SCN5A Variant L1311P Detail

We estimate the penetrance of LQTS for SCN5A L1311P around 1% and the Brugada syndrome penetrance around 52%. SCN5A L1311P was found in a total of 1 carriers in 2 papers and/or in gnomAD: 1 had Brugada syndrome, 0 had LQTS. L1311P is not present in gnomAD. L1311P has been functionally characterized in 2 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 (4 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 L1311P around 1% (0/11) and the Brugada syndrome penetrance around 52% (5/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-6.19 1 -5.43 0.96 68 1
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
26941339 2016 1 0 1 0
20129283 2010 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 1 0 0 1 -
VARIANT FEATURES ALONE: - 15 11 0 4 - -
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
26941339 2016

L1311P has 58 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
1328 12 V1328M,
1659 13
1271 7 W1271C,
1218 14 S1218I, S1218T,
1304 13 T1304M,
1315 7
1274 9
1216 11 L1216V,
1314 6 c.3940_3941delCT,
1320 10 M1320I,
1673 14
1666 7
1272 12
1270 11 A1270S,
1309 8 R1309C, R1309H,
1669 10
1671 12
1668 13 M1668T,
1219 12 S1219N,
1672 15 S1672Y,
1313 7
1660 13 I1660V, I1660S,
1310 4
1316 11 R1316L, R1316Q,
1306 13 R1306H, R1306S,
1319 14 G1319V,
1665 12
1305 11
1273 14 c.3816delG, W1273C,
1663 9
1662 11
1324 9
1317 12 F1317C,
1327 11
1307 8
1758 13 p.I1758del, I1758V,
1275 11 D1275N,
1321 13 R1321K,
1674 14 F1674V,
1323 12 V1323G,
1215 10 I1215V,
1212 11 p.I1212del,
1322 15 c.3963+4A>G, c.3963+2T>C,
1211 14
1312 7
1326 14 A1326S,
1763 14 V1763L, V1763M,
1311 0 L1311P,
1308 6 L1308F,
1670 8
1661 13 G1661R, G1661E,
1331 15 I1331V,
1269 13 N1269S,
1325 13 N1325S,
1278 12 I1278N,
1277 14
1667 9 V1667I,
1664 12