Familial sick sinus syndrome
diseaseOn this page
Also known as familial sinus node dysfunctionhereditary sick sinus syndromesick sinus syndrome 1, autosomal recessiveSSS1
Summary
Familial sick sinus syndrome (MONDO:0012061) is a disease with 9 cohort genes (6 GWAS associations across 2 studies).
At a glance
- Prevalence: <1 / 1 000 000 (Worldwide) [Orphanet-validated]
- Cohort genes: 9
- GWAS associations: 6
- ClinVar variants: 1
Clinical features
Epidemiology
Prevalence records
2 prevalence record(s), Orphanet:
| Type | Class | Value | Geography | Validation |
|---|---|---|---|---|
| Cases/families | 11 | Worldwide | Validated | |
| Point prevalence | <1 / 1 000 000 | Worldwide | Validated |
Identifiers
Disease identifiers
| Field | Value |
|---|---|
| Canonical name | familial sick sinus syndrome |
| Mondo ID | MONDO:0012061 |
| MeSH | C563907 |
| OMIM | 608567 |
| Orphanet | 166282 |
| ICD-11 | 1495462959 |
| SNOMED CT | 233913007 |
| UMLS | C0340491 |
| MedGen | 573766 |
| GARD | 0013663 |
| MedDRA | 10040639 |
| Is cancer (heuristic) | no |
Also known as: familial sinus node dysfunction · hereditary sick sinus syndrome · sick sinus syndrome 1, autosomal recessive · SSS1
Data availability: 1 ClinVar variant · 6 GWAS associations (2 studies) · 2 GenCC gene-disease records · 2 cell lines.
Disease family
An umbrella term covering 4 Mondo subtypes.
Classification path: disease › human disease › disease by body system or component › cardiovascular disorder › heart disorder › heart conduction disease › sinoatrial node disorder › sick sinus syndrome › familial sick sinus syndrome
Subtypes (4): sick sinus syndrome 2, autosomal dominant, sinus node disease and myopia, sick sinus syndrome 1, sick sinus syndrome 4
Genetics & variants
GWAS landscape
6 GWAS associations across 2 studies. Top hits map to 5 distinct genes (as reported by GWAS).
Top associations by p-value
| rsID | p-value | Gene | Risk allele | Odds ratio |
|---|---|---|---|---|
| rs7689774 | 2e-15 | PITX2 - LINC01438 | T | 1.21 |
| rs11554495 | 9e-14 | KRT8 | A | 1.62 |
| rs12932445 | 8e-10 | ZFHX3 | C | 1.16 |
| rs35813871 | 6e-09 | TTN | A | 1.13 |
| rs6795970 | 3e-08 | SCN10A | A | 1.12 |
| rs34883828 | 1e-07 | CCDC141 | A | 1.15 |
Top studies (by case count)
| Study | Lead author | Year | Cases | Controls | Title |
|---|---|---|---|---|---|
| GCST011360 | Thorolfsdottir RB | 2021 | 6,189 | 931,046 | Genetic insight into sick sinus syndrome. |
| GCST001001 | Holm H | 2011 | 792 | 37,592 | A rare variant in MYH6 is associated with high risk of sick sinus syndrome. |
Variant details and genetic-evidence tiers
Tier distribution (top 50 variants)
| Tier | Variants |
|---|---|
| Tier 1: coding | 4 |
| Tier 2: splice/UTR | 0 |
| Tier 3: regulatory | 0 |
| Tier 4: intronic/intergenic | 2 |
MAF distribution
| Bucket | Variants |
|---|---|
| common (>=0.05) | 5 |
| low_freq (0.01-0.05) | 1 |
| rare (<0.01) | 0 |
| unknown | 0 |
Functional consequences
| Consequence | Count |
|---|---|
| missense_variant | 4 |
| intergenic_variant | 1 |
| intron_variant | 1 |
Top variants
| rsID | Chr | Pos | Alleles | MAF | Consequence | Gene | p-value | Tier |
|---|---|---|---|---|---|---|---|---|
| rs7689774 | 4 | 110782354 | G>T | 0.201 | intergenic_variant | PITX2 - LINC01438 | 2e-15 | Tier 4: intronic/intergenic |
| rs11554495 | 12 | 52904798 | C>A,G,T | 0.016 | missense_variant | KRT8 | 9e-14 | Tier 1: coding |
| rs12932445 | 16 | 73035989 | T>C | 0.201 | intron_variant | ZFHX3 | 8e-10 | Tier 4: intronic/intergenic |
| rs35813871 | 2 | 178785681 | G>A | 0.266 | missense_variant | TTN | 6e-09 | Tier 1: coding |
| rs6795970 | 3 | 38725184 | A>G,T | 0.358 | missense_variant | SCN10A | 3e-08 | Tier 1: coding |
| rs34883828 | 2 | 178905448 | C>A,T | 0.152 | missense_variant | CCDC141 | 1e-07 | Tier 1: coding |
ClinVar germline variants
1 retrieved; paginated sample, class counts are floors:
1 likely pathogenic
| ClinVar | Variant (HGVS) | Gene | Classification | Review |
|---|---|---|---|---|
| 1348900 | NM_000335.5(SCN5A):c.999-1G>A | SCN5A | Likely pathogenic | criteria provided, multiple submitters, no conflicts |
Genes & proteins
Mendelian disease overlap and somatic drivers
GenCC: 31 · Orphanet: 36 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0
GenCC gene–disease validity (cohort genes)
the Disease column is the GenCC-asserted condition — a cohort gene’s strongest validity may be for a related predisposition syndrome.
