SCN5A Variant A178G Detail

We estimate the penetrance of LQTS for SCN5A A178G around 3% and the Brugada syndrome penetrance around 49%. SCN5A A178G was found in a total of 1 carriers in 1 papers and/or in gnomAD: 1 had Brugada syndrome, 0 had LQTS. A178G is not present in gnomAD. A178G has been functionally characterized in 2 papers. This residue is located in a 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 (4 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 A178G around 3% (0/11) and the Brugada syndrome penetrance around 49% (5/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-3.85 0.997 1.11 0.946 78 0
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
20129283 2010 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 1 0 0 1 -
VARIANT FEATURES ALONE: - 15 11 0 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)
20129283 2010
32533946 2020 HEK 110 9.2

A178G has 45 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
170 12 F170I,
126 10 K126E,
175 7 K175N,
197 14
113 11 V113I, V113A,
129 9
194 12
188 9
178 0 A178G,
128 7 c.381dupT,
117 13
179 3 R179X, R179Q,
119 12 P119S, P119L,
169 15
177 5 L177P,
189 15
123 9 A123G, A123V,
121 5 R121W, R121Q,
198 13
127 9
124 6 A124D,
118 11
125 5 V125L,
181 11
176 6
172 10
174 6 V174I,
185 11 A185V, A185T,
133 12
115 10 S115G,
130 13
182 13 C182R, C182Y,
173 9
112 11 Y112C,
114 8
184 8 H184R,
191 15
116 10
187 12 T187I, T187S,
180 6 G180V,
134 13 N134S,
120 10
183 13
122 9
171 11