SCN5A Variant I1749N Detail

We estimate the penetrance of LQTS for SCN5A I1749N around 53% and the Brugada syndrome penetrance around 16%. SCN5A I1749N was found in a total of 1 carriers in 1 papers and/or in gnomAD: 0 had Brugada syndrome, 1 had LQTS. I1749N is not present in gnomAD. I1749N has been functionally characterized in 1 papers. This residue is located in a Mild_Hotspot region for Brugada syndrome and a 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 (2 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A I1749N around 53% (3/11) and the Brugada syndrome penetrance around 16% (1/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-6.47 1 -4.36 0.959 14 59
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
30059973 2018 1 1 0 0
LITERATURE, COHORT, AND GNOMAD: - 1 0 1 0 -
VARIANT FEATURES ALONE: - 15 12 2 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

I1749N has 52 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 5 A1746T, A1746V,
1724 14
1417 15
1406 10 G1406E, G1406R,
1757 13
1715 13
1745 6
1756 11 I1756V,
1675 13
1743 12 G1743R, G1743E,
1723 12 T1723N,
1754 9
1707 14
1694 15
1411 12
1407 10
1410 7
1747 6 V1747M,
1716 12 p.L1716SfsX71,
1714 12 D1714G,
1671 13
1404 13
1744 8 S1744I,
1721 7
1753 6 T1753A,
1712 15 G1712C, G1712S,
1412 14 L1412F,
1719 12
1408 12 G1408R,
1758 15 I1758V, p.I1758del,
1678 12 N1678S,
1755 12
1401 14
1674 13 F1674V,
1399 13
1713 11
1748 4 G1748D, p.G1748del,
1405 14 V1405M, V1405L,
1409 10 Y1409X, Y1409C,
1400 13 V1400I,
1718 11 S1718R,
1717 8 L1717P,
1751 8
1682 15
1750 5 L1750F,
1752 7
1722 10 N1722D,
1749 0 I1749N,
1720 9 c.5157delC,
1679 12
1414 12 Q1414H,
1413 11