SCN5A Variant N1443S Detail

We estimate the penetrance of LQTS for SCN5A N1443S around 2% and the Brugada syndrome penetrance around 9%. SCN5A N1443S was found in a total of 15 carriers in 1 papers and/or in gnomAD: 1 had Brugada syndrome, 0 had LQTS. N1443S is present in 10 alleles in gnomAD. N1443S has been functionally characterized in 1 papers. This residue is located in a Mild_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 (1 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 N1443S around 2% (0/25) and the Brugada syndrome penetrance around 9% (2/25).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-3.34 0.967 1.8 0.743 15 1
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
22984773 2013 5 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 15 14 0 1 -
VARIANT FEATURES ALONE: - 15 14 0 1 - -
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)
22984773 2013

N1443S has 44 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 10
1357 14 A1357V,
1430 8 D1430N,
1352 14
1426 11
1445 5 Y1445H,
1361 14
1447 10
1444 6 L1444I,
1440 11 W1440X,
1449 12 Y1449S, Y1449C,
1429 6
1442 6 Y1442C, Y1442N,
806 15 V806M,
1450 13
886 13 H886P, H886Q,
1358 14 G1358W, G1358R,
1362 15 R1362S, c.4083delG,
1433 9 G1433V, G1433W, G1433R,
1438 10 P1438L,
1387 15 L1387F,
1437 13
1431 7 S1431C,
805 14 S805L,
1359 10 K1359N, K1359M,
1434 12 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,
1356 11 c.4066_4068delTT,
889 14
1360 13 F1360C,
1425 12
1427 11 A1427E, A1427S,
1446 6
1424 15 I1424V,
1432 7 R1432G, R1432S,
1448 12 I1448T, I1448L,
1439 9 Q1439H, Q1439R,
885 11
1443 0 N1443S,
1441 9 E1441Q,
879 15 W879R,
883 14
1428 8 A1428S, A1428V,
804 15
1436 12