SCN5A Variant S246T Detail

We estimate the penetrance of LQTS for SCN5A S246T around 31% and the Brugada syndrome penetrance around 9%. SCN5A S246T was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. S246T is not present in gnomAD. S246T has been functionally characterized in 0 papers. This residue is located in a Non_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 (0 diagnosed with Brugada syndrome) and 5 individuals for LQTS (1 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A S246T around 31% (1/10) and the Brugada syndrome penetrance around 9% (0/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.952 2 39
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 1 0 - -
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.

S246T has 61 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 8 M414V,
404 15 L404Q, L404V,
937 14
842 13
249 6 K249X,
247 4 V247L,
240 10 V240M,
254 11
418 10 E418K,
926 11
250 6
409 10 L409V, L409P,
237 14
928 10 L928P,
925 10 I925F,
417 12
934 14
933 8
246 0
935 13 L935P,
1779 14 T1779M,
412 5 V412D,
924 10 V924I,
927 13 N927K, N927S,
245 5 Q245K,
845 14 c.2533delG,
244 6
415 6 A415T,
849 14
921 14
405 14
420 13
248 7
241 8
419 11 Q419X,
930 10 c.2787+17_2787+18insACACACACACACACACACACACA, c.2788-6C>T,
1772 14 L1772V,
239 10 I239V, I239V ,
251 10
410 9 A410V,
242 5 A242D,
929 6
416 9 Y416C,
413 8 A413T, A413E,
408 8
253 11
407 12
846 15 L846R,
936 11
238 12
422 15
1775 13 F1775V, p.F1775LfsX15,
1642 14 G1642E,
923 15
406 14 N406S, N406K,
252 12
411 6 V411M,
243 6
932 10
931 13
1646 15