SCN5A Variant W156X Detail

We estimate the penetrance of LQTS for SCN5A W156X around 2% and the Brugada syndrome penetrance around 30%. SCN5A W156X was found in a total of 3 carriers in 8 papers and/or in gnomAD: 2 had Brugada syndrome, 0 had LQTS. W156X is not present in gnomAD. W156X has been functionally characterized in 8 papers. This residue is located in a Non_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 W156X around 2% (0/13) and the Brugada syndrome penetrance around 30% (3/13).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA None 6 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
27784737 2016 1 0 1 0
12574143 2003 2 0 0 1 DCM, conduction
19251209 2009 1 0 1 0
16764707 2006 1 0 1 0
21273195 2011 1 0 1 0
22885917 2012 2 0 2 0
20129283 2010 1 0 1 0
30059973 2018 1 1 0 0
LITERATURE, COHORT, AND GNOMAD: - 3 1 0 2 -
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)
22885917 2012
20129283 2010
27784737 2016 hiPSC 0
16764707 2006
12574143 2003 Xeno 0
21273195 2011
19251209 2009
30059973 2018