SCN5A Variant T1247I Detail

We estimate the penetrance of LQTS for SCN5A T1247I around 1% and the Brugada syndrome penetrance around 15%. SCN5A T1247I was found in a total of 9 carriers in 2 papers and/or in gnomAD: 1 had Brugada syndrome, 0 had LQTS. T1247I is present in 8 alleles in gnomAD. T1247I 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 T1247I around 1% (0/19) and the Brugada syndrome penetrance around 15% (2/19).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-5.63 0.938 -1.97 0.884 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
28341781 2017 1 0 1 0
27554632 2017 19 0 0 19 CM
LITERATURE, COHORT, AND GNOMAD: - 9 8 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)
28341781 2017
27554632 2017

T1247I has 54 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 7 M1245I,
1218 12 S1218I, S1218T,
1281 9 c.3840+1G>A, V1281F,
1304 14 T1304M,
1217 14
1243 6 D1243N,
1274 15
1285 8
1258 14
1299 14 c.3894delC,
1252 10
1283 7 L1283M,
1241 10
1309 12 R1309H, R1309C,
1288 12 A1288G,
1242 8
1219 15 S1219N,
1251 7 V1251M,
1279 7 V1279I,
1239 13 L1239P,
1306 8 R1306S, R1306H,
1244 6 K1244E,
1286 7
1305 13
1282 5 S1282A,
1246 6
1302 12 p.L1302Vfs18,
1247 0 T1247I,
1257 15
1307 15
1289 11
1256 14
1275 12 D1275N,
1255 12 L1255M,
1222 14 p.L1222LfsX7, L1222R,
1254 10
1215 13 I1215V,
1301 15
1214 12 M1214T,
1253 10 E1253G,
1284 10
1211 13
1280 10
1250 5
1240 11 E1240Q,
1248 4
1287 11
1276 13
1290 15
1278 9 I1278N,
1238 15
1249 6 V1249D,
1277 13
1303 10 R1303Q, R1303W,