SCN5A Variant S786R Detail

We estimate the penetrance of LQTS for SCN5A S786R around 5% and the Brugada syndrome penetrance around 29%. SCN5A S786R was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. S786R is not present in gnomAD. S786R has been functionally characterized in 0 papers. This residue is located in a Mild_Hotspot region for Brugada syndrome and a Non_Hotspot region for LQTS. In silico predictions, functional data (if available), and location in structure are equivalent to phenotyping 10 individuals for Brugada syndrome (2 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 S786R around 5% (0/10) and the Brugada syndrome penetrance around 29% (2/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.881 38 2
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 13 0 2 - -
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.

S786R has 47 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 14 I723V,
766 13
758 13 G758E,
811 15 c.2435_2436+3delTGGTAinsCGCCT, R811G, R811H,
769 13
773 11 P773S,
760 10 p.F760SfsX5,
780 9
776 8 p.Y776del,
765 10
759 14 c.2274delG, p.I759FfsX6, I759V,
792 10
764 7 M764R, M764K,
777 8 F777L,
791 8 L791F,
781 11 W781X,
788 6 I788V,
782 7 N782T,
793 10 L793F,
820 14
762 12
774 15 c.2320delT, Y774D, p.Y774TfsX28, Y774C,
810 13
767 10
770 15
814 11 R814Q,
807 15
816 14 F816Y, F816L,
813 11 c.2437-5C>A, c.2436+12G>A,
757 12
768 9
786 0
817 11 K817E,
761 9
779 12 Q779X, Q779K,
778 13
790 6
784 7 F784L,
763 12 E763D, E763K,
772 14 D772N,
771 13 L771V,
785 5 D785N,
783 6 I783T,
789 5 V789I, V789A,
795 15
787 4
794 11