SCN5A Variant V1747M Detail

We estimate the penetrance of LQTS for SCN5A V1747M around 17% and the Brugada syndrome penetrance around 8%. SCN5A V1747M was found in a total of 8 carriers in 2 papers and/or in gnomAD: 0 had Brugada syndrome, 1 had LQTS. V1747M is present in 7 alleles in gnomAD. V1747M has been functionally characterized in 2 papers. This residue is located in a Mild_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 (1 diagnosed with Brugada syndrome) and 5 individuals for LQTS (1 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A V1747M around 17% (2/18) and the Brugada syndrome penetrance around 8% (1/18).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-2.62 0.99 0.84 0.663 14 27
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
20541041 2010 1 1 0 0
30059973 2018 1 1 0 0
LITERATURE, COHORT, AND GNOMAD: - 8 7 1 0 -
VARIANT FEATURES ALONE: - 15 13 1 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)
30059973 2018
20541041 2010

V1747M has 44 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
1746 4 A1746T, A1746V,
1741 15 D1741E, D1741N, D1741Y,
1304 15 T1304M,
1745 5
1756 14 I1756V,
1673 14
1675 9
1743 8 G1743R, G1743E,
1723 14 T1723N,
1754 11
1694 12
1410 14
1747 0 V1747M,
1716 13 p.L1716SfsX71,
1671 12
1676 13 M1676T, M1676I,
1744 5 S1744I,
1721 8
1753 10 T1753A,
1672 14 S1672Y,
1742 12
1680 12 A1680P, A1680T,
1719 12
1678 6 N1678S,
1755 13
1300 13
1674 9 F1674V,
1713 15
1748 4 p.G1748del, G1748D,
1683 15
1301 13
1718 13 S1718R,
1717 10 L1717P,
1751 7
1677 10
1682 11
1750 6 L1750F,
1752 9
1722 10 N1722D,
1749 6 I1749N,
1740 14 G1740R,
1720 8 c.5157delC,
1732 15
1679 7