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A684V

Category 3/4 — Most DruggablePathogenic/Likely pathogenicLumenal · predictedσ-1 candidateEditorial
AlanineValine at position 684 · C-terminal lumenal domain (653-869) · WFS1 (Wolframin)

A conservative alanine-to-valine swap in the lumenal domain with an outsized clinical footprint — UniProt annotation explicitly notes greatly reduced protein expression, locating A684V mechanistically downstream of an ER-quality-control checkpoint.

Interactive 3D Structure

Wild-type reference
Wild-type A684 — hydrogen bond to I688
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DynaMut2 mutant · A684V
Mutant V684 — van der waals contact to I688 lost
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Bond changes · DynaMut2 interaction analysis

0 lost2 gained7 preserved
Interaction typeWild-type partnerMutant partnerStatus
Hydrogen bondQ687Q687Preserved
Hydrogen bondI688I688Preserved
Polar contactN682N682Preserved
Polar contactQ687Q687Preserved
Polar contactI688I688Preserved
Van der WaalsN682N682Preserved
Van der WaalsI688I688Preserved
HydrophobicN682Gained
HydrophobicI688Gained

Lost / gained / preserved interatomic contacts at the variant residue, from the DynaMut2 (Arpeggio) interaction analysis of the wild-type and energy-minimized mutant structures.

Computational Predictions

DynaMut2 ΔΔG
-0.81kcal/mol
Destabilising — mild
AlphaMissense
0.886
LPath
AlphaFold pLDDT
88
model confidence
Schema
Cat 3/4
Category 3/4 — Most Druggable

Clinical Evidence

ClinVar classificationPathogenic/Likely pathogenic
Review statuscriteria provided, multiple submitters, no conflicts
Associated conditionsWolfram syndrome 1; Wolfram-like syndrome; Autosomal dominant nonsyndromic hearing loss 6; Optic atrophy; WFS1 Spectrum Disorder; Rare genetic deafness
InheritanceAutosomal dominant and autosomal recessive forms both documented.
Population frequency (gnomAD v4)Ultra-rare · AF 0.00027%
cDNA changec.2051C>T
ClinVar accessionVCV000030556
Last evaluated2026/01/25 00:00

Observed at very low frequency in gnomAD.

Structural Context

A684 is held tightly between Met683 (2.46 Angstrom) and Arg685 (2.47 Angstrom), with through-space neighbors Gln687 (3.99 Angstrom), Asn682 (4.00 Angstrom), and Thr686 (4.43 Angstrom). The contact set is small and almost entirely polar — Met683's thioether sulfur, Arg685's guanidinium, Gln687's amide, Asn682's amide, and Thr686's hydroxyl. The wild-type alanine's compact methyl side chain fits neatly into this polar surround without participating in the hydrogen-bond network that the surrounding residues maintain.

Valine introduces an isopropyl side chain — beta-branched, sterically larger, and chemically hydrophobic in a position the protein has evolved to keep small. The most likely structural consequence is not catastrophic packing failure but a subtle reorganization: the isopropyl group displaces one of the polar contacts (likely the Thr686 hydroxyl at 4.43 Angstrom, the most peripheral), and the local hydrogen-bond network rearranges to compensate. This is consistent with DynaMut2's mild DeltaDeltaG of -0.81 kcal/mol — the fold is intact but the contact register is shifted.

The critical functional data does not come from the energy function, however. The UniProt natural-variant annotation for A684V records greatly reduced protein expression compared to wild-type — a direct experimental observation. This locates the mechanism downstream of folding per se and inside the ER's quality-control machinery: A684V folds well enough by computational metrics, but the cell flags it as substandard and degrades it via ERAD (ER-associated degradation). The mild backbone perturbation is sufficient to expose a degron or to delay maturation enough that the protein is removed before reaching the membrane in productive form.

AlphaMissense scores this 0.886 — clearly pathogenic, consistent with the experimental expression data. ClinVar links A684V to an unusually broad phenotypic spectrum: Wolfram syndrome 1, Wolfram-like syndrome, optic atrophy, autosomal dominant nonsyndromic hearing loss 6, and the WFS1 spectrum disorders. This breadth implies that residual A684V wolframin produces graded dysfunction depending on tissue and modifier background.

Amino-acid chemistry
Alanine (small, hydrophobic, methyl side chain) to Valine (slightly larger, hydrophobic, beta-branched isopropyl side chain) at position 684. The substitution adds two carbons and beta-branching to an otherwise structurally similar residue.
Position in the protein
Position 684 sits inside the C-terminal lumenal domain (residues 653-869), wolframin's largest soluble module — the same region that mediates ATF6 binding, Na+/K+ ATPase beta1 contact, and calcium handling. pLDDT 87.94 places A684 in an ordered, well-modeled environment.

Druggability Assessment

Final classification: Category 3 — Most Druggable, with strong druggability arguments. The reduced-expression phenotype documented in UniProt is exactly the mechanism CFTR-corrector pharmacological chaperones rescue: a protein that folds, but not fast enough or stably enough to survive ER quality control. Compounds that stabilize the lumenal contact network around A684-Arg685-Gln687 should slow ERAD targeting and recover protein levels at the membrane. The lesion is contained (DeltaDeltaG 0.81 kcal/mol), the position is modelable (pLDDT 87.94), the surface is lumenal and accessible, and there is published experimental evidence that the cellular phenotype is dosage-rescuable. A684V is a high-priority candidate for pharmacological chaperone screening — possibly the cleanest such candidate in this batch.

Why this matters

A684V is the kind of variant the Atlas was designed to surface and the kind of variant that disproportionately rewards investment. Wolfram-like syndrome and autosomal dominant deafness 6 are clinically diverse but share A684V as a recurrent locus; the breadth of phenotype across tissues suggests a partial loss-of-function that scales with cellular WFS1 levels. That is the precise signature pharmacological chaperones can shift. For the wolframin program, A684V sits at the intersection of three Atlas priorities: high AlphaMissense, lumenal-domain placement, and published expression-level evidence. The variant should be on the short list for chaperone screening, alongside R558C and the other Category 3 lumenal residues. If a corrector molecule restores A684V expression to 50-70% of wild-type, that is plausibly clinically meaningful across the spectrum disorders this variant produces.
Therapeutic Strategy Handoff · prediction

Feed this card to Wolfram Intelligence

Download the A684V PDF below and upload it to Wolfram Intelligence to generate therapeutic-strategy proposals — guanidinium mimetics, sigma-1 agonist docking, NAC thiol-capping. NAC is already on the bench-testing list.

Download A684V PDF card ↓Strategies are AI-generated predictions, not validated therapeutics.

UniProt Domain Annotation

Chain1890 · Wolframin
Topological domain653869 · Lumenal
Natural variant684684 · in WFSL; greatly reduces protein expression compared to wild-type; dbSNP:rs387906930