SCN5A Variant L1704H Detail

We estimate the penetrance of LQTS for SCN5A L1704H around 1% and the Brugada syndrome penetrance around 18%. SCN5A L1704H was found in a total of 1 carriers in 1 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. L1704H is not present in gnomAD. L1704H has been functionally characterized in 1 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 L1704H around 1% (0/11) and the Brugada syndrome penetrance around 18% (2/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-6.48 1 -6.08 0.99 17 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
26746457 2016 1 0 0 0
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.

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)
26746457 2016

L1704H has 76 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 7
387 14
1757 14
1715 13
1687 13
391 15
1698 10 A1698T,
1756 11 I1756V,
1673 11
1675 10
1764 13 V1764F, c.5290delG,
1666 11
371 15 Q371E,
1711 10 c.5131delG,
1754 12
1707 5
1694 8
1704 0 L1704H,
1706 7 Q1706H,
1695 14 Q1695X,
1716 10 p.L1716SfsX71,
1714 15 D1714G,
1688 13
1669 10
1671 8
1668 5 M1668T,
1676 11 M1676T, M1676I,
1692 10
1753 14 T1753A,
1672 7 S1672Y,
1693 11
378 11
1699 9
1665 10
1712 11 G1712S, G1712C,
379 13
1703 5
1663 13
397 14 I397V, I397F, I397T,
1759 10 S1759C,
1719 15
1709 9 p.T1709del, T1709R, T1709M,
1701 6 M1701I,
1758 12 p.I1758del, I1758V,
1678 14 N1678S,
1223 14 c.3667delG,
1755 7
1697 11
393 14
1674 12 F1674V,
1713 10
390 11
394 12
1748 13 G1748D, p.G1748del,
1708 6 T1708I,
382 14
1696 12
374 12 W374G,
1705 5
1700 6
1717 13 L1717P,
1763 13 V1763L, V1763M,
1751 9
1677 14
1760 13
1752 9
1670 10
1661 13 G1661R, G1661E,
375 12
1691 13
1710 11 S1710L,
1720 14 c.5157delC,
1679 11
398 14
1667 9 V1667I,
1664 10