SCN5A Variant V728I Detail

We estimate the penetrance of LQTS for SCN5A V728I around 3% and the Brugada syndrome penetrance around 23%. SCN5A V728I was found in a total of 4 carriers in 1 papers and/or in gnomAD: 1 had Brugada syndrome, 0 had LQTS. V728I is present in 3 alleles in gnomAD. V728I has been functionally characterized in 1 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 V728I around 3% (0/14) and the Brugada syndrome penetrance around 23% (3/14).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-0.95 0.083 2.71 0.638 35 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
22984773 2013 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 4 3 0 1 -
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)
22984773 2013

V728I has 45 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
719 15
723 10 I723V,
811 14 R811H, c.2435_2436+3delTGGTAinsCGCCT, R811G,
733 9 F733L,
821 10
1339 14 p.L1339del, L1339F,
760 12 p.F760SfsX5,
721 11
812 13 L812Q,
1350 14 I1350L, I1350T,
759 13 c.2274delG, I759V, p.I759FfsX6,
755 14
731 5 T731I,
819 13
726 6
818 8
825 15
720 13
822 11 W822X, W822C,
749 14
1346 12 L1346I, L1346P,
724 6 T724I,
728 0 V728I,
820 14
727 5
735 10 A735V, A735T, A735E,
732 6
734 10 c.2201dupT, M734V,
756 10
814 10 R814Q,
816 13 F816L, F816Y,
722 10
813 15 c.2437-5C>A, c.2436+12G>A,
757 14
817 11 K817E,
752 13 G752R,
815 9
1343 12
1342 14
725 6
736 14 L736P,
730 7 N730K,
753 13
1347 14
729 4 p.L729del,