| Gene | Classification | Inheritance | Disease | Records |
|---|---|---|---|---|
| HCN4 | Strong | Autosomal dominant | sick sinus syndrome 2, autosomal dominant | 8 |
| SCN5A | Strong | Autosomal recessive | sick sinus syndrome 1 | 23 |
Orphanet rare-disease linkage (cohort genes)
| Gene | Orphanet ID | Rare disease |
|---|---|---|
| SCN5A | Orphanet:101016 | Romano-Ward syndrome |
| SCN5A | Orphanet:130 | Brugada syndrome |
| SCN5A | Orphanet:1344 | Isolated atrial standstill |
| SCN5A | Orphanet:154 | Familial isolated dilated cardiomyopathy |
| SCN5A | Orphanet:166282 | Hereditary sick sinus syndrome |
| SCN5A | Orphanet:228140 | Idiopathic ventricular fibrillation |
| SCN5A | Orphanet:334 | Hereditary atrial fibrillation |
| SCN5A | Orphanet:871 | Hereditary progressive cardiac conduction defect |
| HCN4 | Orphanet:130 | Brugada syndrome |
| HCN4 | Orphanet:166282 | Hereditary sick sinus syndrome |
| SCN10A | Orphanet:101016 | Romano-Ward syndrome |
| SCN10A | Orphanet:130 | Brugada syndrome |
| SCN10A | Orphanet:306577 | Hereditary sodium channelopathy-related small fibers neuropathy |
| SCN10A | Orphanet:46348 | Paroxysmal extreme pain disorder |
| SCN10A | Orphanet:88642 | Congenital insensitivity to pain-anosmia-neuropathic arthropathy |
| SCN10A | Orphanet:90026 | Primary erythromelalgia |
| TTN | Orphanet:140922 | Titin-related limb-girdle muscular dystrophy R10 |
| TTN | Orphanet:154 | Familial isolated dilated cardiomyopathy |
| TTN | Orphanet:169186 | Autosomal recessive centronuclear myopathy |
| TTN | Orphanet:178464 | Hereditary myopathy with early respiratory failure |
| TTN | Orphanet:289377 | Early-onset myopathy with fatal cardiomyopathy |
| TTN | Orphanet:293888 | Inherited isolated arrhythmogenic cardiomyopathy, dominant-left variant |
| TTN | Orphanet:293899 | Inherited isolated arrhythmogenic ventricular dysplasia, biventricular variant |
| TTN | Orphanet:293910 | Inherited isolated arrhythmogenic cardiomyopathy, dominant-right variant |
| TTN | Orphanet:324604 | Classic multiminicore myopathy |
| TTN | Orphanet:334 | Hereditary atrial fibrillation |
| TTN | Orphanet:466921 | Childhood-onset progressive contractures-limb-girdle weakness-muscle dystrophy syndrome |
| TTN | Orphanet:609 | Tibial muscular dystrophy |
| TTN | Orphanet:707983 | Early-onset autosomal recessive TTN-related distal myopathy |
| CCDC141 | Orphanet:478 | Kallmann syndrome |
| PITX2 | Orphanet:334 | Hereditary atrial fibrillation |
| PITX2 | Orphanet:708 | Peters anomaly |
| PITX2 | Orphanet:782 | Axenfeld-Rieger syndrome |
| PITX2 | Orphanet:91481 | Ring dermoid of cornea |
| PITX2 | Orphanet:91483 | Rieger anomaly |
| PITX2 | Orphanet:98978 | Axenfeld anomaly |
Cohort genes → proteins
9 cohort genes, 8 distinct canonical proteins.
