SCN5A Variant L1338V Detail

We estimate the penetrance of LQTS for SCN5A L1338V around 36% and the Brugada syndrome penetrance around 8%. SCN5A L1338V was found in a total of 2 carriers in 1 papers and/or in gnomAD: 0 had Brugada syndrome, 1 had LQTS. L1338V is present in 1 alleles in gnomAD. L1338V has been functionally characterized in 1 papers. This residue is located in a Non_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 (0 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 L1338V around 36% (2/12) and the Brugada syndrome penetrance around 8% (0/12).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-2.86 0.975 2.15 0.922 8 37
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
19716085 2009 1 1 0 0
LITERATURE, COHORT, AND GNOMAD: - 2 1 1 0 -
VARIANT FEATURES ALONE: - 15 14 1 0 - -
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)
19716085 2009

L1338V has 53 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
1417 15
1765 14
1340 7 V1340I,
1457 12
1757 8
1339 6 L1339F, p.L1339del,
1756 12 I1756V,
1461 9 T1461S,
1333 9
1344 11 F1344L, F1344S,
1754 12
825 12
1458 14 S1458Y,
1410 15
1762 11 p.I1762del, I1762M,
1464 10 c.4389_4396delCCTCTTTA, L1464P,
1466 14 c.4396_4397insG,
1753 11 T1753A,
822 13 W822C, W822X,
1346 12 L1346I, L1346P,
1329 14 G1329S,
1341 5
1334 6 I1334V,
1468 12 V1468A, V1468F,
1462 11
1759 15 S1759C,
1412 15 L1412F,
1327 15
1758 12 I1758V, p.I1758del,
1330 11 A1330P, A1330T, A1330D,
1460 13 F1460L,
1338 0 L1338V,
1409 11 Y1409X, Y1409C,
1343 9
1345 9 W1345C,
1337 4
1342 7
1416 14 A1416G, c.4245+1G>C, c.4245+1G>A, A1416E, c.4245+2T>A,
1332 10 P1332L, P1332Q,
1465 8 p.F1465_L1480dup,
1760 13
1467 14
1750 15 L1750F,
1331 10 I1331V,
1761 9 c.5280delG, L1761H, L1761F,
1347 15
1469 13 I1469V,
1336 7
824 11
1335 6 M1335R,
828 13 L828V,
1463 13 N1463Y,
1413 12