SCN5A Variant R811H Detail

We estimate the penetrance of LQTS for SCN5A R811H around 3% and the Brugada syndrome penetrance around 34%. SCN5A R811H was found in a total of 6 carriers in 1 papers and/or in gnomAD: 2 had Brugada syndrome, 0 had LQTS. R811H is present in 3 alleles in gnomAD. R811H has been functionally characterized in 1 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 (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 R811H around 3% (0/16) and the Brugada syndrome penetrance around 34% (5/16).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-4.94 0.877 -3.42 0.974 44 7
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
23424222 2013 3 0 2 0
LITERATURE, COHORT, AND GNOMAD: - 6 4 0 2 -
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)
23424222 2013 CHO 43 -0.6 -8.4

R811H has 70 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,
1355 13
811 0 R811H, R811G, c.2435_2436+3delTGGTAinsCGCCT,
733 10 F733L,
741 15 p.M741_T742delinsI ,
808 5 R808P, R808C, R808H,
1352 13
746 15 E746K,
1351 11 M1351R, M1351V,
760 11 p.F760SfsX5,
812 7 L812Q,
1350 9 I1350T, I1350L,
759 14 I759V, c.2274delG, p.I759FfsX6,
792 7
755 13
791 9 L791F,
731 10 T731I,
806 10 V806M,
800 14 R800C, R800H, R800L,
754 11
726 14
818 15
1353 12 V1353M,
797 12 G797V,
737 10
1348 14 F1348L,
750 10 Q750R,
1349 13
749 10
788 9 I788V,
1346 14 L1346I, L1346P,
805 10 S805L,
798 12
793 11 L793F,
728 14 V728I,
810 7
727 12
735 12 A735V, A735T, A735E,
732 13
734 6 c.2201dupT, M734V,
756 11
814 6 R814Q,
807 8
816 13 F816L, F816Y,
813 8 c.2436+12G>A, c.2437-5C>A,
757 9
786 15
1354 9
817 14 K817E,
761 14
752 10 G752R,
809 6
815 10
790 13
784 14 F784L,
751 13 V751I, V751F,
796 9
736 13 L736P,
785 14 D785N,
730 8 N730K,
789 11 V789I, V789A,
753 7
1347 12
729 13 p.L729del,
795 6
748 14 M748I,
799 11
787 13
794 11
804 13