SCN5A Variant E161A Detail

We estimate the penetrance of LQTS for SCN5A E161A around 5% and the Brugada syndrome penetrance around 46%. SCN5A E161A was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. E161A is not present in gnomAD. E161A has been functionally characterized in 0 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 E161A around 5% (0/10) and the Brugada syndrome penetrance around 46% (4/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.974 67 2
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: - 0 0 0 0 -
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.

E161A has 50 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
154 13 P154L,
223 13 V223L,
859 14
153 15
149 13
147 7
164 6 F164L,
209 14 N209T, N209S,
143 11
156 9 W156X, W156R,
158 6 K158T,
163 7 c.486delC,
216 15 S216X, S216L,
169 13
222 8 R222L, R222Q, R222X,
155 11
150 12
157 7 T157I,
160 5 p.V160fs,
205 12 Y205X, c.612-2A>G,
206 13
166 10 A166T,
144 8
855 15
148 10
165 7
210 13 I210T,
204 9 A204V, A204T, c.611+3_611+4dupAA, c.611+1G>A,
162 5 Y162H, Y162C,
146 13 V146A, V146M,
203 13
208 8 E208K,
168 10
202 15 I202T,
152 15 D152N,
141 13 I141N, I141V,
167 11
161 0 E161Q, E161K,
201 12
219 9 c.656_657insATTCA, R219H, R219C, p.R219HfsX11,
225 13 R225Q, R225W,
151 9
218 12
159 7 Y159C, Y159X,
207 9
212 14 L212Q, L212P,
200 13
145 12
140 12
220 14 T220I,