SCN5A Variant R1847C Detail

We estimate the penetrance of LQTS for SCN5A R1847C around 6% and the Brugada syndrome penetrance around 11%. SCN5A R1847C was found in a total of 4 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. R1847C is present in 4 alleles in gnomAD. R1847C 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 R1847C around 6% (0/14) and the Brugada syndrome penetrance around 11% (1/14).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-6.82 1 -1.66 0.892 13 5
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: - 4 4 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.

R1847C has 30 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
1852 11 D1852V,
1850 11 C1850S,
1798 12 W1798X,
1811 10 Y1811N, Y1811X,
1803 14
1843 4
1814 12
1851 14 M1851V, M1851I,
1849 9 H1849R,
1805 12
1842 7 M1842V, M1842L, M1842T,
1806 8 p.Thr1806SerfsX27,
1853 12 I1853V,
1848 6
1812 11 S1812L, S1812X,
1817 14
1808 5
1810 7
1813 11
1846 6
1804 12
1809 7 I1809M,
1801 14
1844 5
1807 10 c.5420dupA,
1841 10
1847 0 R1847C, R1847H,
1845 4 G1845R,
1802 11
1840 12