SCN5A Variant Q779K Detail

We estimate the penetrance of LQTS for SCN5A Q779K around 31% and the Brugada syndrome penetrance around 38%. SCN5A Q779K was found in a total of 2 carriers in 3 papers and/or in gnomAD: 1 had Brugada syndrome, 1 had LQTS. Q779K is not present in gnomAD. Q779K has been functionally characterized in 3 papers. This residue is located in a Hotspot region for Brugada syndrome and a Mild_Hotspot region for LQTS. In silico predictions, functional data (if available), and location in structure are equivalent to phenotyping 10 individuals for Brugada syndrome (3 diagnosed with Brugada syndrome) and 5 individuals for LQTS (1 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A Q779K around 31% (2/12) and the Brugada syndrome penetrance around 38% (4/12).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-0.92 0.005 -0.95 0.598 54 35
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
20541041 2010 1 1 0 0
28341781 2017 1 0 1 0
30059973 2018 2 2 0 0
LITERATURE, COHORT, AND GNOMAD: - 2 0 1 1 -
VARIANT FEATURES ALONE: - 15 11 1 3 - -
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)
30059973 2018
20541041 2010
28341781 2017

Q779K has 30 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
715 15 M715I, M715T,
820 10
774 13 p.Y774TfsX28, Y774D, c.2320delT, Y774C,
784 10 F784L,
767 11
778 5
772 12 D772N,
770 14
781 7 W781X,
775 10
771 10 L771V,
720 14
785 10 D785N,
783 7 I783T,
773 11 P773S,
714 13 V714D, V714A,
780 5
830 15
776 7 p.Y776del,
768 12
788 15 I788V,
786 12
817 13 K817E,
787 13
779 0 Q779X, Q779K,
764 13 M764R, M764K,
777 8 F777L,
782 5 N782T,
819 14
826 14 N826D,