SCN5A Variant R1023P Detail

We estimate the penetrance of LQTS for SCN5A R1023P around 2% and the Brugada syndrome penetrance around 7%. SCN5A R1023P was found in a total of 4 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. R1023P is present in 4 alleles in gnomAD. R1023P has been functionally characterized in 0 papers. This residue is located in a Non_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 (0 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 R1023P around 2% (0/14) and the Brugada syndrome penetrance around 7% (0/14).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-0.6 0.895 -0.59 0.566 2 3
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: - 4 4 0 0 -
VARIANT FEATURES ALONE: - 15 15 0 0 - -
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.

R1023P has 31 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
1008 15 P1008S,
1009 14
1010 14
1011 13 P1011L, P1011S,
1012 13
1013 12
1014 11 P1014S,
1015 11 p.G1015DfsX14, E1015K,
1016 10 T1016M, c.3045_3046delGA,
1017 9
1018 8 K1018E,
1019 8
1020 7
1021 5 P1021S,
1022 4
1023 0 R1023P, R1023C, R1023H,
1024 4 K1024R,
1025 5 E1025A,
1026 7
1027 8 R1027Q, R1027P, R1027W,
1028 8
1029 9 E1029K,
1030 10
1031 11 p.G1031fsX27,
1032 11 E1032D, E1032K,
1033 12 Q1033R,
1034 13 P1034T,
1035 13 G1035V,
1036 14
1037 14
1038 15