SCN5A Variant V200M Detail

We estimate the penetrance of LQTS for SCN5A V200M around 5% and the Brugada syndrome penetrance around 20%. SCN5A V200M was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. V200M is not present in gnomAD. V200M has been functionally characterized in 0 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 V200M around 5% (0/10) and the Brugada syndrome penetrance around 20% (1/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.931 21 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
LITERATURE, COHORT, AND GNOMAD: - 0 0 0 0 -
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.

V200M has 56 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
223 8 V223L,
856 13 V856L,
859 14
198 8
164 12 F164L,
193 12 W193R, W193X,
209 14 N209S, N209T,
195 8
228 11 K228R,
138 14 M138I,
227 10 L227P,
171 12
137 14 I137V,
197 7
229 14
216 14 S216L, S216X,
221 7
196 6
169 11
189 12
852 12
222 7 R222X, R222L, R222Q,
224 6 L224F,
191 14
226 10 A226G, A226V,
205 11 Y205X, c.612-2A>G,
206 10
166 14 A166T,
144 12
217 11
855 14
172 11
199 4 S199T,
148 13
165 10
204 7 A204T, c.611+3_611+4dupAA, A204V, c.611+1G>A,
203 5
208 12 E208K,
192 12
168 9
175 13 K175N,
202 6 I202T,
194 11
141 11 I141V, I141N,
188 14
167 13
161 13 E161K, E161Q,
201 5
219 11 p.R219HfsX11, R219H, c.656_657insATTCA, R219C,
225 6 R225Q, R225W,
218 9
207 11
200 0
140 14
145 14
220 10 T220I,