SCN5A Variant L804M Detail

We estimate the penetrance of LQTS for SCN5A L804M around 7% and the Brugada syndrome penetrance around 14%. SCN5A L804M was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. L804M is not present in gnomAD. L804M 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 L804M around 7% (0/10) and the Brugada syndrome penetrance around 14% (1/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.743 11 6
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: - 0 0 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.

L804M has 26 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
1434 15 c.4299G>A, c.4299_4300insG, c.4299+28C>T, c.4299+1delG, c.4299+2T>A, Y1434X, c.4299delG, c.4300-1G>A, c.4300-2A>T, c.4299+1G>T,
1443 15 N1443S,
1355 13
797 11 G797V,
810 11
811 13 R811G, c.2435_2436+3delTGGTAinsCGCCT, R811H,
796 13
802 7
808 10 R808P, R808H, R808C,
801 11 M801V, p.801_803delMSN/insS,
803 4
1445 14 Y1445H,
807 7
795 10
1354 13
1446 14
805 4 S805L,
799 10
792 14
794 11
798 7
804 0
791 13 L791F,
809 11
806 6 V806M,
800 14 R800H, R800L, R800C,