SCN5A Variant K158R Detail

We estimate the penetrance of LQTS for SCN5A K158R around 4% and the Brugada syndrome penetrance around 15%. SCN5A K158R was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. K158R is not present in gnomAD. K158R 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 K158R around 4% (0/10) and the Brugada syndrome penetrance around 15% (1/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.842 14 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.

K158R has 31 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
208 9 E208K,
205 15 c.612-2A>G, Y205X,
154 12 P154L,
156 7 W156R, W156X,
158 0 K158T,
206 15
163 10 c.486delC,
166 14 A166T,
161 6 E161Q, E161K,
219 11 c.656_657insATTCA, R219H, p.R219HfsX11, R219C,
211 15
144 13
151 11
222 12 R222Q, R222L, R222X,
218 14
159 7 Y159C, Y159X,
153 14
155 10
147 10
207 11
150 14
212 12 L212Q, L212P,
164 11 F164L,
209 14 N209S, N209T,
157 6 T157I,
148 13
160 7 p.V160fs,
165 11
210 11 I210T,
204 12 c.611+3_611+4dupAA, A204T, c.611+1G>A, A204V,
162 6 Y162H, Y162C,