# NM_019894.4(TMPRSS4):c.544C>G (p.Pro182Ala)

https://sugi.bio/variant/tmprss4-p-pro182ala

## Summary

**TMPRSS4 p.Pro182Ala (c.544C>G)** is classified **Uncertain significance** in TMPRSS4 (ClinVar, Single submitter, 1 submitter; last evaluated 2023-06-26). AlphaMissense: likely benign (0.0691); Absent from gnomAD v4.1.

**At a glance:** Uncertain significance · review: Single submitter · rsID rs748690185 · 1 submitter · AlphaMissense likely benign · absent from gnomAD v4.1

## For patients & families {#patients}

This is a change in the TMPRSS4 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 | [TMPRSS4](https://sugi.bio/atlas/gene/TMPRSS4/) |
| Protein change (HGVS p.) | p.Pro182Ala |
| Coding change (HGVS c.) | c.544C>G |
| MANE Select transcript | [NM_019894](https://www.ncbi.nlm.nih.gov/nuccore/NM_019894) |
| dbSNP | [rs748690185](https://www.ncbi.nlm.nih.gov/snp/rs748690185/) |
| Variant type | single nucleotide variant |
| Location | chr11:118108857-118108857 (GRCh38) |
| ClinVar | [VCV2606384](https://www.ncbi.nlm.nih.gov/clinvar/variation/2606384/) |

**All HGVS expressions:** `NC_000011.10:g.118108857C>G`, `NC_000011.9:g.117979572C>G`, `NG_011858.3:g.36781C>G`, `NM_001083947.2:c.529C>G`, `NM_001173551.2:c.538C>G`, `NM_001173552.2:c.424C>G`, `NM_001290094.2:c.469C>G`, `NM_001290096.2:c.103C>G`, `NM_019894.4:c.544C>G`, `NR_110734.2:n.763C>G`

## Computational & population evidence {#evidence}

**Concordance:** ClinVar classifies this **uncertain**; the computational predictors unanimously lean **tolerated** — a triage signal, not a reclassification.

- AlphaMissense **likely benign** (0.0691)
- REVEL 0.031 (moderately benign-leaning) — agrees with AlphaMissense
- SaProt LLR -5.876 (tolerated) — agrees with AlphaMissense
- → **In-silico consensus:** AlphaMissense, REVEL and SaProt all call this tolerated
- Conservation: phyloP -0.28, GERP -2.99 — not a conserved position (phyloP < 0.1, ACGS BP7 cut)
- CADD: **PHRED 7.338**. 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 0.98** across the covering region of the MANE Select transcript (118,077,303–118,117,910), spanning 40,607 bp. Chi-square p 0.65. Describes the region, not this allele; gnomAD v4.1.1's own constrained determination. *Descriptive; no ACMG code applied.*
- SpliceAI: **below the reporting threshold**. This position is scored for a different substitution (C>T, Δ0.21 acceptor gain), so this allele was evaluated and its deltas all fell under Δ0.2 — a prediction of no splicing effect for this allele, not a gap in our data. *No ACMG code assigned.*
- 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}

**TMPRSS4** population constraint: LOEUF 0.94, pLI 6.81e-11, missense-Z 0.56131. *Lower LOEUF and higher pLI indicate a gene that tolerates loss-of-function poorly; ClinGen dosage is the curated haploinsufficiency call.*

## Protein context {#protein}

Residue **182** lies in a disulfide bond; the srcr domain.

AlphaFold model confidence (whole protein): pLDDT 88.01, 67% of residues very-high.

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

*Describes the biological roles of TMPRSS4 (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:** TMPRSS4's established molecular role includes serine-type peptidase activity. p.Pro182Ala falls in the srcr domain.


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

**Molecular function:** serine-type peptidase activity.

**Biological process:** proteolysis, regulation of gene expression, protein processing, negative regulation of growth rate, positive regulation of viral entry into host cell.

## Clinical significance {#significance}

**Uncertain significance** — review status Single submitter *(criteria provided, single submitter)*, last evaluated 2023-06-26.

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

### Submitter classifications {#submitters}

| Submitter | Classification | Review | Method | Date |
| --- | --- | --- | --- | --- |
| Ambry Genetics | Uncertain significance | criteria provided, single submitter | clinical testing | 2023-06-26 |

**Reported phenotype names (ClinVar):** not specified, AllHighlyPenetrant.

## Similar variants {#similar}

Related TMPRSS4 variant pages (same residue, condition, or type): [TMPRSS4 p.Pro182Ser](/variant/tmprss4-p-pro182ser), [CAP2 p.Arg17His](/variant/cap2-p-arg17his), [CAP2 p.His203Arg](/variant/cap2-p-his203arg), [TMPRSS4 p.Ala44Val](/variant/tmprss4-p-ala44val), [CAP2 c.1003-5T>G](/variant/cap2-c-1003-minus-5t-g), [CAP2 p.Ala162Thr](/variant/cap2-p-ala162thr), [CAP2 p.Ala262Pro](/variant/cap2-p-ala262pro), [CAP2 p.Ala272Thr](/variant/cap2-p-ala272thr).

### 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 2606384). 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.*