SCN5A Variant V1667I Detail

We estimate the penetrance of LQTS for SCN5A V1667I around 24% and the Brugada syndrome penetrance around 8%. SCN5A V1667I was found in a total of 15 carriers in 8 papers and/or in gnomAD: 1 had Brugada syndrome, 4 had LQTS. V1667I is present in 1 alleles in gnomAD. V1667I has been functionally characterized in 8 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 (0 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 V1667I around 24% (4/25) and the Brugada syndrome penetrance around 8% (1/25).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-0.96 0.986 3.12 0.802 10 19
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
11274952 2001 11 2 0 0
15840476 2005 1 1 0 0
15996170 2005 1 0 0 1 VT
19843921 2009 1 0 1 0
20566482 2010 4 4 0 0
20659946 2010 7 7 0 0
27566755 2016 2 2 0 0
20129283 2010 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 15 10 4 1 -
VARIANT FEATURES ALONE: - 15 15 0 0 - -
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)
11274952 2001
15840476 2005
15996170 2005
19843921 2009
20566482 2010
20659946 2010
27566755 2016
20129283 2010

V1667I has 69 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
1702 14
1328 15 V1328M,
1659 13
1765 14
1304 13 T1304M,
1757 12
1315 14
1216 15 L1216V,
1698 15 A1698T,
1756 12 I1756V,
1314 11 c.3940_3941delCT,
1320 13 M1320I,
1673 11
1675 12
1764 12 V1764F, c.5290delG,
1666 5
1754 10
1707 11
1694 15
1704 9 L1704H,
1706 14 Q1706H,
1669 7
1671 6
1762 11 I1762M, p.I1762del,
1668 5 M1668T,
1676 14 M1676T, M1676I,
1219 14 S1219N,
1753 14 T1753A,
1672 9 S1672Y,
1767 14 Y1767C,
1313 14
1660 10 I1660V, I1660S,
1310 11
1766 12 M1766L, M1766T, M1766V,
1665 7
1305 14
1703 13
1663 6
1759 8 S1759C,
1662 10
1324 13
1327 12
1709 13 T1709R, p.T1709del, T1709M,
1701 10 M1701I,
1307 10
1758 7 p.I1758del, I1758V,
1223 14 c.3667delG,
1755 7
1697 14
1674 11 F1674V,
1713 15
1323 13 V1323G,
394 15
1708 9 T1708I,
1705 11
1700 12
1763 9 V1763L, V1763M,
1751 11
1311 9 L1311P,
1308 10 L1308F,
1760 13
1752 13
1670 5
1661 9 G1661R, G1661E,
1761 13 L1761H, L1761F, c.5280delG,
1710 15 S1710L,
398 14
1667 0 V1667I,
1664 6