SCN5A Variant G241R Detail

We estimate the penetrance of LQTS for SCN5A G241R around 48% and the Brugada syndrome penetrance around 15%. SCN5A G241R was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. G241R is not present in gnomAD. G241R has been functionally characterized in 0 papers. This residue is located in a Mild_Hotspot region for Brugada syndrome and a 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 (2 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A G241R around 48% (2/10) 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 0.947 12 64
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 2 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.

G241R has 51 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
414 12 M414V,
937 14
842 12
249 11 K249X,
247 9 V247L,
240 4 V240M,
231 13 c.692_693delCA,
193 11 W193R, W193X,
418 10 E418K,
926 15
250 13
237 7
925 13 I925F,
227 14 L227P,
234 14 P234S,
417 12
933 10
246 8
412 11 V412D,
245 6 Q245K,
845 11 c.2533delG,
244 4
415 8 A415T,
191 15
849 14
420 10
248 9
241 0
235 10 c.703+1G>A, G235R, c.704-1G>C,
419 6 Q419X,
930 12 c.2787+17_2787+18insACACACACACACACACACACACA, c.2788-6C>T,
423 11
239 6 I239V, I239V ,
230 11 I230T, I230V, I230M,
242 3 A242D,
929 11
416 9 Y416C,
413 12 A413E, A413T,
841 12 N841K, p.N841TfsX2,
236 8
846 15 L846R,
192 13
936 13
238 7
233 13
838 13
422 11
421 14
411 13 V411M,
243 5
932 15