SCN5A Variant c.4396_4397insG Detail

We estimate the penetrance of LQTS for SCN5A c.4396_4397insG around 5% and the Brugada syndrome penetrance around 54%. SCN5A c.4396_4397insG was found in a total of 2 carriers in 1 papers and/or in gnomAD: 2 had Brugada syndrome, 0 had LQTS. c.4396_4397insG is not present in gnomAD. c.4396_4397insG 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 (4 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.4396_4397insG around 5% (0/12) and the Brugada syndrome penetrance around 54% (6/12).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA None 65 6
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
17420262 2007 2 0 2 0
LITERATURE, COHORT, AND GNOMAD: - 2 0 0 2 -
VARIANT FEATURES ALONE: - 15 11 0 4 - -
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)
17420262 2007

c.4396_4397insG has 75 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 8 L939F,
937 12
1417 15
1773 11
1765 5
943 13 S943N,
1457 13
1757 13
1472 10 p.N1472del, N1472S,
1771 11 I1771T,
1756 15 I1756V,
1461 11 T1461S,
1764 9 c.5290delG, V1764F,
409 10 L409V, L409P,
1333 12
934 11
1458 12 S1458Y,
933 13
1471 9
935 7 L935P,
412 14 V412D,
1762 9 I1762M, p.I1762del,
1470 6
1464 7 L1464P, c.4389_4396delCCTCTTTA,
927 15 N927S, N927K,
1466 0 c.4396_4397insG,
1776 15
944 14
1767 11 Y1767C,
1660 14 I1660S, I1660V,
1329 14 G1329S,
1769 7
402 13 F402L,
1766 9 M1766L, M1766V, M1766T,
1768 6 I1768V,
940 13 S940N,
1473 10 F1473S, F1473C,
1334 11 I1334V,
1341 14
1468 6 V1468F, V1468A,
405 13
1462 9
938 9
1474 13
1759 13 S1759C,
1327 13
942 11
1758 14 p.I1758del, I1758V,
1459 13 c.4376_4379delTCTT,
1330 11 A1330P, A1330T, A1330D,
1772 9 L1772V,
1460 11 F1460L,
1323 15 V1323G,
1338 14 L1338V,
410 12 A410V,
1770 11 I1770V,
413 12 A413T, A413E,
408 14
941 13 S941N, S941F,
407 15
1337 11
1326 13 A1326S,
936 10
1763 11 V1763L, V1763M,
1465 6 p.F1465_L1480dup,
1760 10
1467 4
1331 14 I1331V,
1761 9 c.5280delG, L1761F, L1761H,
1469 5 I1469V,
406 10 N406K, N406S,
1336 15
932 10
931 13
1463 6 N1463Y,