SCN5A Variant V1405L Detail

We estimate the penetrance of LQTS for SCN5A V1405L around 2% and the Brugada syndrome penetrance around 66%. SCN5A V1405L was found in a total of 2 carriers in 4 papers and/or in gnomAD: 2 had Brugada syndrome, 0 had LQTS. V1405L is not present in gnomAD. V1405L 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 (5 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 V1405L around 2% (0/12) and the Brugada syndrome penetrance around 66% (7/12).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-2.92 1 1.16 0.937 94 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
12106943 2002 1 0 1 0
19843921 2009 1 0 1 0
21273195 2011 2 0 2 0
20129283 2010 2 0 2 0
LITERATURE, COHORT, AND GNOMAD: - 2 0 0 2 -
VARIANT FEATURES ALONE: - 15 10 0 5 - -
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)
32533946 2020 HEK 14 -2.6 -1.6
12106943 2002
19843921 2009
21273195 2011
20129283 2010

V1405L has 55 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
1355 13
1403 9
1357 10 A1357V,
733 13 F733L,
741 14 p.M741_T742delinsI ,
745 15
1352 9
1406 4 G1406E, G1406R,
1453 14
1351 11 M1351V, M1351R,
739 12
1449 14 Y1449C, Y1449S,
812 13 L812Q,
1350 7 I1350T, I1350L,
1344 14 F1344S, F1344L,
731 11 T731I,
1411 10
1353 7 V1353M,
1407 6
737 9
1410 9
1358 13 G1358W, G1358R,
1348 11 F1348L,
1404 4
1349 6
749 14
1346 7 L1346I, L1346P,
1359 15 K1359N, K1359M,
1341 15
1356 12 c.4066_4068delTT,
1412 10 L1412F,
1408 6 G1408R,
735 6 A735T, A735V, A735E,
732 11
1360 14 F1360C,
734 10 c.2201dupT, M734V,
1401 10
1354 11
738 9
1405 0 V1405M, V1405L,
740 14 p.N740del,
1409 7 Y1409C, Y1409X,
815 14
1400 13 V1400I,
1343 12
1345 11 W1345C,
1342 10
736 8 L736P,
730 15 N730K,
1749 14 I1749N,
1347 11
1415 15
1414 14 Q1414H,
1402 8
1413 12