SCN5A Variant R1309H Detail

We estimate the penetrance of LQTS for SCN5A R1309H around 1% and the Brugada syndrome penetrance around 8%. SCN5A R1309H was found in a total of 6 carriers in 1 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. R1309H is present in 1 alleles in gnomAD. R1309H has been functionally characterized in 1 papers. This residue is located in a Non_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 R1309H around 1% (0/16) and the Brugada syndrome penetrance around 8% (1/16).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-4.42 1 -2.96 0.9 8 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
26801742 2016 7 0 0 2 abnormal ECG
LITERATURE, COHORT, AND GNOMAD: - 6 6 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.

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)
26801742 2016 Oocytes 74 4.5 -6.2 0

R1309H has 65 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 9 W1271C,
1245 14 M1245I,
1218 9 S1218I, S1218T,
1281 12 V1281F, c.3840+1G>A,
1304 11 T1304M,
1217 12
1243 14 D1243N,
1315 12
1274 7
1216 9 L1216V,
1258 15
1314 12 c.3940_3941delCT,
1220 13 G1220E,
1673 14
1213 12
1272 10
1210 12 F1210S,
1270 12 A1270S,
1252 13
1283 15 L1283M,
1309 0 R1309H, R1309C,
1669 13
1221 14 A1221V,
1242 14
1219 10 S1219N,
1251 13 V1251M,
1313 9
1279 10 V1279I,
1310 6
1316 12 R1316L, R1316Q,
1207 13
1306 7 R1306H, R1306S,
1305 9
1273 12 W1273C, c.3816delG,
1246 10
1282 12 S1282A,
1302 14 p.L1302Vfs18,
1247 12 T1247I,
1257 11
1307 7
1256 15
1275 5 D1275N,
1222 13 p.L1222LfsX7, L1222R,
1254 11
1215 5 I1215V,
1214 9 M1214T,
1212 8 p.I1212del,
1253 9 E1253G,
1211 8
1312 9
1280 13
1311 8 L1311P,
1308 7 L1308F,
1250 8
1670 12
1209 12 T1209R,
1269 13 N1269S,
1276 12
1278 7 I1278N,
1266 12
1249 11 V1249D,
1208 12 E1208K, E1208X,
1277 10
1303 13 R1303W, R1303Q,
1666 12