SCN5A Variant S231L Detail

We estimate the penetrance of LQTS for SCN5A S231L around 5% and the Brugada syndrome penetrance around 33%. SCN5A S231L was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. S231L is not present in gnomAD. S231L has been functionally characterized in 0 papers. This residue is located in a 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 (3 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 S231L around 5% (0/10) and the Brugada syndrome penetrance around 33% (3/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.918 44 3
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 12 0 3 - -
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.

S231L has 53 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 11 I848F,
842 14
240 9 V240M,
231 0 c.692_693delCA,
131 13
193 9 W193X, W193R,
237 9
228 6 K228R,
138 8 M138I,
227 9 L227P,
171 15
137 11 I137V,
234 9 P234S,
142 11
197 12
229 6
196 13
852 15
224 14 L224F,
845 10 c.2533delG,
232 4 V232I, V232F,
244 14
133 14
191 14
134 10 N134S,
849 14
226 10 A226V, A226G,
241 13
235 9 c.703+1G>A, c.704-1G>C, G235R,
840 14
843 15 T843A,
837 15
239 12 I239V, I239V ,
230 5 I230M, I230V, I230T,
139 12 p.I137_C139dup,
242 15 A242D,
841 11 p.N841TfsX2, N841K,
236 6
847 14
192 14
136 14 L136P,
238 12
233 6
838 15
194 12
141 11 I141N, I141V,
135 11 M135V,
128 15 c.381dupT,
225 11 R225Q, R225W,
844 11 L844RfsX3,
243 14
145 14
140 14