SCN5A Variant R1826H Detail

We estimate the penetrance of LQTS for SCN5A R1826H around 13% and the Brugada syndrome penetrance around 4%. SCN5A R1826H was found in a total of 15 carriers in 2 papers and/or in gnomAD: 0 had Brugada syndrome, 2 had LQTS. R1826H is present in 13 alleles in gnomAD. R1826H has been functionally characterized in 3 papers. This residue is located in a Non_Hotspot region for Brugada syndrome and a Mild_Hotspot region for LQTS. In silico predictions, functional data (if available), and location in structure are equivalent to phenotyping 10 individuals for Brugada syndrome (0 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 R1826H around 13% (2/25) and the Brugada syndrome penetrance around 4% (0/25).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-2.59 0.96 -2.23 0.848 2 17
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
11710892 2001 1 0 0 1 SIDS
19716085 2009 2 2 0 0
LITERATURE, COHORT, AND GNOMAD: - 15 13 2 0 -
VARIANT FEATURES ALONE: - 15 15 0 0 - -
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)
29540853 2018 Xeno 82 -0.54
19716085 2009
11710892 2001 HEK 700

R1826H has 44 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
1814 13
1794 11
1856 14
1853 14 I1853V,
1828 6 A1828T, A1828S,
1834 13 S1834R,
1818 7
1801 14
1824 7 P1824A,
1838 15
1820 6 A1820T, A1820V,
1641 14
1863 14
1860 10 c.5577_5578dupAA,
1857 10
1862 15
1858 13
1829 10
1865 14
1787 14 S1787N,
1835 13 L1835F,
1819 6 D1819N,
1786 13 L1786Q, L1786R, c.5356_5357delCT,
1861 11 V1861F, V1861I,
1864 11
1821 5
1815 11
1826 0 R1826H, R1826C,
1854 15
1825 7 L1825P,
1797 11 I1797V,
1800 15
1793 10 M1793K,
1789 14
1817 10
1827 6
1796 14
1791 14
1823 4 E1823K, p.E1823HfsX10,
1816 12 c.5445_5446insT, D1816E, D1816N,
1831 11
1790 11 D1790N, D1790G, p.D1790del,
1830 12
1822 5 c.5464_5467delTCTG, c.5464-5467delTCTG,