SCN5A Variant R225G Detail

We estimate the penetrance of LQTS for SCN5A R225G around 18% and the Brugada syndrome penetrance around 17%. SCN5A R225G was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. R225G is not present in gnomAD. R225G has been functionally characterized in 0 papers. This residue is located in a Mild_Hotspot region for Brugada syndrome and a Mild_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 R225G around 18% (0/10) and the Brugada syndrome penetrance around 17% (1/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.971 15 20
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.

R225G has 68 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 12 I848F,
223 8 V223L,
856 14 V856L,
231 11 c.692_693delCA,
198 10
147 13
193 10 W193X, W193R,
164 10 F164L,
195 11
170 14 F170I,
228 6 K228R,
138 8 M138I,
227 7 L227P,
143 11
171 9
137 8 I137V,
142 10
197 6
229 8
163 14 c.486delC,
851 12 c.2552_2553dupGT, c.2550_2551dupGT, F851L, p.F851CfsX19,
221 11
196 7
169 12
189 15
852 11
222 9 R222Q, R222L, R222X,
224 7 L224F,
232 13 V232I, V232F,
133 13
160 15 p.V160fs,
191 14
134 12 N134S,
849 14
226 6 A226V, A226G,
205 15 Y205X, c.612-2A>G,
166 13 A166T,
144 8
855 13
172 12
230 11 I230M, I230V, I230T,
199 9 S199T,
139 11 p.I137_C139dup,
148 11
165 11
204 11 c.611+1G>A, A204V, A204T, c.611+3_611+4dupAA,
146 14 V146A, V146M,
203 11
192 13
136 13 L136P,
168 7
175 12 K175N,
202 12 I202T,
194 10
141 5 I141N, I141V,
188 14
135 14 M135V,
167 11
161 13 E161K, E161Q,
201 8
219 14 R219H, p.R219HfsX11, R219C, c.656_657insATTCA,
225 0 R225Q, R225W,
218 14
207 15
200 6
145 10
140 9
220 13 T220I,