SCN5A Variant W193R Detail

We estimate the penetrance of LQTS for SCN5A W193R around 10% and the Brugada syndrome penetrance around 13%. SCN5A W193R was found in a total of 1 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. W193R is present in 1 alleles in gnomAD. W193R has been functionally characterized in 0 papers. This residue is located in a Non_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 W193R around 10% (0/11) and the Brugada syndrome penetrance around 13% (1/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-13.55 0.998 -6.96 0.909 3 1
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: - 1 1 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.

W193R has 48 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
848 13 I848F,
223 14 V223L,
247 15 V247L,
240 9 V240M,
231 9 c.692_693delCA,
198 11
193 0 W193X, W193R,
195 8
237 11
228 7 K228R,
138 13 M138I,
227 7 L227P,
171 14
137 15 I137V,
197 8
229 11
196 6
190 12 R190L, R190G, R190Q, R190W,
189 11
852 14
245 14 Q245K,
224 10 L224F,
845 13 c.2533delG,
232 13 V232F, V232I,
244 10
191 6
134 15 N134S,
849 14
226 11 A226G, A226V,
248 14
241 11
235 15 c.704-1G>C, G235R, c.703+1G>A,
239 14 I239V , I239V,
230 9 I230M, I230T, I230V,
199 11 S199T,
242 14 A242D,
236 11
192 5
175 13 K175N,
233 13
194 6
141 14 I141N, I141V,
188 11
201 14
225 10 R225W, R225Q,
243 12
200 12
187 13 T187S, T187I,