SCN5A Variant E1240Q Detail

We estimate the penetrance of LQTS for SCN5A E1240Q around 1% and the Brugada syndrome penetrance around 13%. SCN5A E1240Q was found in a total of 11 carriers in 2 papers and/or in gnomAD: 1 had Brugada syndrome, 0 had LQTS. E1240Q is present in 10 alleles in gnomAD. E1240Q has been functionally characterized in 2 papers. This residue is located in a Mild_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 (1 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 E1240Q around 1% (0/21) and the Brugada syndrome penetrance around 13% (2/21).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-2.75 0.95 1.76 0.928 19 0
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
11901046 2002 1 0 1 0
30059973 2018 1 1 0 0
LITERATURE, COHORT, AND GNOMAD: - 11 10 0 1 -
VARIANT FEATURES ALONE: - 15 14 0 1 - -
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)
30059973 2018
11901046 2002

E1240Q has 50 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
1245 10 M1245I,
1233 11 K1233E,
1218 12 S1218I, S1218T,
1281 14 c.3840+1G>A, V1281F,
1304 13 T1304M,
1217 15
1243 5 D1243N,
1234 11
1285 9
1299 11 c.3894delC,
1220 14 G1220E,
1298 13 P1298L,
1283 14 L1283M,
1241 7
1226 13
1288 12 A1288G,
1221 11 A1221V,
1242 6
1219 14 S1219N,
1239 5 L1239P,
1306 12 R1306S, R1306H,
1244 8 K1244E,
1286 11
1282 12 S1282A,
1235 9
1246 11
1302 13 p.L1302Vfs18,
1247 11 T1247I,
1237 6 V1237F,
1289 9
1223 14 c.3667delG,
1222 11 p.L1222LfsX7, L1222R,
1230 12 E1230K,
1300 14
1229 10
1301 12
1292 14
1284 13
1291 15
1250 15
1224 14
1240 0 E1240Q,
1225 9 G1225K, E1225K,
1248 12
1287 14
1290 14
1238 7
1236 7 K1236R, K1236N,
1249 15 V1249D,
1303 8 R1303Q, R1303W,