SCN5A Variant R1432S Detail

We estimate the penetrance of LQTS for SCN5A R1432S around 16% and the Brugada syndrome penetrance around 53%. SCN5A R1432S was found in a total of 3 carriers in 3 papers and/or in gnomAD: 2 had Brugada syndrome, 1 had LQTS. R1432S is not present in gnomAD. R1432S has been functionally characterized in 3 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 R1432S around 16% (1/13) and the Brugada syndrome penetrance around 53% (6/13).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-4.55 0.947 -0.9 0.879 73 4
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
28341781 2017 1 0 1 0
19716085 2009 1 1 0 0
20129283 2010 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 3 0 1 2 -
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)
28341781 2017
19716085 2009
20129283 2010

R1432S has 39 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
1357 13 A1357V,
1386 11
1430 8 D1430N,
1426 13
1445 11 Y1445H,
1361 11
1444 12 L1444I,
1440 12 W1440X,
1382 13 S1382I,
1395 13
1380 14 p.N1380del, N1380K,
1429 10
1442 6 Y1442C, Y1442N,
1358 12 G1358W, G1358R,
1362 12 R1362S, c.4083delG,
1433 5 G1433V, G1433W, G1433R,
1438 7 P1438L,
1388 10
1387 8 L1387F,
1437 7
1384 13 C1384Y,
1431 6 S1431C,
1383 11 Q1383X,
1359 9 K1359N, K1359M,
1434 9 c.4299+2T>A, c.4299G>A, c.4299delG, c.4299_4300insG, c.4299+28C>T, c.4300-2A>T, Y1434X, c.4299+1G>T, c.4300-1G>A, c.4299+1delG,
1356 12 c.4066_4068delTT,
1435 10
1360 12 F1360C,
1427 11 A1427E, A1427S,
1446 12
1432 0 R1432G, R1432S,
1389 14
1439 6 Q1439H, Q1439R,
1443 7 N1443S,
1441 11 E1441Q,
1428 11 A1428S, A1428V,
1363 13 C1363Y,
1436 5