SCN5A Variant L842R Detail

We estimate the penetrance of LQTS for SCN5A L842R around 35% and the Brugada syndrome penetrance around 24%. SCN5A L842R was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. L842R is not present in gnomAD. L842R has been functionally characterized in 0 papers. This residue is located in a Mild_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 (2 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 L842R around 35% (1/10) and the Brugada syndrome penetrance around 24% (2/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.978 27 45
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 1 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.

L842R has 74 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
848 10 I848F,
939 14 L939F,
937 7
895 13 L895F,
839 5 L839P,
842 0
1457 15
240 10 V240M,
231 14 c.692_693delCA,
1455 11
926 11
409 15 L409P, L409V,
237 13
928 14 L928P,
925 13 I925F,
227 15 L227P,
836 11 V836M,
234 11 P234S,
1451 15 V1451D, V1451L,
417 15
934 7
1458 14 S1458Y,
933 7
229 14
246 13
935 11 L935P,
412 12 V412D,
927 13 N927S, N927K,
845 6 c.2533delG,
232 14 V232I, V232F,
833 14 G833R,
244 14
415 14 A415T,
892 15 F892I,
940 13 S940N,
849 10
420 13
938 11
241 12
235 10 c.703+1G>A, G235R, c.704-1G>C,
840 6
942 14
843 4 T843A,
1456 13
419 14 Q419X,
930 7 c.2787+17_2787+18insACACACACACACACACACACACA, c.2788-6C>T,
1459 10 c.4376_4379delTCTT,
834 15 N834D,
1460 12 F1460L,
837 9
239 6 I239V , I239V,
1454 15
230 11 I230T, I230V, I230M,
242 10 A242D,
929 11
416 10 Y416C,
413 14 A413T, A413E,
841 6 p.N841TfsX2, N841K,
236 10
847 9
941 12 S941N, S941F,
846 6 L846R,
936 10
238 9
233 9
838 6
844 7 L844RfsX3,
850 12 V850M, c.2549_2550insTG,
243 9
932 11
832 13
835 10 S835L, S835A,
931 9
1463 13 N1463Y,