SCN5A Variant D1041N Detail

We estimate the penetrance of LQTS for SCN5A D1041N around 6% and the Brugada syndrome penetrance around 6%. SCN5A D1041N was found in a total of 18 carriers in 2 papers and/or in gnomAD: 1 had Brugada syndrome, 1 had LQTS. D1041N is present in 16 alleles in gnomAD. D1041N has been functionally characterized in 2 papers. This residue is located in a Non_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 (0 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 D1041N around 6% (1/28) and the Brugada syndrome penetrance around 6% (1/28).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
0.91 0.83 2.39 0.305 3 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
23631430 2013 1 1 0 0
25650408 2015 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 18 16 1 1 -
VARIANT FEATURES ALONE: - 15 15 0 0 - -
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)
23631430 2013
25650408 2015

D1041N 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
1026 15
1027 14 R1027Q, R1027W, R1027P,
1028 14
1029 13 E1029K,
1030 13
1031 12 p.G1031fsX27,
1032 11 E1032D, E1032K,
1033 11 Q1033R,
1034 10 P1034T,
1035 9 G1035V,
1036 8
1037 8
1038 7
1039 5
1040 4 G1040R,
1041 0 D1041N, D1041G,
1042 4
1043 5 E1043K,
1044 7
1045 8 V1045M,
1046 8
1047 9 c.3140_3141dupTG,
1048 10 P1048S, p.P1048SfsX96, c.3142_3143insTG,
1049 11
1050 11 p.A1050DfsX9, A1050T, p.A1050CfsX9,
1051 12 V1051A,
1052 13 p.A1052CfsX7, A1052D,
1053 13 E1053K,
1054 14
1055 14 D1055G,
1056 15 T1056A,