SCN5A Variant T187I Detail

We estimate the penetrance of LQTS for SCN5A T187I around 1% and the Brugada syndrome penetrance around 41%. SCN5A T187I was found in a total of 1 carriers in 3 papers and/or in gnomAD: 1 had Brugada syndrome, 0 had LQTS. T187I is not present in gnomAD. T187I has been functionally characterized in 5 papers. This residue is located in a Non_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 (3 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 T187I around 1% (0/11) and the Brugada syndrome penetrance around 41% (4/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-5.49 0.999 -4.2 0.965 40 1
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
16325048 2005 2 0 1 1 SSS
29574140 2018 1 0 1 0
30371189 2018 2 0 2 0
LITERATURE, COHORT, AND GNOMAD: - 1 0 0 1 -
VARIANT FEATURES ALONE: - 15 12 0 3 - -
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)
29574140 2018
30371189 2018
16325048 2005 HEK 0
20384651 2010 0
20539757 2010

T187I has 30 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
192 10
175 11 K175N,
197 13
113 12 V113A, V113I,
194 8
188 5
178 12 A178G,
196 13
190 5 R190Q, R190G, R190W, R190L,
179 9 R179Q, R179X,
177 14 L177P,
189 6
198 11
181 12
176 10
172 14
174 15 V174I,
193 13 W193R, W193X,
185 5 A185T, A185V,
199 14 S199T,
186 4
195 11
182 9 C182R, C182Y,
112 12 Y112C,
114 13
184 5 H184R,
191 7
187 0 T187I, T187S,
180 9 G180V,
183 7