SCN5A Variant A1680T Detail

We estimate the penetrance of LQTS for SCN5A A1680T around 5% and the Brugada syndrome penetrance around 20%. SCN5A A1680T was found in a total of 18 carriers in 8 papers and/or in gnomAD: 4 had Brugada syndrome, 1 had LQTS. A1680T is present in 13 alleles in gnomAD. A1680T has been functionally characterized in 9 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 (1 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 A1680T around 5% (1/28) and the Brugada syndrome penetrance around 20% (5/28).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-3.44 1 -3.34 0.889 18 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
16712702 2006 1 0 0 1 Sudden adult death syndrome
18508782 2008 2 0 1 1 SD
19564561 2009 1 0 1 0
23631430 2013 1 1 0 0
26746457 2016 1 0 0 1 AF, BBB
20129283 2010 1 0 1 0
20129283 2010 1 0 1 0
30254039 2018 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 18 13 1 4 -
VARIANT FEATURES ALONE: - 15 14 0 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)
16712702 2006
18508782 2008
19564561 2009
23631430 2013
26746457 2016
20129283 2010
20129283 2010
30254039 2018
32533946 2020 HEK 90 -5.3 -1.2

A1680T 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
1741 8 D1741E, D1741Y, D1741N,
1304 15 T1304M,
1687 15
1698 14 A1698T,
1745 13
1673 12
1675 8
1743 9 G1743R, G1743E,
1681 5 c.5040_5042delTTAinsC, Y1681F,
1694 7
1226 8
1747 12 V1747M,
1716 14 p.L1716SfsX71,
1695 6 Q1695X,
1688 11
1684 12 W1684R,
1676 7 M1676I, M1676T,
1692 14
1744 10 S1744I,
1721 14
1672 12 S1672Y,
1742 9
1693 8
1699 12
1738 13 S1738T, S1738F,
1680 0 A1680P, A1680T,
1703 13
1719 12
1731 14
1228 12 Y1228C, Y1228H, Y1228F,
1690 12 c.5068_5070delGA, D1690N,
1678 7 N1678S,
1223 15 c.3667delG,
1697 13
1230 14 E1230K,
1227 7
1300 13
1674 12 F1674V,
1229 13
1748 13 G1748D, p.G1748del,
1683 9
1301 13
1696 10
1689 15 D1689N,
1739 11 R1739Q, R1739W,
1700 11
1717 15 L1717P,
1734 14
1751 13
1677 7
1682 5
1752 15
1722 14 N1722D,
1740 7 G1740R,
1225 12 G1225K, E1225K,
1691 15
1720 10 c.5157delC,
1732 11
1679 6
1685 14