Evidence partition
| Subset | Genes |
|---|---|
| gwas_only | 7 |
| multi_evidence | 2 |
Cohort genes (full)
| Symbol | HGNC | Ensembl | UniProt | Name | Evidence |
|---|---|---|---|---|---|
| SCN5A | HGNC:10593 | ENSG00000183873 | Q14524 | Sodium channel protein type 5 subunit alpha | gencc,clinvar |
| HCN4 | HGNC:16882 | ENSG00000138622 | Q9Y3Q4 | Potassium/sodium hyperpolarization-activated cyclic nucleotide-gated channel 4 | gencc |
| SCN10A | HGNC:10582 | ENSG00000185313 | Q9Y5Y9 | Sodium channel protein type 10 subunit alpha | gwas |
| TTN | HGNC:12403 | ENSG00000155657 | Q8WZ42 | Titin | gwas |
| CCDC141 | HGNC:26821 | ENSG00000163492 | Q6ZP82 | Coiled-coil domain-containing protein 141 | gwas |
| MIR297 | HGNC:33691 | ENSG00000215961 | microRNA 297 | gwas | |
| KRT8 | HGNC:6446 | ENSG00000170421 | P05787 | Keratin, type II cytoskeletal 8 | gwas |
| ZFHX3 | HGNC:777 | ENSG00000140836 | Q15911 | Zinc finger homeobox protein 3 | gwas |
| PITX2 | HGNC:9005 | ENSG00000164093 | Q99697 | Pituitary homeobox 2 | gwas |
Cohort function summary
Lead sentence per gene, UniProt-curated.
| Symbol | Protein name | Function (lead sentence) |
|---|---|---|
| SCN5A | Sodium channel protein type 5 subunit alpha | Pore-forming subunit of Nav1.5, a voltage-gated sodium (Nav) channel that directly mediates the depolarizing phase of action potentials in excitable membranes. |
| HCN4 | Potassium/sodium hyperpolarization-activated cyclic nucleotide-gated channel 4 | Hyperpolarization-activated ion channel that are permeable to Na(+) and K(+) ions with very slow activation and inactivation. |
| SCN10A | Sodium channel protein type 10 subunit alpha | Tetrodotoxin-resistant channel that mediates the voltage-dependent sodium ion permeability of excitable membranes. |
| TTN | Titin | Key component in the assembly and functioning of vertebrate striated muscles. |
| CCDC141 | Coiled-coil domain-containing protein 141 | Plays a critical role in cortical radial and GnRH neurons migration during brain development. |
| KRT8 | Keratin, type II cytoskeletal 8 | Required for the formation of KRT8/KRT18 filaments that are involved in ARHGEF40-mediated actin stress fiber formation and tensional force-induced stress fiber formation and reinforcement. |
| ZFHX3 | Zinc finger homeobox protein 3 | Transcriptional regulator which can act as an activator or a repressor. |
| PITX2 | Pituitary homeobox 2 | May play a role in myoblast differentiation. |
Protein-family classification
Druggable: 5 · Difficult: 2 · Unknown: 2 · Druggable fraction: 0.56
Family distribution
Cohort families vs a genome-wide background (hypergeometric, BH-FDR; fold = observed/expected). Counts kept; sorted by enrichment, so the catch-all Other/Unknown bucket no longer leads.
