SCN5A Variant L243R Detail

We estimate the penetrance of LQTS for SCN5A L243R around 51% and the Brugada syndrome penetrance around 12%. SCN5A L243R was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. L243R is not present in gnomAD. L243R has been functionally characterized in 0 papers. This residue is located in a Non_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 L243R around 51% (2/10) and the Brugada syndrome penetrance around 12% (1/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.992 6 69
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.

L243R has 70 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 13 M414V,
848 12 I848F,
937 13
895 15 L895F,
839 15 L839P,
842 9
249 11 K249X,
247 7 V247L,
240 5 V240M,
231 14 c.692_693delCA,
193 12 W193X, W193R,
418 12 E418K,
926 10
250 11
409 13 L409P, L409V,
237 11
928 11 L928P,
925 8 I925F,
227 12 L227P,
417 14
934 13
933 7
229 15
246 6
935 14 L935P,
412 8 V412D,
924 11 V924I,
927 12 N927S, N927K,
852 15
245 7 Q245K,
845 9 c.2533delG,
244 5
415 9 A415T,
849 10
921 14
922 14 V922I,
420 13
248 9
241 5
235 13 c.703+1G>A, G235R, c.704-1G>C,
840 14
843 13 T843A,
419 10 Q419X,
930 7 c.2787+17_2787+18insACACACACACACACACACACACA, c.2788-6C>T,
239 6 I239V , I239V,
230 11 I230T, I230V, I230M,
251 14
410 14 A410V,
242 4 A242D,
929 6
416 9 Y416C,
413 11 A413T, A413E,
841 12 p.N841TfsX2, N841K,
236 10
408 12
847 13
846 11 L846R,
192 14
936 12
238 9
233 13
838 13
853 14
923 15
844 13 L844RfsX3,
850 14 V850M, c.2549_2550insTG,
411 11 V411M,
243 0
932 11
931 11