SCN5A Variant c.3840+1G>A Detail

We estimate the penetrance of LQTS for SCN5A c.3840+1G>A around 3% and the Brugada syndrome penetrance around 74%. SCN5A c.3840+1G>A was found in a total of 9 carriers in 17 papers and/or in gnomAD: 9 had Brugada syndrome, 0 had LQTS. c.3840+1G>A is not present in gnomAD. c.3840+1G>A has been functionally characterized in 17 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 c.3840+1G>A around 3% (0/19) and the Brugada syndrome penetrance around 74% (14/19).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA None 76 7
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
19251209 2009 1 0 1 0
17227473 2007 1 0 1 0
17404158 2007 2 0 2 0
18375968 2008 1 0 0 1 ARVC
20625312 2010 1 0 1 0
21273195 2011 4 0 4 0
22885917 2012 2 0 2 0
26173111 2015 1 0 1 0
26729854 2016 1 0 1 0
26921764 2016 2 0 2 0
28341781 2017 1 0 1 0
28781330 2017 1 0 1 0
20129283 2010 1 0 1 0
20129283 2010 2 0 2 0
29325976 2018 1 0 1 0
30059973 2018 5 5 0 0
30371189 2018 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 9 0 0 9 -
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)
22885917 2012
26173111 2015
26729854 2016
26921764 2016
28341781 2017
28781330 2017
20129283 2010
20129283 2010
29325976 2018
30059973 2018
30371189 2018
19251209 2009
17227473 2007
17404158 2007
18375968 2008
20625312 2010
21273195 2011

c.3840+1G>A 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
1218 15 S1218I, S1218T,
1281 0 c.3840+1G>A, V1281F,
1304 9 T1304M,
1243 10 D1243N,
1274 11
1285 7
1299 10 c.3894delC,
1272 15
1298 14 P1298L,
1283 6 L1283M,
1309 12 R1309H, R1309C,
1288 11 A1288G,
1242 14
1251 12 V1251M,
1279 6 V1279I,
1306 8 R1306S, R1306H,
1244 14 K1244E,
1286 10
1305 7
1273 12 W1273C, c.3816delG,
1282 4 S1282A,
1246 13
1302 5 p.L1302Vfs18,
1247 9 T1247I,
1307 12
1289 13
1275 10 D1275N,
1222 14 p.L1222LfsX7, L1222R,
1300 11
1674 14 F1674V,
1254 12
1215 15 I1215V,
1301 9
1253 14 E1253G,
1284 5
1280 5
1308 12 L1308F,
1250 10
1240 14 E1240Q,
1248 13
1287 10
1276 9
1278 6 I1278N,
1249 13 V1249D,
1277 7
1303 8 R1303Q, R1303W,