| Family | Genes | Fold | FDR |
|---|---|---|---|
| Ion channel | 3 | 37.2× | 3e-04 |
| Antibody/Immunoglobulin | 1 | 3.2× | 0.374 |
| Kinase | 1 | 3.1× | 0.374 |
| Transcription factor | 2 | 1.8× | 0.374 |
| Other/Unknown | 2 | 0.4× | 0.992 |
Per-gene assignment
| Symbol | Family | Druggable? | EC | InterPro (top 3) |
|---|---|---|---|---|
| SCN5A | Ion channel | yes | Na_channel_asu, Ion_trans_dom, Na_channel_a5su | |
| HCN4 | Ion channel | yes | cNMP-bd_dom, K_chnl_volt-dep_EAG/ELK/ERG, Ion_trans_dom | |
| SCN10A | Ion channel | yes | Na_channel_asu, Ion_trans_dom, Na_trans_assoc_dom | |
| TTN | Kinase | yes | 2.7.11.1 | Prot_kinase_dom, Ig_sub2, Ig_sub |
| CCDC141 | Antibody/Immunoglobulin | yes | Spectrin_repeat, Ig_sub2, Ig_sub | |
| MIR297 | Other/Unknown | no | ||
| KRT8 | Other/Unknown | no | Keratin_II, IF_conserved, Keratin_2_head | |
| ZFHX3 | Transcription factor | no | HD, Matrin/U1-like-C_Znf_C2H2, Homeodomain-like_sf | |
| PITX2 | Transcription factor | no | HD, OAR_dom, Homeodomain-like_sf |
Expression context
Cohort genes with no expression data: 0.
6 cohort genes are a single-cell marker in ≥1 SCXA experiment.
Breadth distribution (Bgee present_calls)
| Bucket | Genes |
|---|---|
| narrow (1-5 tissues) | 0 |
| moderate (6-20) | 0 |
| broad (>20) | 9 |
| unknown | 0 |
Top tissues across cohort
| Tissue | Cohort genes |
|---|---|
| heart left ventricle | 2 |
| right atrium auricular region | 2 |
| biceps brachii | 2 |
| apex of heart | 1 |
| cardiac ventricle | 1 |
| cardiac atrium | 1 |
| tibialis anterior | 1 |
| diaphragm | 1 |
| olfactory bulb | 1 |
| type B pancreatic cell | 1 |
| gluteal muscle | 1 |
| skeletal muscle tissue of biceps brachii | 1 |
| adrenal tissue | 1 |
| endometrium | 1 |
| gastrocnemius | 1 |
| monocyte | 1 |
| duodenum | 1 |
| endometrium epithelium | 1 |
| mucosa of transverse colon | 1 |
| buccal mucosa cell | 1 |
Per-gene tissue summary (top 30)
| Symbol | Bgee breadth | FANTOM5 breadth | SCXA | Top tissues |
|---|---|---|---|---|
| SCN5A | 161 | broad | yes | apex of heart, heart left ventricle, cardiac ventricle |
| HCN4 | 86 | tissue_specific | yes | tibialis anterior, right atrium auricular region, cardiac atrium |
| SCN10A | 21 | marker | type B pancreatic cell, olfactory bulb, diaphragm | |
| TTN | 223 | broad | marker | biceps brachii, gluteal muscle, skeletal muscle tissue of biceps brachii |
| CCDC141 | 149 | broad | marker | heart left ventricle, adrenal tissue, right atrium auricular region |
| MIR297 | 38 | yes | endometrium, gastrocnemius, monocyte | |
| KRT8 | 159 | ubiquitous | marker | mucosa of transverse colon, endometrium epithelium, duodenum |
| ZFHX3 | 274 | ubiquitous | marker | saphenous vein, buccal mucosa cell, synovial joint |
| PITX2 | 166 | broad | marker | gingiva, biceps brachii, gingival epithelium |
Protein interactions among cohort
Intra-cohort edges: 3.
Hub genes (top 10 by interactor count)
| Symbol | Interactor count |
|---|---|
| TTN | 4,237 |
| KRT8 | 3,915 |
| PITX2 | 2,389 |
| SCN5A | 2,090 |
| SCN10A | 1,802 |
| ZFHX3 | 1,649 |
| HCN4 | 1,279 |
| CCDC141 | 1,255 |
| MIR297 | 0 |
Intra-cohort edges
| A | B | Sources |
|---|---|---|
| HCN4 | PITX2 | string_interaction |
| HCN4 | SCN5A | string_interaction |
| PITX2 | ZFHX3 | string_interaction |
Structural data
PDB: 7 · AlphaFold-only: 1 · No structure: 1
Cohort genes with PDB structures (top 30)
| Symbol | UniProt | PDB entries |
|---|---|---|
| TTN | Q8WZ42 | 64 |
| SCN5A | Q14524 | 16 |
| HCN4 | Q9Y3Q4 | 8 |
| SCN10A | Q9Y5Y9 | 8 |
| KRT8 | P05787 | 3 |
| ZFHX3 | Q15911 | 3 |
| PITX2 | Q99697 | 3 |
AlphaFold-only cohort genes (top 30 by pLDDT)
| Symbol | UniProt | pLDDT |
|---|---|---|
| CCDC141 | Q6ZP82 | 72.36 |
Function
Pathway analysis
Distinct Reactome pathways touched by cohort: 17. Enrichment computed across 9 evidence-associated genes (7 with Reactome annotation).
