SCN5A Variant F1246L Detail

We estimate the penetrance of LQTS for SCN5A F1246L around 4% and the Brugada syndrome penetrance around 17%. SCN5A F1246L was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. F1246L is not present in gnomAD. F1246L 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 F1246L 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 0.948 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.

F1246L has 53 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 4 M1245I,
1218 6 S1218I, S1218T,
1281 13 c.3840+1G>A, V1281F,
1304 13 T1304M,
1217 8
1243 7 D1243N,
1216 11 L1216V,
1285 12
1220 12 G1220E,
1213 11
1210 11 F1210S,
1252 11
1283 13 L1283M,
1241 8
1309 10 R1309H, R1309C,
1221 10 A1221V,
1242 5
1219 10 S1219N,
1251 10 V1251M,
1279 11 V1279I,
1239 10 L1239P,
1310 14
1306 7 R1306S, R1306H,
1244 8 K1244E,
1286 12
1305 13
1282 9 S1282A,
1246 0
1235 15
1302 15 p.L1302Vfs18,
1247 6 T1247I,
1237 14 V1237F,
1307 12
1223 15 c.3667delG,
1275 13 D1275N,
1222 11 L1222R, p.L1222LfsX7,
1254 13
1215 8 I1215V,
1214 6 M1214T,
1212 12 p.I1212del,
1253 10 E1253G,
1284 15
1211 10
1280 15
1308 15 L1308F,
1250 6
1240 11 E1240Q,
1248 8
1225 14 G1225K, E1225K,
1278 11 I1278N,
1238 11
1249 5 V1249D,
1303 10 R1303Q, R1303W,