SCN5A Variant P1014S Detail

We estimate the penetrance of LQTS for SCN5A P1014S around 6% and the Brugada syndrome penetrance around 43%. SCN5A P1014S was found in a total of 2 carriers in 2 papers and/or in gnomAD: 2 had Brugada syndrome, 0 had LQTS. P1014S is not present in gnomAD. P1014S 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 (0 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A P1014S around 6% (0/12) and the Brugada syndrome penetrance around 43% (5/12).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
0.2 0.09 0.07 0.447 54 13
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
29325976 2018 1 0 1 0
29574140 2018 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 2 0 0 2 -
VARIANT FEATURES ALONE: - 15 12 0 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)
32533946 2020 HEK 121 -9.8 -0.4
29325976 2018
29574140 2018

P1014S 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
999 15 G999D,
1000 14 Q1000L, p.Gln1000del, Q1000X,
1001 14
1002 13 P1002S, c.3005-3012delCCAGCTGG,
1003 13
1004 12 C1004R,
1005 11 I1005V, I1005T,
1006 11 A1006S,
1007 10 T1007I, T1007N,
1008 9 P1008S,
1009 8
1010 8
1011 7 P1011L, P1011S,
1012 5
1013 4
1014 0 P1014S,
1015 4 p.G1015DfsX14, E1015K,
1016 5 T1016M, c.3045_3046delGA,
1017 7
1018 8 K1018E,
1019 8
1020 9
1021 10 P1021S,
1022 11
1023 11 R1023P, R1023H, R1023C,
1024 12 K1024R,
1025 13 E1025A,
1026 13
1027 14 R1027P, R1027Q, R1027W,
1028 14
1029 15 E1029K,