SCN5A Variant R1193W Detail

We estimate the penetrance of LQTS for SCN5A R1193W around 3% and the Brugada syndrome penetrance around 3%. SCN5A R1193W was found in a total of 18 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. R1193W is present in 18 alleles in gnomAD. R1193W has been functionally characterized in 0 papers. This residue is located in a Non_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 (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 R1193W around 3% (0/28) and the Brugada syndrome penetrance around 3% (0/28).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-3.98 0.944 -1.48 0.647 2 11
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: - 18 18 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.

R1193W 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
1178 15 C1178Y,
1179 14
1180 14 A1180V,
1181 13 V1181M, V1181A, V1181L,
1182 13
1183 12 T1183I,
1184 11
1185 11 c.3553_3554delCA,
1186 10 A1186T,
1187 9 P1187Q,
1188 8
1189 8 K1189T,
1190 7 V1190F,
1191 5 W1191X,
1192 4 W1192X,
1193 0 R1193W, R1193Q,
1194 4 L1194M,
1195 5 R1195H, R1195S,
1196 7
1197 8
1198 8
1199 9 Y1199S,
1200 10 H1200R, H1200Y, p.H1200PfsX41,
1201 11 I1201M,
1202 11 V1202M,
1203 12
1204 13
1205 13
1206 14
1207 14
1208 15 E1208X, E1208K,