SCN5A Variant A1924T Detail

We estimate the penetrance of LQTS for SCN5A A1924T around 0% and the Brugada syndrome penetrance around 9%. SCN5A A1924T was found in a total of 17 carriers in 7 papers and/or in gnomAD: 1 had Brugada syndrome, 0 had LQTS. A1924T is present in 16 alleles in gnomAD. A1924T has been functionally characterized in 10 papers. This residue is located in a Mild_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 (1 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 A1924T around 0% (0/27) and the Brugada syndrome penetrance around 9% (2/27).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-1.23 0.653 0.24 0.743 13 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
12106943 2002 1 0 1 0
20950709 2011 2 0 0 2 sinus pauses, VT, conduction
21273195 2011 1 0 1 0
26111534 2015 2 0 0 2 SND, AF, VT
19251209 2009 1 0 1 0
10690282 1999 1 0 1 0
20129283 2010 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 17 16 0 1 -
VARIANT FEATURES ALONE: - 15 14 0 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)
12106943 2002
20950709 2011
21273195 2011
26111534 2015
19251209 2009
19171938 2009
11807557 2002 HEK-tSA205
16505387 2006 tsA201 9.13
10690282 1999 Xeno -9 -0.2 0
20129283 2010

A1924T 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
1909 15 Q1909R,
1910 14 R1910K,
1911 14
1912 13
1913 13 R1913C, R1913S, R1913H,
1914 12 R1914G,
1915 11 H1915Q, H1915N, H1915P, H1915Y,
1916 11
1917 10
1918 9
1919 8 R1919C, R1919H,
1920 8 S1920C,
1921 7
1922 5 K1922R, K1922N,
1923 4 H1923Y, H1923D,
1924 0 A1924T,
1925 4 S1925F, p.S1925CfsX20,
1926 5
1927 7 L1927P,
1928 8 F1928V,
1929 8 R1929C, R1929H,
1930 9 Q1930H,
1931 10
1932 11 A1932V,
1933 11 G1933D, G1933A, G1933V,
1934 12
1935 13 G1935S,
1936 13
1937 14 S1937A,
1938 14 E1938K, E1938X,
1939 15 p.E1939_E1943del,