SCN5A Variant N1774D Detail

We estimate the penetrance of LQTS for SCN5A N1774D around 45% and the Brugada syndrome penetrance around 14%. SCN5A N1774D was found in a total of 1 carriers in 3 papers and/or in gnomAD: 0 had Brugada syndrome, 1 had LQTS. N1774D is not present in gnomAD. N1774D has been functionally characterized in 3 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 (1 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A N1774D around 45% (2/11) and the Brugada syndrome penetrance around 14% (1/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-4.62 0.998 -2.51 0.959 36 48
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
24112685 2014 1 1 0 0
19996378 2010 1 1 0 0
30059973 2018 1 1 0 0
LITERATURE, COHORT, AND GNOMAD: - 1 0 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
24112685 2014 CHO 216 -7.9 -0.9 170
19996378 2010

N1774D has 68 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 12
414 13 M414V,
1659 14
1643 15 I1643L,
404 15 L404V, L404Q,
1778 7
1480 13 c.4437+5G>A, c.4438-1C>T,
1773 5
1653 6
1472 15 p.N1472del, N1472S,
1771 6 I1771T,
1652 5 M1652R, M1652T,
1777 6 V1777L, V1777M,
409 13 L409P, L409V,
1650 8 L1650F,
1492 13
1656 9
1477 8 K1477N,
1471 14
1779 9 T1779M,
1493 14 K1493R, K1493X, p.K1493del,
1470 11
1478 13 K1478E,
1776 6
1787 13 S1787N,
1767 11 Y1767C,
1660 14 I1660V, I1660S,
1654 10
1648 9
1769 8
1766 13 M1766V, M1766L, M1766T,
1319 14 G1319V,
1649 6 A1649V,
1768 11 I1768V,
1774 0 c.5321_5324dupACTT, N1774D,
1473 10 F1473S, F1473C,
1657 10
1496 12
1474 10
1481 13 G1481V, G1481E, G1481R,
1781 10 E1781G, E1781D,
1772 7 L1772V,
1645 11 T1645M,
1323 14 V1323G,
410 10 A410V,
1780 11 E1780G,
1788 13 c.5361_5364delTGAG,
1770 6 I1770V,
1651 10
1500 14 p.K1500del,
413 13 A413E, A413T,
1482 14
408 15
1322 12 c.3963+2T>C, c.3963+4A>G,
407 11
1476 13 Q1476R, Q1476X,
1775 7 p.F1775LfsX15, F1775V,
1642 15 G1642E,
1655 11
1475 14 Q1475L, p.Q1475NfsX6,
1469 14 I1469V,
406 12 N406S, N406K,
411 13 V411M,
1647 12
1646 10
1489 14 E1489D,
1782 13
1658 14