SCN5A Variant L1854H Detail

We estimate the penetrance of LQTS for SCN5A L1854H around 7% and the Brugada syndrome penetrance around 15%. SCN5A L1854H was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. L1854H is not present in gnomAD. L1854H 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 L1854H around 7% (0/10) and the Brugada syndrome penetrance around 15% (1/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.989 11 4
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.

L1854H has 67 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 6 C1850S,
1855 6
1814 12
1785 14
1794 6
1849 9 H1849R,
1856 7
1806 15 p.Thr1806SerfsX27,
1853 5 I1853V,
1795 8 Y1795N, Y1795H, Y1795C, p.Y1795_E1796insD,
1818 12
1880 15 M1880V,
1801 14
1824 12 P1824A,
1838 12
1802 14
1820 14 A1820V, A1820T,
1504 8 K1504E,
1863 15
1851 5 M1851V, M1851I,
1501 5 p.L1501_K1505del, L1501V,
1860 12 c.5577_5578dupAA,
1857 6
1862 12
1507 14 p.Q1507_P1509del,
1505 12 p.K1505_Q1507del, K1505N,
1858 6
1808 12
1787 13 S1787N,
1835 13 L1835F,
1786 10 L1786R, L1786Q, c.5356_5357delCT,
1807 11 c.5420dupA,
1861 11 V1861I, V1861F,
1821 11
1798 9 W1798X,
1826 15 R1826C, R1826H,
1496 14
1854 0
1825 9 L1825P,
1797 12 I1797V,
1793 12 M1793K,
1789 14
1848 11
1499 12
1817 10
1827 13
1498 9 M1498R, M1498T, M1498V,
1839 11 D1839G,
1796 14
1799 15
1788 13 c.5361_5364delTGAG,
1500 10 p.K1500del,
1859 10
1876 15
1791 7
1852 7 D1852V,
1792 11 D1792Y, D1792V, D1792N,
1502 9 G1502S, G1502A,
1497 10
1790 11 p.D1790del, D1790G, D1790N,
1809 12 I1809M,
1494 13
1506 11 P1506T, P1506S,
1841 12
1503 10 S1503Y,
1840 10
1822 13 c.5464-5467delTCTG, c.5464_5467delTCTG,