SCN5A Variant V1328M Detail

We estimate the penetrance of LQTS for SCN5A V1328M around 24% and the Brugada syndrome penetrance around 37%. SCN5A V1328M was found in a total of 1 carriers in 3 papers and/or in gnomAD: 1 had Brugada syndrome, 0 had LQTS. V1328M is not present in gnomAD. V1328M has been functionally characterized in 3 papers. This residue is located in a 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 (3 diagnosed with Brugada syndrome) and 5 individuals for LQTS (1 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A V1328M around 24% (1/11) and the Brugada syndrome penetrance around 37% (4/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-1.96 0.988 3.37 0.775 50 35
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
27560382 2016 1 0 1 0 drug induced BrS
28341781 2017 1 0 1 0
29574140 2018 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 1 0 0 1 -
VARIANT FEATURES ALONE: - 15 11 1 3 - -
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)
28341781 2017
27560382 2016 HEK 97 2.4 7.1 50
29574140 2018

V1328M 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
1328 0 V1328M,
1271 10 W1271C,
1757 14
1472 10 N1472S, p.N1472del,
1315 11
1274 15
1314 13 c.3940_3941delCT,
1320 11 M1320I,
1333 10
1270 11 A1270S,
1471 15
1762 11 I1762M, p.I1762del,
1660 14 I1660V, I1660S,
1329 4 G1329S,
1766 11 M1766V, M1766L, M1766T,
1319 14 G1319V,
1479 13
1473 11 F1473C, F1473S,
1334 10 I1334V,
1468 13 V1468A, V1468F,
1663 12
1324 6
1327 4
1758 12 I1758V, p.I1758del,
1330 6 A1330D, A1330T, A1330P,
1321 12 R1321K,
1323 9 V1323G,
1322 10 c.3963+2T>C, c.3963+4A>G,
1312 12
1326 6 A1326S,
1763 12 V1763L, V1763M,
1311 12 L1311P,
1332 8 P1332L, P1332Q,
1465 15 p.F1465_L1480dup,
1476 10 Q1476R, Q1476X,
1331 6 I1331V,
1475 13 p.Q1475NfsX6, Q1475L,
1469 11 I1469V,
1336 14
1269 13 N1269S,
1325 6 N1325S,
1335 11 M1335R,
1667 15 V1667I,