Pathways by enrichment
Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 7 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.
| Pathway | Cohort genes | Fold | FDR | Sample cohort genes |
|---|---|---|---|---|
| Interaction between L1 and Ankyrins | 2 | 105.2× | 0.001 | SCN5A, SCN10A |
| Phase 0 - rapid depolarisation | 2 | 98.9× | 0.001 | SCN5A, SCN10A |
| HCN channels | 1 | 407.9× | 0.007 | HCN4 |
| TFAP2 (AP-2) family regulates transcription of other transcription factors | 1 | 407.9× | 0.007 | PITX2 |
| L1CAM interactions | 2 | 34.4× | 0.007 | SCN5A, SCN10A |
| Cardiac conduction | 2 | 31.1× | 0.007 | SCN5A, SCN10A |
| Muscle contraction | 2 | 22.1× | 0.008 | SCN5A, SCN10A |
| RUNX3 regulates CDKN1A transcription | 1 | 233.1× | 0.009 | ZFHX3 |
| Developmental Lineage of Mammary Gland Alveolar Cells | 1 | 90.6× | 0.016 | KRT8 |
| Axon guidance | 2 | 12.9× | 0.016 | SCN5A, SCN10A |
| Nervous system development | 2 | 12.3× | 0.016 | SCN5A, SCN10A |
| Developmental Biology | 3 | 6.2× | 0.016 | SCN5A, SCN10A, KRT8 |
| Developmental Lineage of Mammary Gland Luminal Epithelial Cells | 1 | 65.3× | 0.020 | KRT8 |
| Striated Muscle Contraction | 1 | 44.1× | 0.027 | TTN |
| Platelet degranulation | 1 | 12.6× | 0.082 | TTN |
| Formation of the cornified envelope | 1 | 12.6× | 0.082 | KRT8 |
| Keratinization | 1 | 8.0× | 0.119 | KRT8 |
GO biological processes by enrichment
Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 8 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.
| GO term | Cohort genes | Fold | FDR | Sample cohort genes |
|---|---|---|---|---|
| bundle of His cell action potential | 2 | 2106.5× | 3e-05 | SCN5A, SCN10A |
| regulation of heart rate | 3 | 175.5× | 3e-05 | SCN5A, SCN10A, HCN4 |
| AV node cell action potential | 2 | 1053.2× | 5e-05 | SCN5A, SCN10A |
| membrane depolarization during SA node cell action potential | 2 | 842.6× | 6e-05 | SCN5A, HCN4 |
| SA node cell action potential | 2 | 702.2× | 8e-05 | SCN5A, HCN4 |
| regulation of atrial cardiac muscle cell membrane depolarization | 2 | 468.1× | 1e-04 | SCN5A, SCN10A |
| sodium ion transmembrane transport | 3 | 76.1× | 1e-04 | SCN5A, SCN10A, HCN4 |
| membrane depolarization during action potential | 2 | 421.3× | 1e-04 | SCN5A, SCN10A |
| membrane depolarization during cardiac muscle cell action potential | 2 | 351.1× | 2e-04 | SCN5A, HCN4 |
| regulation of cardiac muscle contraction | 2 | 221.7× | 4e-04 | SCN10A, HCN4 |
| cardiac muscle cell action potential involved in contraction | 2 | 175.5× | 6e-04 | SCN5A, SCN10A |
| cardiac muscle contraction | 2 | 100.3× | 0.002 | SCN5A, TTN |
| regulation of heart rate by cardiac conduction | 2 | 93.6× | 0.002 | SCN5A, HCN4 |
| odontogenesis of dentin-containing tooth | 2 | 75.2× | 0.003 | SCN5A, SCN10A |
| subthalamic nucleus development | 1 | 2106.5× | 0.004 | PITX2 |
