SCN5A Variant L567M Detail

We estimate the penetrance of LQTS for SCN5A L567M around 5% and the Brugada syndrome penetrance around 22%. SCN5A L567M was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. L567M is not present in gnomAD. L567M has been functionally characterized in 0 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 L567M around 5% (0/10) and the Brugada syndrome penetrance around 22% (2/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.25 31 5
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 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.

L567M 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
552 15 G552W, G552R,
553 14 E553X, E553K,
554 14 S554N, S554I,
555 13 E555K,
556 13
557 12 H557Q, H557L, H557Y,
558 11 H558R,
559 11 T559I, T559R,
560 10
561 9
562 8
563 8 V563G,
564 7
565 5
566 4
567 0 L567Q,
568 4 R568C, R568H,
569 5 c.1705dupC, R569Q, R569W,
570 7 T570N,
571 8 S571I,
572 8 A572S, A572F, A572V, A572D,
573 9 Q573R, Q573X, Q573E,
574 10 G574E, c.1721delG,
575 11
576 11
577 12 S577N,
578 13 P578R, P578T,
579 13 G579R,
580 14
581 14 S581L,
582 15