SCN5A Variant F164L Detail

We estimate the penetrance of LQTS for SCN5A F164L around 3% and the Brugada syndrome penetrance around 19%. SCN5A F164L was found in a total of 1 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. F164L is present in 1 alleles in gnomAD. F164L has been functionally characterized in 0 papers. This residue is located in a Mild_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 (2 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 F164L around 3% (0/11) and the Brugada syndrome penetrance around 19% (2/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-5.78 0.951 -1.61 0.935 23 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
LITERATURE, COHORT, AND GNOMAD: - 1 1 0 0 -
VARIANT FEATURES ALONE: - 15 13 0 2 - -
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.

F164L 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
223 13 V223L,
149 14
147 8
164 0 F164L,
170 12 F170I,
228 15 K228R,
138 12 M138I,
171 11
143 7
137 10 I137V,
142 11
156 14 W156R, W156X,
158 11 K158T,
197 14
163 5 c.486delC,
169 10
222 9 R222L, R222Q, R222X,
224 15 L224F,
150 13
133 14
157 10 T157I,
160 5 p.V160fs,
226 13 A226G, A226V,
205 14 c.612-2A>G, Y205X,
166 7 A166T,
144 6
172 14
139 10 p.I137_C139dup,
148 10
165 6
204 10 c.611+3_611+4dupAA, A204T, c.611+1G>A, A204V,
162 8 Y162H, Y162C,
146 11 V146M, V146A,
203 15
208 11 E208K,
136 12 L136P,
168 6
202 15 I202T,
141 8 I141V, I141N,
167 6
161 6 E161Q, E161K,
201 11
219 13 c.656_657insATTCA, R219C, R219H, p.R219HfsX11,
225 10 R225Q, R225W,
151 12
159 9 Y159X, Y159C,
207 13
200 12
145 10
140 6