SCN5A Variant c.3963+2T>C Detail

We estimate the penetrance of LQTS for SCN5A c.3963+2T>C around 4% and the Brugada syndrome penetrance around 50%. SCN5A c.3963+2T>C was found in a total of 3 carriers in 5 papers and/or in gnomAD: 2 had Brugada syndrome, 0 had LQTS. c.3963+2T>C is not present in gnomAD. c.3963+2T>C has been functionally characterized in 5 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.3963+2T>C around 4% (0/13) and the Brugada syndrome penetrance around 50% (6/13).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA None 66 5
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
10471492 1999 15 0 0 15 PCCD
16643399 2006 1 0 1 0
20031634 2009 9 0 2 6 PCCD
22717692 2012 20 0 0 20 Conduction defects
20129283 2010 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 3 1 0 2 -
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)
10471492 1999
16643399 2006
20031634 2009
22717692 2012
20129283 2010

c.3963+2T>C has 57 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 10 V1328M,
1659 9
1480 7 c.4438-1C>T, c.4437+5G>A,
1773 12
1653 12
1472 11 N1472S, p.N1472del,
1315 9
1771 14 I1771T,
1652 14 M1652T, M1652R,
1314 11 c.3940_3941delCT,
1320 6 M1320I,
1656 8
1477 7 K1477N,
1471 14
1762 14 I1762M, p.I1762del,
1470 13
1478 12 K1478E,
1767 13 Y1767C,
1313 14
1660 10 I1660V, I1660S,
1654 14
1329 11 G1329S,
1769 11
1316 13 R1316Q, R1316L,
1766 10 M1766L, M1766V, M1766T,
1319 5 G1319V,
1768 15 I1768V,
1774 12 N1774D, c.5321_5324dupACTT,
1479 9
1473 7 F1473S, F1473C,
1663 12
1657 11
1474 11
1662 13
1324 6
1481 11 G1481V, G1481R, G1481E,
1317 10 F1317C,
1327 9
1318 8
1330 12 A1330T, A1330D, A1330P,
1321 7 R1321K,
1323 4 V1323G,
1770 9 I1770V,
1482 13
1322 0 c.3963+2T>C, c.3963+4A>G,
1312 13
1326 7 A1326S,
1763 13 V1763L, V1763M,
1311 15 L1311P,
1476 5 Q1476X, Q1476R,
1661 13 G1661E, G1661R,
1331 15 I1331V,
1655 11
1475 11 p.Q1475NfsX6, Q1475L,
1469 12 I1469V,
1325 6 N1325S,
1658 13