| superior vena cava morphogenesis | 1 | 2106.5× | 0.004 | PITX2 |
| muscle contraction | 2 | 52.0× | 0.005 | TTN, HCN4 |
| hypothalamus cell migration | 1 | 1053.2× | 0.005 | PITX2 |
| prolactin secreting cell differentiation | 1 | 1053.2× | 0.005 | PITX2 |
| left lung morphogenesis | 1 | 1053.2× | 0.005 | PITX2 |
| pulmonary vein morphogenesis | 1 | 1053.2× | 0.005 | PITX2 |
| cell proliferation involved in outflow tract morphogenesis | 1 | 1053.2× | 0.005 | PITX2 |
| AV node cell to bundle of His cell communication | 1 | 1053.2× | 0.005 | SCN5A |
| regulation of locomotor rhythm | 1 | 1053.2× | 0.005 | ZFHX3 |
| pulmonary myocardium development | 1 | 702.2× | 0.005 | PITX2 |
| skeletal muscle myosin thick filament assembly | 1 | 702.2× | 0.005 | TTN |
| vascular associated smooth muscle cell differentiation | 1 | 702.2× | 0.005 | PITX2 |
| deltoid tuberosity development | 1 | 702.2× | 0.005 | PITX2 |
| sarcomerogenesis | 1 | 702.2× | 0.005 | TTN |
| response to other organism | 1 | 702.2× | 0.005 | KRT8 |
Therapeutics
Drug target analysis
Approved (phase 4): 3 · Phase ≥3: 3 · Phased (≥1): 3 · Undrugged: 6
Druggability breadth: 4 of 9 evidence-associated genes (44%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).
Genes with an approved drug
The molecule shown is one approved compound that hits the gene — not necessarily a drug of choice or one indicated for this disease.
| Symbol | Example approved molecule |
|---|---|
| SCN5A | BEPRIDIL |
| HCN4 | IVABRADINE |
| SCN10A | IMIPRAMINE |
Top cohort targets by molecule count
| Symbol | Molecules | Max phase |
|---|---|---|
| SCN5A | 108 | 4 |
| SCN10A | 21 | 4 |
| HCN4 | 2 | 4 |
| TTN | 0 | 0 |
| CCDC141 | 0 | 0 |
| MIR297 | 0 | 0 |
| KRT8 | 0 | 0 |
| ZFHX3 | 0 | 0 |
| PITX2 | 0 | 0 |
Drugs targeting cohort genes (top 30)
| Molecule | Max phase | Targets in cohort |
|---|---|---|
| BEPRIDIL | 4 | SCN5A |
| CANDESARTAN CILEXETIL | 4 | SCN5A |
| TELMISARTAN | 4 | SCN5A |
| CARBAMAZEPINE | 4 | SCN5A |
| DIBUCAINE | 4 | SCN5A |
| IMIPRAMINE | 4 | SCN10A, SCN5A |
| DROPERIDOL | 4 | SCN5A |
| PONATINIB | 4 | SCN5A |
| DULOXETINE | 4 | SCN5A |
| PALONOSETRON | 4 | SCN5A |
| VILANTEROL | 4 | SCN5A |
| MEXILETINE HYDROCHLORIDE | 4 | SCN5A |
| UNOPROSTONE ISOPROPYL | 4 | SCN5A |
| LURASIDONE | 4 | SCN5A |
| LETERMOVIR | 4 | SCN5A |
| SERTINDOLE | 4 | SCN10A, SCN5A |
| FEDRATINIB | 4 | SCN5A |
| QUINIDINE | 4 | SCN5A |
| DARUNAVIR | 4 | SCN5A |
| DARIFENACIN | 4 | SCN5A |
| BENZONATATE | 4 | SCN5A |
| TOLTERODINE | 4 | SCN5A |
| RANOLAZINE | 4 | SCN5A |
| PIMOZIDE | 4 | SCN10A, SCN5A |
| NIMODIPINE | 4 | SCN5A |
| FELODIPINE | 4 | SCN5A |
| NICARDIPINE | 4 | SCN5A |
| AMLODIPINE | 4 | SCN5A |
| PHENYTOIN | 4 | SCN5A |
| PALIPERIDONE | 4 | SCN5A |
Bioactivity and enzyme data
Enzyme cohort genes (≥1 EC): 1.
