SCN5A Variant F93S Detail

We estimate the penetrance of LQTS for SCN5A F93S around 8% and the Brugada syndrome penetrance around 53%. SCN5A F93S was found in a total of 2 carriers in 4 papers and/or in gnomAD: 2 had Brugada syndrome, 0 had LQTS. F93S is not present in gnomAD. F93S has been functionally characterized in 5 papers. This residue is located in a 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 (4 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 F93S around 8% (0/12) and the Brugada syndrome penetrance around 53% (6/12).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-7.6 0.999 -0.45 0.99 57 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
17404158 2007 2 0 2 0
26921764 2016 2 0 2 0
20129283 2010 1 0 1 0
30059973 2018 3 3 0 0
LITERATURE, COHORT, AND GNOMAD: - 2 0 0 2 -
VARIANT FEATURES ALONE: - 15 11 0 4 - -
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)
32533946 2020 HEK 0
30059973 2018
17404158 2007
26921764 2016
20129283 2010

F93S 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
78 15
79 14 P79A, P79S, P79H,
80 14
81 13
82 13 D82E,
83 12 p.L83WfsX14,
84 11 D84N, D84G,
85 11 P85T, P85S,
86 10 F86L,
87 9 Y87C,
88 8 S88G,
89 8
90 7 p.Q90WfsX14,
91 5
92 4 c.274-24C>T, T92I,
93 0 F93S,
94 4 I94V, I94S,
95 5 V95I, V95L,
96 7
97 8
98 8
99 9
100 10
101 11 T101I,
102 11
103 12
104 13 R104G, R104W, R104Q,
105 13
106 14 S106T,
107 14
108 15