SCN5A Variant S1904L Detail

We estimate the penetrance of LQTS for SCN5A S1904L around 4% and the Brugada syndrome penetrance around 3%. SCN5A S1904L was found in a total of 51 carriers in 3 papers and/or in gnomAD: 1 had Brugada syndrome, 2 had LQTS. S1904L is present in 48 alleles in gnomAD. S1904L has been functionally characterized in 4 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 (0 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 S1904L around 4% (2/61) and the Brugada syndrome penetrance around 3% (1/61).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-5.55 1 -3.14 0.952 2 4
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
18708744 2007 1 1 0 0
26746457 2016 1 1 0 0
20129283 2010 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 51 48 2 1 -
VARIANT FEATURES ALONE: - 15 15 0 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)
18708744 2007 HEK 100 -1.3 -4.9 475
26746457 2016
22426227 2012 HEK 0.6 425
20129283 2010

S1904L has 31 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
1889 15 Y1889C,
1890 14 E1890K,
1891 14
1892 13
1893 13 c.5676delC,
1894 12
1895 11 T1895I,
1896 11 L1896P, p.L1896PfsX47,
1897 10 R1897Q, R1897W, R1897Y,
1898 9 R1898C, R1898H,
1899 8
1900 8
1901 7 E1901Q, E1901K,
1902 5 E1902A,
1903 4 V1903M,
1904 0 S1904L,
1905 4
1906 5 M1906T, M1906V,
1907 7
1908 8 I1908V,
1909 8 Q1909R,
1910 9 R1910K,
1911 10
1912 11
1913 11 R1913H, R1913C, R1913S,
1914 12 R1914G,
1915 13 H1915Y, H1915P, H1915Q, H1915N,
1916 13
1917 14
1918 14
1919 15 R1919H, R1919C,