SCN5A Variant c.3940_3941delCT Detail

We estimate the penetrance of LQTS for SCN5A c.3940_3941delCT around 3% and the Brugada syndrome penetrance around 52%. SCN5A c.3940_3941delCT was found in a total of 1 carriers in 2 papers and/or in gnomAD: 1 had Brugada syndrome, 0 had LQTS. c.3940_3941delCT is not present in gnomAD. c.3940_3941delCT 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 c.3940_3941delCT around 3% (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 (%)
NA NA NA None 69 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
19026623 2009 1 0 1 0
24687331 2014 1 1 0 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)
19026623 2009
24687331 2014

c.3940_3941delCT has 50 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 13 V1328M,
1659 8
1271 11 W1271C,
1315 5
1274 14
1216 11 L1216V,
1314 0 c.3940_3941delCT,
1320 5 M1320I,
1213 15
1666 7
1656 12
1309 12 R1309H, R1309C,
1669 12
1668 14 M1668T,
1219 14 S1219N,
1660 10 I1660V, I1660S,
1313 5
1310 7
1316 8 R1316Q, R1316L,
1766 14 M1766L, M1766V, M1766T,
1319 9 G1319V,
1665 10
1663 7
1657 14
1662 6
1324 8
1317 6 F1317C,
1327 12
1307 12
1318 10
1321 9 R1321K,
1323 9 V1323G,
1215 12 I1215V,
1212 10 p.I1212del,
1322 11 c.3963+4A>G, c.3963+2T>C,
1211 14
1312 7
1326 13 A1326S,
1763 13 V1763M, V1763L,
1311 6 L1311P,
1308 11 L1308F,
1670 12
1661 10 G1661E, G1661R,
1209 13 T1209R,
1655 13
1325 12 N1325S,
1208 14 E1208K, E1208X,
1667 11 V1667I,
1664 11
1658 13