SCN5A Variant R1898C Detail

We estimate the penetrance of LQTS for SCN5A R1898C around 2% and the Brugada syndrome penetrance around 17%. SCN5A R1898C was found in a total of 13 carriers in 3 papers and/or in gnomAD: 2 had Brugada syndrome, 0 had LQTS. R1898C is present in 10 alleles in gnomAD. R1898C has been functionally characterized in 4 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 R1898C around 2% (0/23) and the Brugada syndrome penetrance around 17% (3/23).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-5.73 0.979 -2.71 0.814 13 2
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
26173111 2015 1 0 1 0
27707468 2016 1 0 1 0
26746457 2016 1 0 0 0
LITERATURE, COHORT, AND GNOMAD: - 13 11 0 2 -
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.

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)
26173111 2015
27707468 2016
26746457 2016
32533946 2020 HEK 28 -7.6 -5.2

R1898C has 31 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
1883 15
1884 14 P1884L,
1885 14
1886 13
1887 13
1888 12
1889 11 Y1889C,
1890 11 E1890K,
1891 10
1892 9
1893 8 c.5676delC,
1894 8
1895 7 T1895I,
1896 5 p.L1896PfsX47, L1896P,
1897 4 R1897Q, R1897W, R1897Y,
1898 0 R1898H, R1898C,
1899 4
1900 5
1901 7 E1901Q, E1901K,
1902 8 E1902A,
1903 8 V1903M,
1904 9 S1904L,
1905 10
1906 11 M1906T, M1906V,
1907 11
1908 12 I1908V,
1909 13 Q1909R,
1910 13 R1910K,
1911 14
1912 14
1913 15 R1913H, R1913S, R1913C,