SCN5A Variant R1195H Detail

We estimate the penetrance of LQTS for SCN5A R1195H around 12% and the Brugada syndrome penetrance around 11%. SCN5A R1195H was found in a total of 8 carriers in 2 papers and/or in gnomAD: 1 had Brugada syndrome, 1 had LQTS. R1195H is present in 6 alleles in gnomAD. R1195H has been functionally characterized in 3 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 (1 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 R1195H around 12% (1/18) and the Brugada syndrome penetrance around 11% (2/18).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-4.87 1 -3.48 0.959 6 16
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
19632629 2009 1 1 0 0
28341781 2017 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 8 6 1 1 -
VARIANT FEATURES ALONE: - 15 14 0 1 - -
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)
19632629 2009 HEK 100 -9.1 -10 100
28341781 2017
19560406 2009

R1195H 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
1180 15 A1180V,
1181 14 V1181M, V1181A, V1181L,
1182 14
1183 13 T1183I,
1184 13
1185 12 c.3553_3554delCA,
1186 11 A1186T,
1187 11 P1187Q,
1188 10
1189 9 K1189T,
1190 8 V1190F,
1191 8 W1191X,
1192 7 W1192X,
1193 5 R1193Q, R1193W,
1194 4 L1194M,
1195 0 R1195H, R1195S,
1196 4
1197 5
1198 7
1199 8 Y1199S,
1200 8 H1200Y, H1200R, p.H1200PfsX41,
1201 9 I1201M,
1202 10 V1202M,
1203 11
1204 11
1205 12
1206 13
1207 13
1208 14 E1208X, E1208K,
1209 14 T1209R,
1210 15 F1210S,