SCN5A Variant A847S Detail

We estimate the penetrance of LQTS for SCN5A A847S around 20% and the Brugada syndrome penetrance around 38%. SCN5A A847S was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. A847S is not present in gnomAD. A847S 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 (1 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A A847S around 20% (1/10) and the Brugada syndrome penetrance around 38% (3/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.927 53 24
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 11 1 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.

A847S has 68 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
891 10 I891N, I891T,
888 9
848 4 I848F,
223 13 V223L,
856 14 V856L,
890 14 I890T,
896 13 C896S,
895 10 L895F,
839 12 L839P,
842 9
894 14 I894M,
240 14 V240M,
231 14 c.692_693delCA,
1455 11
1447 13
149 15
1452 13
926 10
228 15 K228R,
925 12 I925F,
227 11 L227P,
887 13
1451 11 V1451D, V1451L,
142 13
934 13
933 14
229 10
851 7 c.2552_2553dupGT, c.2550_2551dupGT, F851L, p.F851CfsX19,
927 14 N927K, N927S,
852 8
854 10 c.2559delT,
224 14 L224F,
845 6 c.2533delG,
232 14 V232I, V232F,
892 10 F892I,
849 6
226 10 A226V, A226G,
922 12 V922I,
840 10
889 13
843 7 T843A,
1456 15
930 10 c.2787+17_2787+18insACACACACACACACACACACACA, c.2788-6C>T,
1459 12 c.4376_4379delTCTT,
855 12
837 15
239 13 I239V, I239V ,
1454 14
230 10 I230M, I230V, I230T,
148 14
929 14
1448 13 I1448L, I1448T,
884 12
841 11 p.N841TfsX2, N841K,
236 14
885 14
847 0
146 14 V146A, V146M,
846 4 L846R,
233 11
838 14
141 15 I141N, I141V,
853 9
844 6 L844RfsX3,
850 5 c.2549_2550insTG, V850M,
243 13
145 11
931 12