SCN5A Variant P640L Detail

We estimate the penetrance of LQTS for SCN5A P640L around 7% and the Brugada syndrome penetrance around 12%. SCN5A P640L was found in a total of 1 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. P640L is present in 1 alleles in gnomAD. P640L 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 (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 P640L around 7% (0/11) and the Brugada syndrome penetrance around 12% (1/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-1.53 0.025 0.18 0.458 14 9
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: - 1 1 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.

P640L 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
625 15 E625D, E625Q, c.1872dupA,
626 14
627 14 P627L,
628 13 P628R,
629 13 D629Y,
630 12 T630M,
631 11 p.T631VfsX101, c.1890G>A, c.1890+5G>A,
632 11 T632M,
633 10
634 9 S634W, S634L,
635 8
636 8 E636K,
637 7 P637L,
638 5 G638D,
639 4 G639R, G639A,
640 0 P640A, P640S, P640L,
641 4
642 5
643 7
644 8
645 8
646 9 c.1936delC, p.Q646RfsX5,
647 10 A647D, A647V, A647S,
648 11 P648L,
649 11 C649R, C649Y,
650 12
651 13 c.1950_1953delAGAT, D651H,
652 13 G652S, G652D,
653 14
654 14 E654D, E654Q, E654X , E654K,
655 15 E655K,