SCN5A Variant D1595N Detail

We estimate the penetrance of LQTS for SCN5A D1595N around 23% and the Brugada syndrome penetrance around 10%. SCN5A D1595N was found in a total of 0 carriers in 2 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. D1595N is not present in gnomAD. D1595N has been functionally characterized in 2 papers. This residue is located in a Non_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 (1 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A D1595N around 23% (1/10) and the Brugada syndrome penetrance around 10% (1/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-4.46 1 -2.65 0.95 2 32
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
11804990 2002 3 0 0 3 AV block
30059973 2018 1 1 0 0
LITERATURE, COHORT, AND GNOMAD: - 0 0 0 0 -
VARIANT FEATURES ALONE: - 15 13 1 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)
11804990 2002 HEK-tSA203 75 -1.3 4.2
30059973 2018

D1595N has 60 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
1569 13 A1569P,
1525 13 V1525A, V1525M,
1627 11
1586 8
1567 13 F1567L,
1624 13 V1624I,
1538 9
1531 12
1635 12
1568 11
1587 10 F1587V,
1634 15 L1634P,
1602 11
1534 10
1542 14
1601 11 L1601H,
1575 7 C1575S,
1600 10
1571 8 F1571C,
1572 10
1570 12 p.1570_F1571insI, I1570V, p.I1570dup,
1599 7
1580 14
1630 11 I1630R, I1630V,
1532 15 V1532I, V1532F,
1626 10 R1626P, R1626C, R1626L, R1626H,
1603 13 I1603F,
1625 9
1576 12
1596 6 F1596I, F1596C,
1628 9
1589 9
1632 7 R1632L, R1632C, R1632H,
1539 13 C1539F, C1539Y,
1597 7 V1597M,
1530 12
1573 11
1535 10
1537 12
1594 6 F1594S,
1633 13
1588 12 T1588I,
1581 15 A1581S,
1591 7 W1591X,
1593 7 I1593M,
1595 0
1629 5 R1629X, R1629G, R1629Q,
1574 7 E1574K, c.4719C>T,
1533 14 T1533I,
1541 12
1592 5
1578 8 c.4732_4733dupAA,
1631 10 G1631D,
1590 8
1622 12
1582 13 L1582P,
1621 15
1579 11 L1579fsX53,
1598 6 V1598A,
1577 12