SCN5A Variant L1821R Detail

We estimate the penetrance of LQTS for SCN5A L1821R around 9% and the Brugada syndrome penetrance around 19%. SCN5A L1821R was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. L1821R is not present in gnomAD. L1821R 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 (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 L1821R around 9% (0/10) and the Brugada syndrome penetrance around 19% (1/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.991 19 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 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.

L1821R has 54 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
1850 13 C1850S,
1814 10
1794 7
1856 12
1853 10 I1853V,
1795 11 Y1795C, p.Y1795_E1796insD, Y1795N, Y1795H,
1828 9 A1828S, A1828T,
1834 14 S1834R,
1813 12
1818 5
1801 10
1824 8 P1824A,
1838 14
1802 15
1820 4 A1820V, A1820T,
1641 15
1501 15 L1501V, p.L1501_K1505del,
1860 11 c.5577_5578dupAA,
1857 8
1858 11
1829 11
1787 13 S1787N,
1835 12 L1835F,
1819 6 D1819N,
1786 12 L1786Q, c.5356_5357delCT, L1786R,
1861 11 V1861I, V1861F,
1864 14
1815 10
1821 0
1798 10 W1798X,
1826 5 R1826H, R1826C,
1854 11
1825 5 L1825P,
1797 6 I1797V,
1800 11
1793 7 M1793K,
1789 12
1848 15
1817 5
1827 7
1796 10
1799 13
1788 15 c.5361_5364delTGAG,
1638 14 R1638X, R1638Q,
1791 11
1792 12 D1792Y, D1792N, D1792V,
1823 8 E1823K, p.E1823HfsX10,
1816 10 D1816E, c.5445_5446insT, D1816N,
1831 11
1790 9 D1790N, D1790G, p.D1790del,
1809 13 I1809M,
1830 14
1840 15
1822 4 c.5464-5467delTCTG, c.5464_5467delTCTG,