SCN5A Variant D1275N Detail

We estimate the penetrance of LQTS for SCN5A D1275N around 1% and the Brugada syndrome penetrance around 13%. SCN5A D1275N was found in a total of 28 carriers in 17 papers and/or in gnomAD: 3 had Brugada syndrome, 0 had LQTS. D1275N is present in 2 alleles in gnomAD. D1275N has been functionally characterized in 24 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 D1275N around 1% (0/38) and the Brugada syndrome penetrance around 13% (4/38).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-4.87 1 -2.2 0.935 21 5
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
28637969 2017 1 0 0 1 AV conduction block
12522116 2003 8 0 0 3 Atrial standstill
15466643 2004 8 0 0 8 Dilated Cardiomyopathy
15671429 2005 22 0 0 7 DCM
16684018 2006 1 0 0 1 conduction defect, atrial arrythmia
24762805 2014 4 0 0 2 SSS
26111534 2015 1 0 0 1 SND, AF
26798387 2016 2 0 0 2 SSS
27707468 2016 1 0 1 0
19251209 2009 1 0 1 0
26746457 2016 1 0 0 0
28294644 2017 13 0 0 13 BBBlock, AF
20129283 2010 1 0 1 0
20129283 2010 1 0 1 0
29325976 2018 1 0 1 0
29579189 2018 1 0 0 1 Afib
30059973 2018 4 4 0 0
LITERATURE, COHORT, AND GNOMAD: - 28 25 0 3 -
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)
24573164 2014 HEK 88 -0.84
12522116 2003 Xeno 89 3.3 -0.7
15466643 2004
15671429 2005
20384651 2010 68 3 1
15671436 2005
24762805 2014
16684018 2006
26111534 2015
26798387 2016
20539757 2010
19251209 2009
21824921 2011
23791817 2013
27707468 2016
28294644 2017
15998690 2005
26746457 2016
20129283 2010
20129283 2010
29325976 2018
29579189 2018
30059973 2018
28637969 2017 HEK 77 10.1 2

D1275N has 59 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
1267 10
1271 8 W1271C,
1218 14 S1218I, S1218T,
1281 10 V1281F, c.3840+1G>A,
1304 13 T1304M,
1315 14
1274 4
1216 14 L1216V,
1258 10
1272 6
1270 9 A1270S,
1252 12
1283 12 L1283M,
1309 5 R1309H, R1309C,
1265 15
1219 15 S1219N,
1251 11 V1251M,
1313 12
1279 7 V1279I,
1310 10
1316 14 R1316Q, R1316L,
1207 14
1306 9 R1306H, R1306S,
1305 9
1273 8 W1273C, c.3816delG,
1246 13
1282 11 S1282A,
1302 14 p.L1302Vfs18,
1262 14 G1262S,
1247 12 T1247I,
1257 8
1268 13 T1268N, T1268S,
1307 11
1256 12
1275 0 D1275N,
1255 12 L1255M,
1254 7
1215 10 I1215V,
1260 15 A1260D,
1263 14
1214 13 M1214T,
1212 12 p.I1212del,
1253 8 E1253G,
1284 15
1211 10
1312 10
1280 9
1311 11 L1311P,
1308 9 L1308F,
1250 7
1269 9 N1269S,
1276 7
1278 5 I1278N,
1266 8
1261 12
1249 11 V1249D,
1208 13 E1208K, E1208X,
1277 7
1303 14 R1303Q, R1303W,