SCN5A Variant L1582P Detail

We estimate the penetrance of LQTS for SCN5A L1582P around 1% and the Brugada syndrome penetrance around 50%. SCN5A L1582P was found in a total of 1 carriers in 3 papers and/or in gnomAD: 1 had Brugada syndrome, 0 had LQTS. L1582P is not present in gnomAD. L1582P has been functionally characterized in 3 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 L1582P around 1% (0/11) and the Brugada syndrome penetrance around 50% (5/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-6.27 1 -5.4 0.984 63 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
19843921 2009 1 0 1 0
21273195 2011 1 0 1 0
20129283 2010 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 1 0 0 1 -
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)
20129283 2010
19843921 2009
21273195 2011

L1582P 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
1525 7 V1525A, V1525M,
1524 11 I1524T,
1512 10 R1512W, R1512L, R1512Q,
1586 6
1514 14 L1514M,
1518 10
1531 13
1587 8 F1587V,
1511 9
1522 7
1575 10 C1575S,
1510 6
1523 12 D1523N,
1521 9 I1521T, I1521K,
1527 14 K1527R,
1507 15 p.Q1507_P1509del,
1509 11 P1509T,
1526 10 T1526P,
1583 6 R1583H, R1583C,
1580 6
1585 5 Y1585C,
1576 11
1519 11
1596 12 F1596I, F1596C,
1589 9
1584 7
1530 12
1573 13
1799 15
1588 9 T1588I,
1581 4 A1581S,
1591 14 W1591X,
1513 9
1520 14
1593 12 I1593M,
1595 13
1508 12
1574 11 E1574K, c.4719C>T,
1592 9
1578 6 c.4732_4733dupAA,
1590 13
1582 0 L1582P,
1579 6 L1579fsX53,
1577 8