SCN5A Variant c.4389_4396delCCTCTTTA Detail

We estimate the penetrance of LQTS for SCN5A c.4389_4396delCCTCTTTA around 5% and the Brugada syndrome penetrance around 42%. SCN5A c.4389_4396delCCTCTTTA was found in a total of 1 carriers in 2 papers and/or in gnomAD: 1 had Brugada syndrome, 0 had LQTS. c.4389_4396delCCTCTTTA is not present in gnomAD. c.4389_4396delCCTCTTTA has been functionally characterized in 2 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.4389_4396delCCTCTTTA around 5% (0/11) and the Brugada syndrome penetrance around 42% (4/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA None 50 4
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
28341781 2017 1 0 1 0
20129283 2010 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 1 0 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)
20129283 2010
28341781 2017

c.4389_4396delCCTCTTTA has 71 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
939 9 L939F,
937 11
1417 15
1765 11
839 13 L839P,
943 12 S943N,
1340 9 V1340I,
1457 9
1453 14
1455 13
1757 13
1472 12 p.N1472del, N1472S,
1339 12 L1339F, p.L1339del,
1461 5 T1461S,
1764 14 c.5290delG, V1764F,
409 14 L409V, L409P,
1333 10
1344 11 F1344L, F1344S,
825 13
934 9
1458 10 S1458Y,
933 14
1471 11
935 9 L935P,
1762 12 I1762M, p.I1762del,
1470 10
1464 0 L1464P, c.4389_4396delCCTCTTTA,
1466 7 c.4396_4397insG,
944 12
1769 14
1766 14 M1766L, M1766V, M1766T,
1768 13 I1768V,
940 12 S940N,
1334 10 I1334V,
1341 8
1468 7 V1468F, V1468A,
831 11
1462 7
938 6
942 7
1456 11
1459 11 c.4376_4379delTCTT,
1330 13 A1330P, A1330T, A1330D,
827 13
1460 6 F1460L,
1454 14
1338 10 L1338V,
1343 14
1345 12 W1345C,
941 10 S941N, S941F,
1337 7
1342 14
936 11
1416 13 c.4245+1G>C, c.4245+2T>A, A1416G, c.4245+1G>A, A1416E,
1332 14 P1332Q, P1332L,
1465 5 p.F1465_L1480dup,
1760 13
1467 6
1331 14 I1331V,
1761 10 c.5280delG, L1761F, L1761H,
1469 9 I1469V,
1336 11
824 13
829 13
932 13
1335 13 M1335R,
832 11
835 13 S835A, S835L,
828 9 L828V,
931 13
1463 5 N1463Y,