SCN5A Variant L618F Detail

We estimate the penetrance of LQTS for SCN5A L618F around 2% and the Brugada syndrome penetrance around 1%. SCN5A L618F was found in a total of 138 carriers in 7 papers and/or in gnomAD: 1 had Brugada syndrome, 2 had LQTS. L618F is present in 134 alleles in gnomAD. L618F has been functionally characterized in 7 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 (0 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 L618F around 2% (2/148) and the Brugada syndrome penetrance around 1% (1/148).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-2.18 0.748 -0.79 0.676 4 8
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
11997281 2002 1 0 0 1 diLQT
15840476 2005 2 2 0 0
19843921 2009 1 0 1 0
21273195 2011 1 0 1 0
24631775 2014 2 0 0 2 SD, SIDS
25163546 2015 1 0 0 1 DCM
20129283 2010 1 0 0 0
LITERATURE, COHORT, AND GNOMAD: - 138 135 2 1 -
VARIANT FEATURES ALONE: - 15 15 0 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.

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)
20129283 2010
11997281 2002 HEK-tSA202 105 -4.9 3.9
15840476 2005
19843921 2009
21273195 2011
24631775 2014
25163546 2015

L618F 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
603 15
604 14 L604V,
605 14 G605E,
606 13 A606T,
607 13 G607V, G607R, G607D,
608 12 D608H, D608N,
609 11
610 11 E610K,
611 10
612 9
613 8
614 8 P614S,
615 7 G615E,
616 5 S616N,
617 4
618 0 L618F,
619 4 L619F,
620 5 R620C, R620H,
621 7
622 8
623 8 M623T,
624 9 L624Q,
625 10 E625Q, c.1872dupA, E625D,
626 11
627 11 P627L,
628 12 P628R,
629 13 D629Y,
630 13 T630M,
631 14 c.1890+5G>A, c.1890G>A, p.T631VfsX101,
632 14 T632M,
633 15