SCN5A Variant A1581S Detail

We estimate the penetrance of LQTS for SCN5A A1581S around 7% and the Brugada syndrome penetrance around 20%. SCN5A A1581S was found in a total of 1 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. A1581S is present in 1 alleles in gnomAD. A1581S 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 (2 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 A1581S around 7% (0/11) and the Brugada syndrome penetrance around 20% (2/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-0.77 0.607 -1.01 0.651 31 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: - 1 1 0 0 -
VARIANT FEATURES ALONE: - 15 13 0 2 - -
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.

A1581S has 44 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
1523 9 D1523N,
1521 6 I1521K, I1521T,
1508 15
1585 8 Y1585C,
1527 13 K1527R,
1576 9
1517 13
1525 6 V1525A, V1525M,
1519 8
1572 14
1596 14 F1596C, F1596I,
1589 13
1584 9
1515 12 N1515S, c.4542+15G>A,
1574 11 c.4719C>T, E1574K,
1524 9 I1524T,
1512 8 R1512W, R1512Q, R1512L,
1530 11
1586 8
1514 12 L1514M,
1518 7
1509 13 P1509T,
1592 11
1578 7 c.4732_4733dupAA,
1531 13
1573 12
1587 11 F1587V,
1526 9 T1526P,
1516 14 L1516sp,
1583 6 R1583H, R1583C,
1580 4
1588 13 T1588I,
1511 9
1582 4 L1582P,
1579 6 L1579fsX53,
1513 7
1581 0 A1581S,
1593 15 I1593M,
1522 5
1520 11
1577 6
1575 10 C1575S,
1595 15
1510 8