SCN5A Variant R1306H Detail

We estimate the penetrance of LQTS for SCN5A R1306H around 2% and the Brugada syndrome penetrance around 25%. SCN5A R1306H was found in a total of 2 carriers in 1 papers and/or in gnomAD: 1 had Brugada syndrome, 0 had LQTS. R1306H is present in 1 alleles in gnomAD. R1306H 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 (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 R1306H around 2% (0/12) and the Brugada syndrome penetrance around 25% (2/12).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-4.42 1 -4.23 0.866 21 3
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
29325976 2018 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 2 1 0 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)
29325976 2018

R1306H has 69 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
1271 15 W1271C,
1245 11 M1245I,
1218 7 S1218I, S1218T,
1281 8 V1281F, c.3840+1G>A,
1304 7 T1304M,
1217 11
1243 7 D1243N,
1274 10
1216 11 L1216V,
1285 10
1299 13 c.3894delC,
1220 11 G1220E,
1673 11
1213 14
1272 15
1252 14
1283 11 L1283M,
1241 13
1309 7 R1309H, R1309C,
1226 15
1669 12
1221 10 A1221V,
1242 9
1219 8 S1219N,
1672 15 S1672Y,
1251 12 V1251M,
1313 15
1279 9 V1279I,
1239 11 L1239P,
1310 10
1306 0 R1306H, R1306S,
1244 12 K1244E,
1286 13
1305 6
1246 7
1282 7 S1282A,
1302 9 p.L1302Vfs18,
1247 8 T1247I,
1307 7
1223 12 c.3667delG,
1275 9 D1275N,
1222 8 p.L1222LfsX7, L1222R,
1300 14
1674 13 F1674V,
1254 13
1215 8 I1215V,
1301 10
1214 10 M1214T,
1212 13 p.I1212del,
1253 12 E1253G,
1284 12
1211 12
1280 11
1311 13 L1311P,
1677 14
1308 8 L1308F,
1250 7
1224 15
1670 12
1240 12 E1240Q,
1248 12
1225 12 G1225K, E1225K,
1276 13
1278 6 I1278N,
1238 15
1249 10 V1249D,
1277 11
1303 6 R1303W, R1303Q,
1666 15