SCN5A Variant L1721R Detail

We estimate the penetrance of LQTS for SCN5A L1721R around 9% and the Brugada syndrome penetrance around 37%. SCN5A L1721R was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. L1721R is not present in gnomAD. L1721R has been functionally characterized in 0 papers. This residue is located in a 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 (3 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 L1721R around 9% (0/10) and the Brugada syndrome penetrance around 37% (3/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.98 51 7
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 0 3 - -
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.

L1721R has 59 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
1746 8 A1746T, A1746V,
1724 10
1741 13 D1741Y, D1741N, D1741E,
1406 13 G1406E, G1406R,
1715 10
1687 13
1745 5
1397 14 c.4189delT, c.4190delA,
1675 14
1743 7 G1743E, G1743R,
1723 7 T1723N,
1754 15
1707 15
1725 11 P1725L,
1398 13 V1398M,
1694 13
1411 13
1407 11
1410 10
1747 8 V1747M,
1716 10 p.L1716SfsX71,
1714 10 D1714G,
1688 12
1684 15 W1684R,
1404 15
1744 5 S1744I,
1721 0
1753 12 T1753A,
1742 11
1712 13 G1712C, G1712S,
1680 14 A1680T, A1680P,
1719 6
1408 14 G1408R,
1420 15 G1420R, G1420D, G1420V, G1420P,
1731 14
1728 13 C1728Y, C1728R, C1728W,
1678 12 N1678S,
1401 12
1399 8
1713 13
1748 6 p.G1748del, G1748D,
1683 11
1409 15 Y1409C, Y1409X,
1400 10 V1400I,
1718 5 S1718R,
1717 6 L1717P,
1751 11
1682 10
1750 11 L1750F,
1752 10
1722 5 N1722D,
1686 11
1749 7 I1749N,
1740 14 G1740R,
1720 4 c.5157delC,
1679 10
1685 10
1414 13 Q1414H,
1413 14