SCN5A Variant V1604M Detail

We estimate the penetrance of LQTS for SCN5A V1604M around 2% and the Brugada syndrome penetrance around 22%. SCN5A V1604M was found in a total of 9 carriers in 1 papers and/or in gnomAD: 1 had Brugada syndrome, 0 had LQTS. V1604M is present in 8 alleles in gnomAD. V1604M 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 (3 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 V1604M around 2% (0/19) and the Brugada syndrome penetrance around 22% (4/19).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-2.21 0.844 3.15 0.833 46 1
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
20129283 2010 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 9 8 0 1 -
VARIANT FEATURES ALONE: - 15 12 0 3 - -
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

V1604M 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
1600 7
1571 15 F1571C,
1606 7 T1606I,
1610 8 D1610G,
1569 14 A1569P,
1612 13
1615 13 Y1615X,
1572 13
1564 14
1596 12 F1596I, F1596C,
1605 4 G1605D, c.4813+2_4813+5dupTGGG, G1605C, c.4813+3_4813+6dupGGGT, c.4813+5insTGGG,
1611 11 I1611V,
1597 10 V1597M,
1616 7
1607 7
1599 9
1620 14 T1620M, T1620K,
1568 12
1617 6 p.F1617del,
1608 5
1565 13 L1565M,
1604 0 c.4810+3_4810+6dupGGGT, V1604M,
1602 6
1622 9
1618 10
1614 13
1626 13 R1626H, R1626P, R1626L, R1626C,
1601 5 L1601H,
1621 12
1609 8 S1609W, S1609L,
1603 5 I1603F,
1598 10 V1598A,
1623 14 R1623X, c.4867delC, R1623L, R1623Q,
1619 11 c.4856delC, P1619Q, P1619L,
1625 13
1613 10 Q1613L, Q1613H,