SCN5A Variant N109K Detail

We estimate the penetrance of LQTS for SCN5A N109K around 11% and the Brugada syndrome penetrance around 40%. SCN5A N109K was found in a total of 4 carriers in 3 papers and/or in gnomAD: 3 had Brugada syndrome, 0 had LQTS. N109K is present in 1 alleles in gnomAD. N109K has been functionally characterized in 4 papers. This residue is located in a Non_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 (2 diagnosed with Brugada syndrome) and 5 individuals for LQTS (1 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A N109K around 11% (1/14) and the Brugada syndrome penetrance around 40% (5/14).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-0.67 0.208 2.46 0.361 49 23
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
19843921 2009 1 0 1 0
21273195 2011 3 0 3 0
20129283 2010 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 4 1 0 3 -
VARIANT FEATURES ALONE: - 15 12 1 2 - -
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)
20129283 2010
32533946 2020 HEK 120 -1.4 1.3
19843921 2009
21273195 2011

N109K 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
94 15 I94V, I94S,
95 14 V95I, V95L,
96 14
97 13
98 13
99 12
100 11
101 11 T101I,
102 10
103 9
104 8 R104Q, R104G, R104W,
105 8
106 7 S106T,
107 5
108 4
109 0 N109K,
110 4 A110T,
111 5
112 7 Y112C,
113 8 V113I, V113A,
114 8
115 9 S115G,
116 10
117 11
118 11
119 12 P119L, P119S,
120 13
121 13 R121W, R121Q,
122 14
123 14 A123G, A123V,
124 15 A124D,