SCN5A Variant R1919L Detail

We estimate the penetrance of LQTS for SCN5A R1919L around 4% and the Brugada syndrome penetrance around 15%. SCN5A R1919L was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. R1919L is not present in gnomAD. R1919L 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 R1919L around 4% (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 0.858 13 0
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.

R1919L 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
1904 15 S1904L,
1905 14
1906 14 M1906T, M1906V,
1907 13
1908 13 I1908V,
1909 12 Q1909R,
1910 11 R1910K,
1911 11
1912 10
1913 9 R1913S, R1913H, R1913C,
1914 8 R1914G,
1915 8 H1915P, H1915Q, H1915N, H1915Y,
1916 7
1917 5
1918 4
1919 0 R1919H, R1919C,
1920 4 S1920C,
1921 5
1922 7 K1922N, K1922R,
1923 8 H1923Y, H1923D,
1924 8 A1924T,
1925 9 S1925F, p.S1925CfsX20,
1926 10
1927 11 L1927P,
1928 11 F1928V,
1929 12 R1929H, R1929C,
1930 13 Q1930H,
1931 13
1932 14 A1932V,
1933 14 G1933A, G1933D, G1933V,
1934 15