SCN5A Variant W1591R Detail

We estimate the penetrance of LQTS for SCN5A W1591R around 24% and the Brugada syndrome penetrance around 11%. SCN5A W1591R was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. W1591R is not present in gnomAD. W1591R has been functionally characterized in 0 papers. This residue is located in a Non_Hotspot region for Brugada syndrome and a Mild_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 (1 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A W1591R around 24% (1/10) and the Brugada syndrome penetrance around 11% (1/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.96 6 30
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 13 1 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.

W1591R has 45 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
1525 15 V1525M, V1525A,
1627 12
1586 11
1624 13 V1624I,
1538 12
1531 13
1635 7
1587 12 F1587V,
1634 9 L1634P,
1534 13
1542 15
1575 13 C1575S,
1571 14 F1571C,
1599 14
1654 15
1630 9 I1630R, I1630V,
1626 14 R1626C, R1626P, R1626L, R1626H,
1625 11
1596 12 F1596C, F1596I,
1628 7
1589 6
1632 5 R1632H, R1632C, R1632L,
1597 12 V1597M,
1539 14 C1539Y, C1539F,
1535 11
1594 6 F1594S,
1651 13
259 14
1588 11 T1588I,
1633 10
1591 0 W1591X,
1593 8 I1593M,
1595 7
1637 14
1636 12
263 14 V263I,
1629 7 R1629G, R1629X, R1629Q,
1574 13 c.4719C>T, E1574K,
1592 6
1578 12 c.4732_4733dupAA,
1631 6 G1631D,
1590 4
1647 14
1582 14 L1582P,
1598 12 V1598A,