SCN5A Variant V1249D Detail

We estimate the penetrance of LQTS for SCN5A V1249D around 0% and the Brugada syndrome penetrance around 57%. SCN5A V1249D was found in a total of 1 carriers in 1 papers and/or in gnomAD: 1 had Brugada syndrome, 0 had LQTS. V1249D is not present in gnomAD. V1249D has been functionally characterized in 1 papers. This residue is located in a 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 (5 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 V1249D around 0% (0/11) and the Brugada syndrome penetrance around 57% (6/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-6.08 0.945 -5.71 0.945 74 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
20129283 2010 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 1 0 0 1 -
VARIANT FEATURES ALONE: - 15 10 0 5 - -
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)
20129283 2010

V1249D has 46 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 11 S1218I, S1218T,
1281 13 c.3840+1G>A, V1281F,
1217 12
1243 10 D1243N,
1216 14 L1216V,
1285 14
1258 13
1213 12
1210 10 F1210S,
1252 5
1283 12 L1283M,
1241 11
1309 11 R1309H, R1309C,
1242 10
1219 14 S1219N,
1251 6 V1251M,
1279 10 V1279I,
1207 12
1306 10 R1306S, R1306H,
1244 10 K1244E,
1286 13
1282 10 S1282A,
1246 5
1247 6 T1247I,
1257 11
1256 10
1275 11 D1275N,
1255 10 L1255M,
1254 9
1215 10 I1215V,
1206 14
1214 7 M1214T,
1212 13 p.I1212del,
1253 6 E1253G,
1211 8
1280 14
1250 4
1209 14 T1209R,
1240 15 E1240Q,
1248 6
1276 14
1278 11 I1278N,
1249 0 V1249D,
1208 14 E1208X, E1208K,
1303 14 R1303Q, R1303W,