SCN5A Variant T1645R Detail

We estimate the penetrance of LQTS for SCN5A T1645R around 23% and the Brugada syndrome penetrance around 16%. SCN5A T1645R was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. T1645R is not present in gnomAD. T1645R 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 (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 T1645R around 23% (1/10) and the Brugada syndrome penetrance around 16% (1/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.968 14 27
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.

T1645R has 58 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
403 15
414 12 M414V,
1785 12
1643 6 I1643L,
1778 7
249 13 K249X,
1653 13
1635 15
1771 13 I1771T,
1652 10 M1652T, M1652R,
1634 12 L1634P,
1824 15 P1824A,
1777 11 V1777L, V1777M,
250 14
1650 9 L1650F,
1641 6
1639 10 G1639A,
1779 8 T1779M,
1776 11
1787 8 S1787N,
1654 15
1786 12 L1786R, L1786Q, c.5356_5357delCT,
1648 6
1649 7 A1649V,
1774 11 N1774D, c.5321_5324dupACTT,
1644 5 R1644C, R1644H, R1644L,
1640 8
256 12
1793 13 M1793K,
1781 10 E1781D, E1781G,
1789 8
255 14
1772 15 L1772V,
1645 0 T1645M,
251 14
410 13 A410V,
1780 12 E1780G,
1788 9 c.5361_5364delTGAG,
1638 11 R1638X, R1638Q,
1651 10
1500 14 p.K1500del,
1633 15
1791 13
1637 9
253 12
1792 12 D1792Y, D1792V, D1792N,
1636 14
407 12
1783 12
1775 8 F1775V, p.F1775LfsX15,
1642 5 G1642E,
1790 10 D1790G, D1790N, p.D1790del,
252 11
411 12 V411M,
1647 6
1822 15 c.5464-5467delTCTG, c.5464_5467delTCTG,
1646 5
1782 8