SCN5A Variant E1208K Detail

We estimate the penetrance of LQTS for SCN5A E1208K around 26% and the Brugada syndrome penetrance around 6%. SCN5A E1208K was found in a total of 4 carriers in 1 papers and/or in gnomAD: 0 had Brugada syndrome, 1 had LQTS. E1208K is present in 3 alleles in gnomAD. E1208K has been functionally characterized in 2 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 (0 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 E1208K around 26% (2/14) and the Brugada syndrome penetrance around 6% (0/14).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-3.91 0.974 -0.87 0.867 3 35
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
27566755 2016 1 1 0 0
LITERATURE, COHORT, AND GNOMAD: - 4 3 1 0 -
VARIANT FEATURES ALONE: - 15 14 1 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)
27566755 2016
25904541 2015 HEK 82 -4 -8 71

E1208K has 33 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
1253 10 E1253G,
1211 6
1312 10
1252 14
1309 12 R1309H, R1309C,
1271 14 W1271C,
1317 14 F1317C,
1257 10
1256 12
1250 14
1275 13 D1275N,
1209 5 T1209R,
1321 15 R1321K,
1315 13
1216 13 L1216V,
1313 10
1254 14
1314 14 c.3940_3941delCT,
1310 14
1316 8 R1316L, R1316Q,
1207 4
1213 11
1215 12 I1215V,
1272 13
1266 14
1260 13 A1260D,
1261 12
1249 14 V1249D,
1206 8
1208 0 E1208K, E1208X,
1210 8 F1210S,
1214 11 M1214T,
1212 7 p.I1212del,