SCN5A Variant V125L Detail

We estimate the penetrance of LQTS for SCN5A V125L around 2% and the Brugada syndrome penetrance around 3%. SCN5A V125L was found in a total of 55 carriers in 4 papers and/or in gnomAD: 0 had Brugada syndrome, 1 had LQTS. V125L is present in 54 alleles in gnomAD. V125L has been functionally characterized in 6 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 (2 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 V125L around 2% (1/65) and the Brugada syndrome penetrance around 3% (2/65).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-1.33 0.264 -0.05 0.603 34 1
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
15840476 2005 1 1 0 0
27566755 2016 1 1 0 0
19716085 2009 1 1 0 0
29396286 2018 1 0 0 1 electrical storm
LITERATURE, COHORT, AND GNOMAD: - 55 54 1 0 -
VARIANT FEATURES ALONE: - 15 13 0 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)
25904541 2015 HEK 71 4 4 157
29396286 2018
23805106 2013 HEK 83 0.7 3.1 36
15840476 2005
27566755 2016
19716085 2009

V125L has 36 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
126 5 K126E,
175 9 K175N,
113 14 V113I, V113A,
129 6
188 13
178 5 A178G,
128 6 c.381dupT,
117 13
179 7 R179Q, R179X,
119 10 P119L, P119S,
177 8 L177P,
123 5 A123V, A123G,
121 6 R121Q, R121W,
127 6
124 4 A124D,
118 11
125 0 V125L,
176 11
172 13
131 13
174 8 V174I,
133 10
115 12 S115G,
173 11
132 14 c.393-5C>A,
112 13 Y112C,
114 11
130 10
184 13 H184R,
116 10
180 11 G180V,
134 12 N134S,
170 13 F170I,
120 9
122 7
171 13