SCN5A Variant Q750R Detail

We estimate the penetrance of LQTS for SCN5A Q750R around 46% and the Brugada syndrome penetrance around 14%. SCN5A Q750R was found in a total of 1 carriers in 1 papers and/or in gnomAD: 0 had Brugada syndrome, 1 had LQTS. Q750R is not present in gnomAD. Q750R has been functionally characterized in 2 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 Q750R around 46% (2/11) and the Brugada syndrome penetrance around 14% (1/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-1.38 0.049 -0.12 0.633 8 51
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
19716085 2009 1 1 0 0
LITERATURE, COHORT, AND GNOMAD: - 1 0 1 0 -
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)
25904541 2015 HEK 48 3 -2 114
19716085 2009

Q750R has 42 previously observed neighbors within 15 angstroms

A residue within a folded protein on average has nearest neighbors that fall roughly into two shells: a "nearest" neighbor around 5-6 angstroms and a second shell around 11 angstroms. All variants shown in the rightmost column have been observed in at least one individual in the literature or gnomAD.

Neighbor Distance (Angstroms) Variants Observed in Individuals
758 13 G758E,
742 13 T742A,
811 10 c.2435_2436+3delTGGTAinsCGCCT, R811H, R811G,
733 10 F733L,
741 11 p.M741_T742delinsI ,
808 10 R808C, R808P, R808H,
745 11
746 8 E746K,
760 15 p.F760SfsX5,
759 14 I759V, p.I759FfsX6, c.2274delG,
792 12
755 9
800 10 R800H, R800L, R800C,
754 6
797 12 G797V,
737 11
750 0 Q750R,
749 6
743 11
798 14
793 14 L793F,
747 6 E747A,
735 14 A735V, A735E, A735T,
732 15
734 12 M734V, c.2201dupT,
756 11
814 14 R814Q,
807 15
757 10
1354 14
744 12
752 6 G752R,
751 5 V751I, V751F,
796 9
802 14
736 13 L736P,
730 12 N730K,
753 5
729 15 p.L729del,
795 10
748 8 M748I,
799 9