SCN5A Variant D1790N Detail

We estimate the penetrance of LQTS for SCN5A D1790N around 21% and the Brugada syndrome penetrance around 6%. SCN5A D1790N was found in a total of 5 carriers in 2 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. D1790N is present in 3 alleles in gnomAD. D1790N has been functionally characterized in 2 papers. This residue is located in a Non_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 (0 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 D1790N around 21% (2/15) and the Brugada syndrome penetrance around 6% (0/15).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-4.62 1 -1.39 0.935 2 56
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
23200271 2013 3 0 0 1 SSS
30059973 2018 1 1 0 0
LITERATURE, COHORT, AND GNOMAD: - 5 5 0 0 -
VARIANT FEATURES ALONE: - 15 13 2 0 - -
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
23200271 2013

D1790N has 66 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
1850 15 C1850S,
1855 15
1785 9
1794 8
1856 14
1778 12
1853 14 I1853V,
1795 10 Y1795H, p.Y1795_E1796insD, Y1795N, Y1795C,
1818 13
1652 15 M1652T, M1652R,
1777 15 V1777M, V1777L,
1824 7 P1824A,
1820 12 A1820V, A1820T,
1504 11 K1504E,
1641 9
1501 11 L1501V, p.L1501_K1505del,
1860 14 c.5577_5578dupAA,
1857 12
1862 13
1639 13 G1639A,
1779 14 T1779M,
1493 14 p.K1493del, K1493X, K1493R,
1858 10
1865 14
1787 4 S1787N,
1786 5 L1786R, L1786Q, c.5356_5357delCT,
1648 11
1861 10 V1861I, V1861F,
1649 14 A1649V,
1864 14
1821 9
1644 10 R1644L, R1644C, R1644H,
1640 14
1798 14 W1798X,
1826 11 R1826H, R1826C,
1496 13
1854 11
1825 7 L1825P,
1797 11 I1797V,
1793 6 M1793K,
1781 10 E1781G, E1781D,
1789 4
1817 13
1645 10 T1645M,
1784 13 E1784K, E1784X,
1827 14
1498 14 M1498T, M1498V, M1498R,
1796 10
1780 15 E1780G,
1788 7 c.5361_5364delTGAG,
1638 11 R1638Q, R1638X,
1500 9 p.K1500del,
1791 5
1637 14
1792 7 D1792Y, D1792N, D1792V,
1823 9 E1823K, p.E1823HfsX10,
1502 15 G1502A, G1502S,
1783 12
1642 13 G1642E,
1497 11
1790 0 p.D1790del, D1790N, D1790G,
1647 15
1503 14 S1503Y,
1822 7 c.5464_5467delTCTG, c.5464-5467delTCTG,
1646 15
1782 10