SCN5A Variant V95I Detail

We estimate the penetrance of LQTS for SCN5A V95I around 1% and the Brugada syndrome penetrance around 13%. SCN5A V95I was found in a total of 8 carriers in 3 papers and/or in gnomAD: 1 had Brugada syndrome, 0 had LQTS. V95I is present in 7 alleles in gnomAD. V95I has been functionally characterized in 4 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 V95I around 1% (0/18) and the Brugada syndrome penetrance around 13% (2/18).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-0.95 0.999 1.23 0.856 19 2
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
17081365 2006 1 0 1 0
20877689 2010 1 0 1 0
24529773 2014 1 0 0 1 SUNDS
LITERATURE, COHORT, AND GNOMAD: - 8 7 0 1 -
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.

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)
20877689 2010
24529773 2014
17081365 2006
23805106 2013 HEK 106 1.2 1

V95I 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
80 15
81 14
82 14 D82E,
83 13 p.L83WfsX14,
84 13 D84N, D84G,
85 12 P85S, P85T,
86 11 F86L,
87 11 Y87C,
88 10 S88G,
89 9
90 8 p.Q90WfsX14,
91 8
92 7 c.274-24C>T, T92I,
93 5 F93S,
94 4 I94V, I94S,
95 0 V95L, V95I,
96 4
97 5
98 7
99 8
100 8
101 9 T101I,
102 10
103 11
104 11 R104Q, R104G, R104W,
105 12
106 13 S106T,
107 13
108 14
109 14 N109K,
110 15 A110T,