SCN5A Variant G1408R Detail

We estimate the penetrance of LQTS for SCN5A G1408R around 4% and the Brugada syndrome penetrance around 33%. SCN5A G1408R was found in a total of 28 carriers in 13 papers and/or in gnomAD: 8 had Brugada syndrome, 1 had LQTS. G1408R is not present in gnomAD. G1408R has been functionally characterized in 18 papers. This residue is located in a 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 (4 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 G1408R around 4% (1/38) and the Brugada syndrome penetrance around 33% (12/38).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-7.79 1 -4.96 0.983 56 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
14523039 2003 13 0 0 3 SSS
16643399 2006 1 0 1 0
20031634 2009 13 0 4 0
20541041 2010 1 1 0 0
26921764 2016 1 0 1 0
26941339 2016 1 0 1 0
28341781 2017 1 0 1 0
19251209 2009 1 0 1 0
20129283 2010 1 0 1 0
20129283 2010 1 0 1 0
20129283 2010 2 0 2 0
29574140 2018 1 0 1 0
30059973 2018 2 2 0 0
LITERATURE, COHORT, AND GNOMAD: - 28 19 1 8 -
VARIANT FEATURES ALONE: - 15 11 0 4 - -
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)
19251209 2009
20129284 2010
20129285 2010
20188230 2010
20129283 2010
20129283 2010
20129283 2010
29574140 2018
30059973 2018
20384651 2010 0
14523039 2003 HEK-tSA201 0
16643399 2006
20031634 2009
20541041 2010
26921764 2016
26941339 2016
28341781 2017
20539757 2010

G1408R has 66 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
1355 12
1403 8
1357 10 A1357V,
1417 13
1352 8
1406 5 G1406R, G1406E,
1457 14
1453 11
1351 11 M1351V, M1351R,
739 13
1397 13 c.4189delT, c.4190delA,
1449 11 Y1449C, Y1449S,
1350 9 I1350T, I1350L,
1723 13 T1723N,
1344 14 F1344S, F1344L,
1450 12
1398 12 V1398M,
1411 5
1353 8 V1353M,
1407 3
737 12
1410 5
1714 13 D1714G,
1358 12 G1358R, G1358W,
1348 10 F1348L,
1404 6
1423 15 D1423H,
1721 14
1349 6
1753 14 T1753A,
1346 9 L1346I, L1346P,
1359 13 K1359N, K1359M,
1341 14
1356 9 c.4066_4068delTT,
1412 5 L1412F,
1408 0 G1408R,
735 11 A735V, A735T, A735E,
1420 13 G1420P, G1420V, G1420R, G1420D,
1360 11 F1360C,
734 14 M734V, c.2201dupT,
1401 6
1425 14
1399 12
1454 15
1354 12
1427 13 A1427S, A1427E,
1424 10 I1424V,
738 12
1405 6 V1405M, V1405L,
1409 6 Y1409X, Y1409C,
1400 8 V1400I,
1421 14
1718 15 S1718R,
1343 14
1345 10 W1345C,
1717 14 L1717P,
1342 12
1416 12 A1416G, c.4245+2T>A, c.4245+1G>C, c.4245+1G>A, A1416E,
736 13 L736P,
1749 12 I1749N,
1347 12
1415 10
1428 13 A1428S, A1428V,
1414 9 Q1414H,
1402 5
1413 8