SCN5A Variant c.5290delG Detail

We estimate the penetrance of LQTS for SCN5A c.5290delG around 22% and the Brugada syndrome penetrance around 46%. SCN5A c.5290delG was found in a total of 1 carriers in 3 papers and/or in gnomAD: 1 had Brugada syndrome, 0 had LQTS. c.5290delG is not present in gnomAD. c.5290delG has been functionally characterized in 3 papers. This residue is located in a 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 (4 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 c.5290delG around 22% (1/11) and the Brugada syndrome penetrance around 46% (5/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA None 58 33
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
17697823 2007 1 0 1 0
28341781 2017 1 0 1 0
20129283 2010 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 1 0 0 1 -
VARIANT FEATURES ALONE: - 15 10 1 4 - -
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)
17697823 2007
28341781 2017
20129283 2010

c.5290delG has 80 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
403 11
1659 13
404 14 L404V, L404Q,
1417 13
1765 4
1653 14
1757 11
1472 15 p.N1472del, N1472S,
1771 11 I1771T,
401 10 S401P,
1756 11 I1756V,
1320 15 M1320I,
1764 0 c.5290delG, V1764F,
1666 15
371 11 Q371E,
409 13 L409P, L409V,
1711 13 c.5131delG,
1754 14
1707 12
1656 13
1704 13 L1704H,
1706 14 Q1706H,
1671 15
935 14 L935P,
1762 7 p.I1762del, I1762M,
1470 12
1464 14 c.4389_4396delCCTCTTTA, L1464P,
1668 12 M1668T,
1466 9 c.4396_4397insG,
369 15 M369K,
1767 6 Y1767C,
1660 8 I1660S, I1660V,
1769 9
402 7 F402L,
1766 6 M1766V, M1766T, M1766L,
1665 14
1768 7 I1768V,
1473 12 F1473S, F1473C,
1334 14 I1334V,
1468 13 V1468F, V1468A,
1663 10
399 14
397 11 I397F, I397T, I397V,
405 11
1462 12
1657 10
1759 6 S1759C,
1662 13
1324 15
1327 12
1709 8 T1709M, p.T1709del, T1709R,
1758 9 p.I1758del, I1758V,
1755 10
1330 14 A1330T, A1330D, A1330P,
1772 13 L1772V,
1713 13
1323 12 V1323G,
394 14
1770 11 I1770V,
1708 8 T1708I,
374 14 W374G,
1705 13
1326 13 A1326S,
1763 4 V1763M, V1763L,
1465 11 p.F1465_L1480dup,
1760 6
1467 13
370 14 T370M,
1661 10 G1661R, G1661E,
1761 8 L1761F, L1761H, c.5280delG,
1469 10 I1469V,
406 10 N406K, N406S,
1710 10 S1710L,
932 15
398 10
400 13 G400R, G400A, G400E,
1667 12 V1667I,
1664 8
1463 12 N1463Y,
1658 14