SCN5A Variant A551T Detail

We estimate the penetrance of LQTS for SCN5A A551T around 1% and the Brugada syndrome penetrance around 33%. SCN5A A551T was found in a total of 3 carriers in 4 papers and/or in gnomAD: 2 had Brugada syndrome, 0 had LQTS. A551T is not present in gnomAD. A551T has been functionally characterized in 4 papers. This residue is located in a Mild_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 (2 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 A551T around 1% (0/13) and the Brugada syndrome penetrance around 33% (4/13).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-0.54 0.801 0.09 0.563 25 0
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
24463578 2014 1 0 1 0
19706159 2009 1 0 1 0
16155735 2005 3 0 2 0
26154754 2015 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 3 1 0 2 -
VARIANT FEATURES ALONE: - 15 13 0 2 - -
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.

Functional Data

Peak and late/persistent current are relative to wildtype (100% being no different from wildtype). V0.5 act/inact are the voltages at which half of the maximal current is reached during an activation and inactivation protocol, each is in units of mV and relative to wildtype.
PubMed ID Year Cell Type Peak Current (%WT) V1/2 Act. (mV) V1/2 Inact. (mV) Late/Persistent Current (%WT)
16155735 2005
26154754 2015
24463578 2014 HEK 39 -1.8 -1.4
19706159 2009 HEK 58 0 -5

A551T 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
536 15 D536H,
537 14
538 14 G538D,
539 13
540 13
541 12
542 11
543 11 F543L,
544 10
545 9
546 8
547 8
548 7
549 5
550 4
551 0 A551T, A551V,
552 4 G552W, G552R,
553 5 E553X, E553K,
554 7 S554I, S554N,
555 8 E555K,
556 8
557 9 H557Y, H557L, H557Q,
558 10 H558R,
559 11 T559I, T559R,
560 11
561 12
562 13
563 13 V563G,
564 14
565 14
566 15