SCN5A Variant P468A Detail

We estimate the penetrance of LQTS for SCN5A P468A around 3% and the Brugada syndrome penetrance around 10%. SCN5A P468A was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. P468A is not present in gnomAD. P468A has been functionally characterized in 0 papers. This residue is located in a Non_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 (1 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 P468A around 3% (0/10) and the Brugada syndrome penetrance around 10% (1/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.198 10 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 14 0 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.

P468A has 31 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
453 15 V453M,
454 14
455 14
456 13 V456M,
457 13
458 12 R458C, p.R458VfsX12, R458H,
459 11 S459G,
460 11
461 10 L461V,
462 9 E462K, E462A,
463 8 M463T, M463R,
464 8
465 7 p.P465LfsX5,
466 5 L466F,
467 4
468 0 P468L,
469 4 V469I,
470 5 N470K,
471 7
472 8
473 8 E473X,
474 9 R474G, R474K,
475 10 R475K, R475S,
476 11
477 11 c.1428_1431delCAAG,
478 12
479 13
480 13 K480N,
481 14 R481W, R481Q,
482 14 M482I,
483 15