SCN5A Variant K1236R Detail

We estimate the penetrance of LQTS for SCN5A K1236R around 3% and the Brugada syndrome penetrance around 40%. SCN5A K1236R was found in a total of 2 carriers in 1 papers and/or in gnomAD: 1 had Brugada syndrome, 0 had LQTS. K1236R is present in 1 alleles in gnomAD. K1236R has been functionally characterized in 1 papers. This residue is located in a Mild_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 (3 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 K1236R around 3% (0/12) and the Brugada syndrome penetrance around 40% (4/12).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-2.15 0.571 2.92 0.755 60 1
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
21126620 2010 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 2 1 0 1 -
VARIANT FEATURES ALONE: - 15 12 0 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.

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)
21126620 2010

K1236R has 30 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
1233 5 K1233E,
1243 12 D1243N,
1234 7
1285 15
1299 13 c.3894delC,
1298 14 P1298L,
1241 12
1226 11
1221 13 A1221V,
1242 11
1239 7 L1239P,
1244 14 K1244E,
1235 6
1231 10 E1231K,
1237 5 V1237F,
1289 14
1228 12 Y1228F, Y1228H, Y1228C,
1223 14 c.3667delG,
1222 13 p.L1222LfsX7, L1222R,
1230 6 E1230K,
1227 12
1229 5
1301 14
1224 13
1240 7 E1240Q,
1225 8 E1225K, G1225K,
1232 11 R1232W, R1232Q,
1238 8
1236 0 K1236R, K1236N,
1303 12 R1303W, R1303Q,