SCN5A Variant D1523N Detail

We estimate the penetrance of LQTS for SCN5A D1523N around 4% and the Brugada syndrome penetrance around 6%. SCN5A D1523N was found in a total of 10 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. D1523N is present in 10 alleles in gnomAD. D1523N has been functionally characterized in 0 papers. This residue is located in a Mild_Hotspot region for Brugada syndrome and a Mild_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 D1523N around 4% (0/20) and the Brugada syndrome penetrance around 6% (1/20).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-4.35 0.983 0.87 0.833 11 10
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
LITERATURE, COHORT, AND GNOMAD: - 10 10 0 0 -
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.

D1523N has 36 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
1523 0 D1523N,
1521 7 I1521K, I1521T,
1803 15
1527 7 K1527R,
1576 14
1517 11
1525 7 V1525A, V1525M,
1519 5
1515 13 c.4542+15G>A, N1515S,
1800 14
1529 11
1574 15 c.4719C>T, E1574K,
1512 7 R1512Q, R1512L, R1512W,
1530 10
1524 5 I1524T,
1514 13 L1514M,
1518 10
1509 14 P1509T,
1578 12 c.4732_4733dupAA,
1528 11
1531 12
1573 15
1799 15
1526 5 T1526P,
1516 14 L1516sp,
1583 14 R1583H, R1583C,
1580 11
1511 12
1513 10
1581 9 A1581S,
1582 12 L1582P,
1579 14 L1579fsX53,
1522 5
1520 6
1577 10
1510 11