SCN5A Variant c.3667delG Detail

We estimate the penetrance of LQTS for SCN5A c.3667delG around 10% and the Brugada syndrome penetrance around 41%. SCN5A c.3667delG was found in a total of 5 carriers in 4 papers and/or in gnomAD: 3 had Brugada syndrome, 0 had LQTS. c.3667delG is not present in gnomAD. c.3667delG has been functionally characterized in 4 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 (1 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A c.3667delG around 10% (1/15) and the Brugada syndrome penetrance around 41% (6/15).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA None 41 25
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
17404158 2007 1 0 1 0
20031634 2009 5 0 3 0
26921764 2016 1 0 1 0
20129283 2010 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 5 2 0 3 -
VARIANT FEATURES ALONE: - 15 11 1 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)
17404158 2007
20031634 2009
26921764 2016
20129283 2010

c.3667delG has 61 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
1702 14
387 15
1218 9 S1218T, S1218I,
1304 11 T1304M,
1217 11
1243 15 D1243N,
1216 11 L1216V,
1234 15
1698 9 A1698T,
1220 5 G1220E,
1673 7
1675 12
1694 13
1704 14 L1704H,
1226 7
1695 13 Q1695X,
1669 7
1671 14
1221 5 A1221V,
1668 12 M1668T,
1242 13
1676 8 M1676I, M1676T,
1219 7 S1219N,
1672 8 S1672Y,
1699 12
1693 14
1239 10 L1239P,
1310 13
1306 12 R1306H, R1306S,
1665 12
1305 15
1680 15 A1680P, A1680T,
1246 15
1235 10
1231 15 E1231K,
1701 10 M1701I,
1307 10
1228 10 Y1228F, Y1228H, Y1228C,
1678 15 N1678S,
1223 0 c.3667delG,
1697 6
1222 5 p.L1222LfsX7, L1222R,
1227 11
1674 13 F1674V,
1229 11
1215 13 I1215V,
1301 13
1696 8
1700 10
1677 12
1308 14 L1308F,
1224 4
1670 11
1240 14 E1240Q,
1225 7 G1225K, E1225K,
1238 13
1679 15
1236 14 K1236N, K1236R,
1667 14 V1667I,
1303 11 R1303W, R1303Q,
1666 12