SCN5A Variant T1304M Detail

We estimate the penetrance of LQTS for SCN5A T1304M around 22% and the Brugada syndrome penetrance around 4%. SCN5A T1304M was found in a total of 67 carriers in 18 papers and/or in gnomAD: 2 had Brugada syndrome, 15 had LQTS. T1304M is present in 46 alleles in gnomAD. T1304M has been functionally characterized in 22 papers. This residue is located in a Mild_Hotspot region for Brugada syndrome and a Mild_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 T1304M around 22% (15/77) and the Brugada syndrome penetrance around 4% (3/77).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-5.3 1 0.36 0.924 7 12
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
24613995 2014 1 0 0 1 irritable bowel syndrome
17210841 2007 1 0 0 1 SIDS
10508990 1999 6 5 0 0
10961955 2000 1 1 0 0
10973849 2000 1 1 0 0
22360817 2012 3 3 0 0
23631430 2013 1 1 0 0
24144883 2014 1 0 0 1 AF
24631775 2014 1 0 0 1 SIDS
25210526 2014 2 0 2 0
26669661 2016 4 2 0 0
26746457 2016 1 0 0 0
27566755 2016 9 9 0 0
22685113 2012 1 0 0 1 AF
19716085 2009 3 3 0 0
29325976 2018 1 0 1 0
29764897 2018 1 0 0 0
30059973 2018 2 2 0 0
LITERATURE, COHORT, AND GNOMAD: - 67 50 15 2 -
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)
27566755 2016
22685113 2012 HEK
29325976 2018
24613995 2014 HEK 68 -0.3 0.6 81
10508990 1999
10961955 2000
10973849 2000
22360817 2012
23631430 2013
24144883 2014
24631775 2014
25210526 2014
26669661 2016
18451998 2008 tsA201 100
17210841 2007 tsA206 100 6.7 11.2 718
29017927 2017
28412158 2017
17646591 2007
26746457 2016
19716085 2009
29764897 2018
30059973 2018

T1304M has 61 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 11 S1218I, S1218T,
1281 9 V1281F, c.3840+1G>A,
1304 0 T1304M,
1243 11 D1243N,
1274 12
1216 14 L1216V,
1285 12
1299 12 c.3894delC,
1220 12 G1220E,
1673 6
1675 9
1283 15 L1283M,
1309 11 R1309C, R1309H,
1226 11
1747 15 V1747M,
1669 10
1671 10
1221 12 A1221V,
1242 13
1668 15 M1668T,
1676 10 M1676I, M1676T,
1219 10 S1219N,
1672 10 S1672Y,
1279 13 V1279I,
1239 12 L1239P,
1310 12
1306 7 R1306H, R1306S,
1305 4
1680 15 A1680T, A1680P,
1246 13
1282 11 S1282A,
1302 6 p.L1302Vfs18,
1247 14 T1247I,
1307 6
1678 10 N1678S,
1223 11 c.3667delG,
1697 15
1275 13 D1275N,
1222 8 L1222R, p.L1222LfsX7,
1300 10
1674 7 F1674V,
1215 12 I1215V,
1301 5
1284 13
1700 15
1280 14
1751 13
1311 13 L1311P,
1677 8
1308 7 L1308F,
1250 13
1224 14
1670 8
1240 13 E1240Q,
1225 10 G1225K, E1225K,
1278 9 I1278N,
1679 13
1277 12
1667 13 V1667I,
1303 6 R1303W, R1303Q,
1666 13