SCN5A Variant A1686S Detail

We estimate the penetrance of LQTS for SCN5A A1686S around 2% and the Brugada syndrome penetrance around 20%. SCN5A A1686S was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. A1686S is not present in gnomAD. A1686S 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 A1686S around 2% (0/10) and the Brugada syndrome penetrance around 20% (2/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.33 27 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: - 0 0 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.

A1686S has 48 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
1741 15 D1741N, D1741E, D1741Y,
1715 5
1687 4
1743 14 G1743R, G1743E,
1711 13 c.5131delG,
1723 15 T1723N,
1707 14
1398 14 V1398M,
1694 13
1706 13 Q1706H,
1716 7 p.L1716SfsX71,
376 12 R376H, R376C,
1714 8 D1714G,
1688 6
1684 8 W1684R,
1423 13 D1423H,
1692 11
1744 14 S1744I,
1378 14 V1378M,
1721 11
1693 12
1712 10 G1712C, G1712S,
379 11
1703 12
1719 6
1420 12 G1420R, G1420V, G1420D, G1420P,
1690 12 c.5068_5070delGA, D1690N,
324 13
1399 10
1713 13
383 14
1683 11
1400 13 V1400I,
1718 7 S1718R,
1689 9 D1689N,
1717 9 L1717P,
1682 12
1752 14
1722 14 N1722D,
1686 0
375 11
1691 13
380 14
1720 10 c.5157delC,
1679 15
1685 4
1419 14 K1419E,
1414 14 Q1414H,