E385K
Category 3/4 — Most DruggableConflictingTransmembrane · predictedEditorialGlutamate → Lysine at position 385 in a connecting loop. ClinVar Conflicting including WFS1-Related Spectrum Disorders, monogenic diabetes. AlphaMissense 0.851, ΔΔG -0.16.
Interactive 3D Structure
Bond changes · DynaMut2 interaction analysis
| Interaction type | Wild-type partner | Mutant partner | Status |
|---|---|---|---|
| Ionic bond | K178 | — | Lost |
| Hydrogen bond | K178 | — | Lost |
| Hydrogen bond | L381 | L381 | Preserved |
| Hydrogen bond | L382 | L382 | Preserved |
| Hydrogen bond | L388 | L388 | Preserved |
| Polar contact | K178 | — | Lost |
| Polar contact | L381 | L381 | Preserved |
| Polar contact | — | L382 | Gained |
| Polar contact | N387 | N387 | Preserved |
| Polar contact | L388 | L388 | Preserved |
| Carbonyl | L382 | L382 | Preserved |
| Van der Waals | K178 | — | Lost |
| Hydrophobic | A175 | A175 | Preserved |
| Hydrophobic | — | K178 | Gained |
| Hydrophobic | A179 | A179 | Preserved |
| Hydrophobic | — | N387 | Gained |
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
- transmembrane position; predictor benchmarked on soluble proteins
This variant sits in the transmembrane band. The stability value was computed with a predictor benchmarked on water-soluble proteins. Published benchmarks of ddG predictors on membrane proteins report correlation below 0.4. Treat the magnitude as unreliable and the sign as weak evidence only.
Do not rank this value against a variant from a different region on ΔΔG alone.
Clinical Evidence
Observed in the general population.
ClinVar classifies this variant as Conflicting classifications of pathogenicity for WFS1-related spectrum (unresolved mode) (dominant or recessive); WFS1-related diabetes (autosomal dominant); Nonsyndromic hearing loss (DFNA6/14/38) (autosomal dominant, OMIM 600965). ClinVar records this under a WFS1-spectrum label that spans both disease families — recessive Wolfram syndrome (biallelic) and the dominant WFS1-related disorders. The label does not resolve which applies, and it is not a severity statement.
- WFS1-related spectrum (unresolved mode)dominant or recessivesubmitted as: WFS1-Related Spectrum Disorders
- WFS1-related diabetesautosomal dominantsubmitted as: Monogenic diabetes
- Nonsyndromic hearing loss (DFNA6/14/38)autosomal dominant · OMIM 600965submitted as: Autosomal dominant nonsyndromic hearing loss 6
- Submitters conflict on this classification (1★). Treat the conditions above as submitted, not as documented phenotypes.
- Phenotype scope is interpretation of submitted records. The computed values on this card (AlphaMissense, DynaMut2 ΔΔG, pLDDT) are measurements of the model, not of a patient.
- Presentation cannot be generalised from neighbouring variants: one nucleotide over can present very differently. Structural similarity supports a mechanistic hypothesis, never a phenotype claim.
Review status: 1★ conflicting classifications. ClinVar "conditions" is the union of all submissions; 0–1★ entries are submitted conditions, not documented phenotypes.
Highest in Ashkenazi Jewish: AF 0.574% (170 of 29,602 alleles), 7.9x the global figure. The global AF describes the general population, not the at-risk group.
1 homozygote reported in gnomAD v4 (1 South Asian). gnomAD excludes individuals with severe pediatric disease, so homozygotes in this dataset argue against a fully penetrant severe recessive phenotype and belong in the clinical picture. This is interpretive signal, not a classification.
| Ancestry group | Allele freq. | AC / AN | Hom. | Carrier est. |
|---|---|---|---|---|
| Ashkenazi Jewish | 0.574% | 170 / 29,602 | 0 | ~1 in 87 |
| Finnish | 0.280% | 179 / 64,010 | 0 | ~1 in 180 |
| Middle Eastern | 0.264% | 16 / 6,062 | 0 | ~1 in 190 |
| Remaining individuals | 0.126% | 79 / 62,504 | 0 | ~1 in 400 |
| South Asian | 0.120% | 109 / 91,082 | 1 | ~1 in 420 |
| Admixed American | 0.093% | 56 / 59,900 | 0 | ~1 in 530 |
| European (non-Finnish) | 0.047% | 557 / 1,180,004 | 0 | ~1 in 1060 |
| African / African American | 0.0093% | 7 / 75,006 | 0 | ~1 in 5360 |
| East Asian · under-sampled | 0.0022% | 1 / 44,866 | 0 | — |
Source: gnomAD r4, retrieved 2026-08-21. Values are allele frequencies. The carrier estimate is derived from the allele frequency (Hardy-Weinberg, ~2·AF) and is an approximation, not a published figure — where a published carrier frequency exists it outranks this column and is cited on the card.
Structural Context
Position 385 sits in a connecting loop. Neighbors: PHE384 (2.5 Å), PRO386 (2.5 Å), LEU381 (3.8 Å), LEU382 (4.2 Å — partner of L382P!). Adjacent to L382P region.
E385K charge-flips at this position. The variant lysine likely engages different partners than the wild-type glutamate. Combined with L382P, multiple Atlas variants converge on the 381-386 loop. ΔΔG mild; AM 0.851 + multi-phenotype confirm severe consequence.
Druggability Assessment
Mechanism: charge-flip in the L382-E385 loop. Therapeutic: same loop region as L382P.
Why this matters
Feed this card to Wolfram Intelligence
Download the E385K 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.