SCN5A Variant c.4189delT Detail

We estimate the penetrance of LQTS for SCN5A c.4189delT around 2% and the Brugada syndrome penetrance around 34%. SCN5A c.4189delT was found in a total of 4 carriers in 1 papers and/or in gnomAD: 1 had Brugada syndrome, 0 had LQTS. c.4189delT is not present in gnomAD. c.4189delT has been functionally characterized in 1 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 (3 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.4189delT around 2% (0/14) and the Brugada syndrome penetrance around 34% (4/14).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA None 54 0
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
15135718 2004 4 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 4 3 0 1 -
VARIANT FEATURES ALONE: - 15 12 0 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)
15135718 2004

c.4189delT 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
1403 8
1357 11 A1357V,
1724 10
1394 12 Y1394X,
1430 13 D1430N,
1426 15
1406 14 G1406E, G1406R,
1361 6
1726 12
739 9
1395 8
1397 0 c.4190delA, c.4189delT,
1380 14 p.N1380del, N1380K,
1723 8 T1723N,
1725 11 P1725L,
1398 5 V1398M,
1411 13
1353 15 V1353M,
1407 11
1410 15
1358 9 G1358W, G1358R,
1396 6
1362 9 R1362S, c.4083delG,
1433 13 G1433V, G1433W, G1433R,
1438 12 P1438L,
1388 15
1404 11
1423 14 D1423H,
1378 14 V1378M,
1437 13
1721 14
1431 12 S1431C,
1359 10 K1359N, K1359M,
1356 13 c.4066_4068delTT,
1434 13 c.4299+2T>A, c.4299G>A, c.4299delG, c.4299_4300insG, c.4299+28C>T, c.4300-2A>T, Y1434X, c.4299+1G>T, c.4300-1G>A, c.4299+1delG,
1727 14
1366 14 Q1366H, Q1366R,
1408 13 G1408R,
1435 14
1360 7 F1360C,
1393 15 L1393X,
1401 7
1399 7
1427 11 A1427E, A1427S,
1424 13 I1424V,
1365 15 N1365S,
738 12
1389 14
740 12 p.N740del,
1364 10 I1364V,
1400 9 V1400I,
1718 13 S1718R,
1722 13 N1722D,
1428 13 A1428S, A1428V,
1363 11 C1363Y,
1436 15
1402 11