SCN5A Variant W781S Detail

We estimate the penetrance of LQTS for SCN5A W781S around 11% and the Brugada syndrome penetrance around 40%. SCN5A W781S was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. W781S is not present in gnomAD. W781S has been functionally characterized in 0 papers. This residue is located in a Hotspot region for Brugada syndrome and a Mild_Hotspot region for LQTS. In silico predictions, functional data (if available), and location in structure are equivalent to phenotyping 10 individuals for Brugada syndrome (3 diagnosed with Brugada syndrome) and 5 individuals for LQTS (0 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A W781S around 11% (0/10) and the Brugada syndrome penetrance around 40% (3/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.876 57 10
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
LITERATURE, COHORT, AND GNOMAD: - 0 0 0 0 -
VARIANT FEATURES ALONE: - 15 12 0 3 - -
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.

W781S has 45 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
723 13 I723V,
821 10
760 14 p.F760SfsX5,
776 11 p.Y776del,
780 5
764 12 M764K, M764R,
777 12 F777L,
819 7
826 9 N826D,
818 10
825 11
781 0 W781X,
720 12
822 13 W822X, W822C,
830 12
788 11 I788V,
833 13 G833R,
724 13 T724I,
782 6 N782T,
820 5
823 13 P823T,
727 13
767 12
827 13
814 13 R814Q,
816 9 F816L, F816Y,
813 11 c.2436+12G>A, c.2437-5C>A,
768 15
786 11
817 6 K817E,
779 7 Q779X, Q779K,
815 12
778 12
784 5 F784L,
763 15 E763K, E763D,
771 14 L771V,
785 7 D785N,
783 8 I783T,
789 14 V789A, V789I,
714 15 V714A, V714D,
824 14
829 10
787 11
832 14
828 14 L828V,