SCN5A Variant R808C Detail

We estimate the penetrance of LQTS for SCN5A R808C around 3% and the Brugada syndrome penetrance around 46%. SCN5A R808C was found in a total of 5 carriers in 1 papers and/or in gnomAD: 3 had Brugada syndrome, 0 had LQTS. R808C is present in 2 alleles in gnomAD. R808C has been functionally characterized in 2 papers. This residue is located in a 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 (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 R808C around 3% (0/15) and the Brugada syndrome penetrance around 46% (6/15).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-7.92 0.998 -4.84 0.964 48 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
19406494 2010 3 0 3 0
LITERATURE, COHORT, AND GNOMAD: - 5 2 0 3 -
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.

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)
19406494 2010
32533946 2020 HEK 21 1 -8.6

R808C has 60 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
1355 10
1357 12 A1357V,
811 5 R811G, c.2435_2436+3delTGGTAinsCGCCT, R811H,
733 13 F733L,
741 12 p.M741_T742delinsI ,
808 0 R808C, R808H, R808P,
1352 11
746 13 E746K,
1351 10 M1351V, M1351R,
1449 15 Y1449C, Y1449S,
812 9 L812Q,
1350 10 I1350T, I1350L,
792 10
791 11 L791F,
731 13 T731I,
806 8 V806M,
800 13 R800C, R800L, R800H,
754 13
1353 10 V1353M,
797 12 G797V,
737 8
1358 15 G1358W, G1358R,
1348 15 F1348L,
801 15 p.801_803delMSN/insS, M801V,
750 10 Q750R,
1349 13
749 11
788 13 I788V,
805 7 S805L,
798 10
793 13 L793F,
1356 13 c.4066_4068delTT,
1434 13 Y1434X, c.4299G>A, c.4299+1G>T, c.4299+2T>A, c.4300-1G>A, c.4299+1delG, c.4299delG, c.4299_4300insG, c.4300-2A>T, c.4299+28C>T,
810 8
735 13 A735T, A735V, A735E,
734 9 c.2201dupT, M734V,
756 15
803 12
814 11 R814Q,
807 7
813 12 c.2437-5C>A, c.2436+12G>A,
757 13
1354 6
738 15
752 13 G752R,
809 6
815 14
751 14 V751I, V751F,
796 10
802 12
736 13 L736P,
730 12 N730K,
789 15 V789I, V789A,
753 9
1347 13
795 6
748 15 M748I,
799 9
794 12
804 10