Cohort genes with ChEMBL bioactivity (full, sorted by assay count)
| Symbol | Assays | Type breakdown |
|---|---|---|
| SCN5A | 594 | Binding:380, Functional:98, ADMET:72, Toxicity:43, Unclassified:1 |
| SCN10A | 144 | Binding:124, Functional:16, ADMET:4 |
| HCN4 | 30 | Binding:20, ADMET:5, Functional:4, Toxicity:1 |
| TTN | 1 | Binding:1 |
Cohort enzymes (BRENDA EC)
| Symbol | EC numbers | Names |
|---|---|---|
| TTN | 2.7.11.1 | non-specific serine/threonine protein kinase |
Cohort genes with high screening signal
≥100 ChEMBL assays — a studied-ness signal; see Therapeutics for approved-drug status.
| Symbol | ChEMBL assays |
|---|---|
| SCN5A | 594 |
| SCN10A | 144 |
Pharmacogenomics
Cohort genes with a PharmGKB record: 9; with CPIC/DPWG dosing guidelines: 0.
No cohort gene has a CPIC/DPWG genotype-guided dosing guideline (PharmGKB).
Chemical tractability of cohort targets
30 approved/phased compounds have measured bioactivity against a cohort gene (and aren’t yet in disease-level trials). This is a research / tractability signal, NOT a therapeutic recommendation — a bioactivity row often reflects off-target or screening binding (e.g. promiscuous kinase inhibitors against a cohort kinase), implying no disease mechanism.
| Compound | Max phase | Cohort target (bioactivity) |
|---|---|---|
| BEPRIDIL | 4 | SCN5A |
| CANDESARTAN CILEXETIL | 4 | SCN5A |
| TELMISARTAN | 4 | SCN5A |
| CARBAMAZEPINE | 4 | SCN5A |
| DIBUCAINE | 4 | SCN5A |
| IMIPRAMINE | 4 | SCN10A, SCN5A |
| DROPERIDOL | 4 | SCN5A |
| PONATINIB | 4 | SCN5A |
| DULOXETINE | 4 | SCN5A |
| PALONOSETRON | 4 | SCN5A |
| VILANTEROL | 4 | SCN5A |
| MEXILETINE HYDROCHLORIDE | 4 | SCN5A |
| UNOPROSTONE ISOPROPYL | 4 | SCN5A |
| LURASIDONE | 4 | SCN5A |
| LETERMOVIR | 4 | SCN5A |
| SERTINDOLE | 4 | SCN10A, SCN5A |
| FEDRATINIB | 4 | SCN5A |
| QUINIDINE | 4 | SCN5A |
| DARUNAVIR | 4 | SCN5A |
| DARIFENACIN | 4 | SCN5A |
| BENZONATATE | 4 | SCN5A |
| TOLTERODINE | 4 | SCN5A |
| RANOLAZINE | 4 | SCN5A |
| PIMOZIDE | 4 | SCN10A, SCN5A |
| NIMODIPINE | 4 | SCN5A |
| FELODIPINE | 4 | SCN5A |
| NICARDIPINE | 4 | SCN5A |
| AMLODIPINE | 4 | SCN5A |
| PHENYTOIN | 4 | SCN5A |
| PALIPERIDONE | 4 | SCN5A |
Druggability pyramid
Cohort genes binned by druggability tier (high → low):
| Tier | Definition | Genes | Symbols |
|---|---|---|---|
| A | Approved (phase 4 drug) | 3 | SCN5A, HCN4, SCN10A |
| B | Phased (≥1) drug, not yet approved | 0 | |
| C | Druggable family + PDB, no drug | 1 | TTN |
| D | Druggable family + AlphaFold only, no drug | 1 | CCDC141 |
| E | Difficult family or no structure, no drug | 4 | MIR297, KRT8, ZFHX3, PITX2 |
Undrugged target profiles
6 cohort genes are undrugged. Ranked by ‘starting-point quality’ (assay depth + drugged-partner adjacency).
| Symbol | ChEMBL assays | Drugged partners (top 3) |
|---|---|---|
| TTN | 1 | — |
| CCDC141 | 0 | — |
| MIR297 | 0 | — |
| KRT8 | 0 | — |
| ZFHX3 | 0 | — |
| PITX2 | 0 | — |
Clinical trials & evidence
Clinical trials
Clinical trials: 0.