SCN5A Variant F784L Detail

We estimate the penetrance of LQTS for SCN5A F784L around 5% and the Brugada syndrome penetrance around 17%. SCN5A F784L was found in a total of 1 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. F784L is present in 1 alleles in gnomAD. F784L 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 F784L around 5% (0/11) and the Brugada syndrome penetrance around 17% (1/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-5.94 0.036 1.63 0.93 24 1
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.

F784L has 48 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
723 13 I723V,
811 14 c.2435_2436+3delTGGTAinsCGCCT, R811G, R811H,
821 13
760 11 p.F760SfsX5,
780 6
776 11 p.Y776del,
812 12 L812Q,
792 12
764 10 M764K, M764R,
777 11 F777L,
791 10 L791F,
819 10
826 13 N826D,
818 11
825 14
781 5 W781X,
720 14
788 6 I788V,
724 14 T724I,
782 7 N782T,
793 15 L793F,
820 9
810 11
727 12
767 13
814 9 R814Q,
816 8 F816L, F816Y,
813 7 c.2436+12G>A, c.2437-5C>A,
757 14
768 14
786 7
817 7 K817E,
761 14
779 10 Q779X, Q779K,
809 14
815 10
778 14
790 11
784 0 F784L,
763 14 E763D, E763K,
785 4 D785N,
783 6 I783T,
730 15 N730K,
789 9 V789I, V789A,
1347 14
829 12
787 6
794 15