SCN5A Variant A1242S Detail

We estimate the penetrance of LQTS for SCN5A A1242S around 4% and the Brugada syndrome penetrance around 17%. SCN5A A1242S was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. A1242S is not present in gnomAD. A1242S has been functionally characterized in 0 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 (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 A1242S around 4% (0/10) and the Brugada syndrome penetrance around 17% (1/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.899 16 0
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 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.

A1242S has 54 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
1245 5 M1245I,
1218 7 S1218T, S1218I,
1281 14 c.3840+1G>A, V1281F,
1304 13 T1304M,
1217 10
1243 5 D1243N,
1216 14 L1216V,
1234 13
1285 11
1299 15 c.3894delC,
1220 11 G1220E,
1213 14
1210 15 F1210S,
1252 15
1283 14 L1283M,
1241 5
1309 14 R1309H, R1309C,
1221 9 A1221V,
1242 0
1219 11 S1219N,
1251 14 V1251M,
1279 14 V1279I,
1239 6 L1239P,
1306 9 R1306S, R1306H,
1244 6 K1244E,
1286 12
1305 15
1282 11 S1282A,
1246 5
1235 10
1302 14 p.L1302Vfs18,
1247 8 T1247I,
1237 9 V1237F,
1307 14
1289 13
1223 13 c.3667delG,
1222 9 L1222R, p.L1222LfsX7,
1229 13
1215 12 I1215V,
1301 14
1214 10 M1214T,
1253 15 E1253G,
1284 15
1211 15
1250 10
1224 13
1240 6 E1240Q,
1248 9
1225 11 G1225K, E1225K,
1278 14 I1278N,
1238 7
1236 11 K1236N, K1236R,
1249 10 V1249D,
1303 8 R1303W, R1303Q,