SCN5A Variant L1283M Detail

We estimate the penetrance of LQTS for SCN5A L1283M around 55% and the Brugada syndrome penetrance around 14%. SCN5A L1283M was found in a total of 1 carriers in 1 papers and/or in gnomAD: 0 had Brugada syndrome, 1 had LQTS. L1283M is not present in gnomAD. L1283M has been functionally characterized in 1 papers. This residue is located in a Mild_Hotspot region for Brugada syndrome and a 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 (2 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A L1283M around 55% (3/11) and the Brugada syndrome penetrance around 14% (1/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-1.46 0.99 0.87 0.683 18 62
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
19716085 2009 1 1 0 0
LITERATURE, COHORT, AND GNOMAD: - 1 0 1 0 -
VARIANT FEATURES ALONE: - 15 12 2 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)
19716085 2009

L1283M has 43 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 14 M1245I,
1281 6 c.3840+1G>A, V1281F,
1304 15 T1304M,
1243 10 D1243N,
1274 14
1285 6
1258 13
1299 12 c.3894delC,
1252 13
1283 0 L1283M,
1309 15 R1309H, R1309C,
1288 9 A1288G,
1242 14
1251 8 V1251M,
1279 6 V1279I,
1306 11 R1306S, R1306H,
1244 11 K1244E,
1286 5
1305 13
1273 14 W1273C, c.3816delG,
1282 4 S1282A,
1246 13
1302 11 p.L1302Vfs18,
1247 7 T1247I,
1289 10
1275 12 D1275N,
1255 13 L1255M,
1254 11
1301 15
1253 13 E1253G,
1284 5
1291 14
1280 5
1250 9
1240 14 E1240Q,
1248 9
1287 7
1276 10
1290 12
1278 9 I1278N,
1249 12 V1249D,
1277 11
1303 12 R1303Q, R1303W,