | --- |
| Illumina Laboratory Services, Illumina | Uncertain significance | criteria provided, single submitter | clinical testing | 2018-01-12 |

## Associated conditions {#conditions}

[hereditary angioedema type 1](https://sugi.bio/atlas/disease/hereditary-angioedema-type-1/).

**Reported phenotype names (ClinVar):** Hereditary angioedema type 1.

## Similar variants {#similar}

Related SERPING1 variant pages (same residue, condition, or type): [SERPING1 p.Val45Phe](/variant/serping1-p-val45phe), [SERPING1 p.Val45Ala](/variant/serping1-p-val45ala), [SERPING1 c.1030-1G>T](/variant/serping1-c-1030-minus-1g-t), [SERPING1 c.51+1G>T](/variant/serping1-c-51-plus-1g-t), [SERPING1 c.51+3A>C](/variant/serping1-c-51-plus-3a-c), [SERPING1 c.52-1G>A](/variant/serping1-c-52-minus-1g-a), [SERPING1 c.550+1G>A](/variant/serping1-c-550-plus-1g-a), [SERPING1 c.551-1G>C](/variant/serping1-c-551-minus-1g-c).

### Data sources & attribution {#sources}

ClinVar (NCBI — public domain, built 2026-10-14); gnomAD v4.1 (Broad Institute, built 2026-10-15); 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 305019). 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.*