SCN5A Variant W1684R Detail

We estimate the penetrance of LQTS for SCN5A W1684R around 7% and the Brugada syndrome penetrance around 9%. SCN5A W1684R was found in a total of 1 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. W1684R is present in 1 alleles in gnomAD. W1684R has been functionally characterized in 0 papers. This residue is located in a Non_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 W1684R around 7% (0/11) and the Brugada syndrome penetrance around 9% (1/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
0.2 0.117 0.57 0.562 9 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 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.

W1684R has 38 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
333 13 c.998+1G>A, c.998+5G>A,
326 15
1741 10 D1741Y, D1741E, D1741N,
1715 12
1687 8
1743 13 G1743R, G1743E,
334 14 c.999-424_1338+81del,
1681 11 c.5040_5042delTTAinsC, Y1681F,
1694 12
1695 11 Q1695X,
1716 12 p.L1716SfsX71,
1688 5
1684 0 W1684R,
1692 10
1721 15
1742 14
1693 9
1699 13
379 13
1680 12 A1680P, A1680T,
1703 14
1719 9
1690 5 D1690N, c.5068_5070delGA,
324 13
383 12
1683 7
1718 12 S1718R,
1689 6 D1689N,
1739 12 R1739Q, R1739W,
1717 15 L1717P,
1682 9
336 14 P336L,
1686 8
1740 13 G1740R,
1691 10
1720 12 c.5157delC,
1679 14
1685 6