SCN5A Variant S1787N Detail

We estimate the penetrance of LQTS for SCN5A S1787N around 1% and the Brugada syndrome penetrance around 1%. SCN5A S1787N was found in a total of 240 carriers in 6 papers and/or in gnomAD: 1 had Brugada syndrome, 2 had LQTS. S1787N is present in 234 alleles in gnomAD. S1787N has been functionally characterized in 10 papers. This residue is located in a Mild_Hotspot region for Brugada syndrome and a 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 S1787N around 1% (3/250) and the Brugada syndrome penetrance around 1% (2/250).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-2.32 0.976 0.16 0.86 12 41
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
10973849 2000 1 1 0 0
16414944 2005 1 1 0 0
23631430 2013 1 1 0 0
23503384 2013 1 0 1 0
28069705 2017 1 0 0 1 ARVD
20129283 2010 3 0 0 0
LITERATURE, COHORT, AND GNOMAD: - 240 237 2 1 -
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.

Functional Data

Peak and late/persistent current are relative to wildtype (100% being no different from wildtype). V0.5 act/inact are the voltages at which half of the maximal current is reached during an activation and inactivation protocol, each is in units of mV and relative to wildtype.
PubMed ID Year Cell Type Peak Current (%WT) V1/2 Act. (mV) V1/2 Inact. (mV) Late/Persistent Current (%WT)
10973849 2000
15851227 2004
15898185 2004
16414944 2005
23631430 2013
29017927 2017
23503384 2013
28069705 2017
20129283 2010
25923670 2015 HEK 95 1 0 210

S1787N has 65 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
1785 7
1794 11
1643 14 I1643L,
1778 8
1795 13 Y1795H, p.Y1795_E1796insD, Y1795N, Y1795C,
1652 11 M1652R, M1652T,
1777 11 V1777L, V1777M,
1824 10 P1824A,
1650 15 L1650F,
1492 14
1504 12 K1504E,
1641 9
1501 12 L1501V, p.L1501_K1505del,
1857 15
1862 13
1639 14 G1639A,
1779 10 T1779M,
1493 11 p.K1493del, K1493R, K1493X,
1858 11
1865 14
1776 13
1787 0 S1787N,
1786 4 c.5356_5357delCT, L1786R, L1786Q,
1648 8
1861 11 V1861I, V1861F,
1495 15 Y1495S,
1649 11 A1649V,
1774 13 N1774D, c.5321_5324dupACTT,
1821 13
1644 10 R1644L, R1644C, R1644H,
1640 14
1826 14 R1826C, R1826H,
1496 10
1854 13
1825 10 L1825P,
1797 15 I1797V,
1793 10 M1793K,
1781 6 E1781D, E1781G,
1789 5
1499 14
1645 8 T1645M,
1784 11 E1784X, E1784K,
1498 13 M1498R, M1498T, M1498V,
1796 13
1780 11 E1780G,
1788 5 c.5361_5364delTGAG,
1638 12 R1638Q, R1638X,
1651 13
1500 8 p.K1500del,
1791 6
1637 14
1792 8 D1792N, D1792Y, D1792V,
1823 12 p.E1823HfsX10, E1823K,
1502 15 G1502A, G1502S,
1783 10
1775 13 F1775V, p.F1775LfsX15,
1642 12 G1642E,
1497 9
1790 4 D1790G, D1790N, p.D1790del,
1494 14
1647 13
1503 13 S1503Y,
1822 11 c.5464-5467delTCTG, c.5464_5467delTCTG,
1646 12
1782 7