SCN5A Variant R535X Detail

We estimate the penetrance of LQTS for SCN5A R535X around 16% and the Brugada syndrome penetrance around 37%. SCN5A R535X was found in a total of 13 carriers in 16 papers and/or in gnomAD: 7 had Brugada syndrome, 1 had LQTS. R535X is present in 1 alleles in gnomAD. R535X has been functionally characterized in 16 papers. This residue is located in a Non_Hotspot region for Brugada syndrome and a Hotspot region for LQTS. In silico predictions, functional data (if available), and location in structure are equivalent to phenotyping 10 individuals for Brugada syndrome (1 diagnosed with Brugada syndrome) and 5 individuals for LQTS (1 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A R535X around 16% (2/23) and the Brugada syndrome penetrance around 37% (8/23).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA None 1 50
PROVEAN scores less than -2 are considered deleterious. REVEL scores higher than 0.5 or 0.75 are considered likely pathogenic (higher sensitivity with the former cutoff, higher specificity with the latter cutoff). A PolyPhen-2 score of 0.85 or greater is considered likely pathogenic. BLAST-PSSM reflects the evolutionary conservation of residue substitutions, more negative numbers indicate fewer observations of the specific substitution than is expected. Penetrance Density is our previously published method to calculate the average BrS/LQTS probability density in a shell of residues surrounding a residue of interest (Kroncke et al. 2019).

Reported Carrier Data

PubMed ID Year Carriers Unaffected LQT3 BrS1 Other Other Disease
25757662 2015 1 0 0 1 SIDS
15890323 2005 1 0 1 0
19251209 2009 1 0 1 0
12106943 2002 1 0 1 0
16643399 2006 1 0 1 0
17404158 2007 1 0 1 0
20031634 2009 9 0 5 0
23631430 2013 1 1 0 0
26921764 2016 1 0 1 0
28361098 2017 3 0 0 3 Conduction defects, Epilepsy
20129283 2010 1 0 1 0
20129283 2010 1 0 1 0
20129283 2010 1 0 1 0
20129283 2010 1 0 1 0
29325976 2018 1 0 1 0
30059973 2018 4 4 0 0
LITERATURE, COHORT, AND GNOMAD: - 13 5 1 7 -
VARIANT FEATURES ALONE: - 15 13 1 1 - -
Summary totals might not agree with the literature table because of duplicate patients, which were excluded from the total counts. We do not distinguish here between multiple missense codons. Missense variants are combined across degenerate codon substitutions since codon-level data were not consistently available for curation.

Functional Data

Peak and late/persistent current are relative to wildtype (100% being no different from wildtype). V0.5 act/inact are the voltages at which half of the maximal current is reached during an activation and inactivation protocol, each is in units of mV and relative to wildtype.
PubMed ID Year Cell Type Peak Current (%WT) V1/2 Act. (mV) V1/2 Inact. (mV) Late/Persistent Current (%WT)
16643399 2006
17404158 2007
25757662 2015 0
15890323 2005 HEK 0
20031634 2009
23631430 2013
26921764 2016
28361098 2017
20129283 2010
20129283 2010
20129283 2010
20129283 2010
29325976 2018
30059973 2018
19251209 2009
12106943 2002