SCN5A Variant L1636R Detail

We estimate the penetrance of LQTS for SCN5A L1636R around 23% and the Brugada syndrome penetrance around 21%. SCN5A L1636R was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. L1636R is not present in gnomAD. L1636R has been functionally characterized in 0 papers. This residue is located in a Mild_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 (2 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 L1636R around 23% (1/10) and the Brugada syndrome penetrance around 21% (2/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.981 23 28
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 12 1 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.

L1636R has 46 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
1643 11 I1643L,
1536 11
1538 12
1531 9
1635 6
1634 7 L1634P,
1534 11
1542 15
260 15
1641 12
1527 14 K1527R,
1639 9 G1639A,
1529 12
1526 15 T1526P,
1630 10 I1630R, I1630V,
1532 8 V1532I, V1532F,
1644 9 R1644L, R1644H, R1644C,
1640 10
256 13
1628 15
1589 14
1793 14 M1793K,
1789 13
1632 8 R1632L, R1632C, R1632H,
1530 13
1539 11 C1539F, C1539Y,
255 13
1645 14 T1645M,
1796 14
1535 7
1537 14
1638 7 R1638X, R1638Q,
1651 15
259 12
1633 5
1591 12 W1591X,
1637 5
1636 0
1629 13 R1629X, R1629G, R1629Q,
1533 11 T1533I,
1642 14 G1642E,
1592 15
1528 11
1631 9 G1631D,
252 15
1647 12