SCN5A Variant D2003N Detail

We estimate the penetrance of LQTS for SCN5A D2003N around 5% and the Brugada syndrome penetrance around 8%. SCN5A D2003N was found in a total of 4 carriers in 1 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. D2003N is present in 4 alleles in gnomAD. D2003N has been functionally characterized in 1 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 D2003N around 5% (0/14) and the Brugada syndrome penetrance around 8% (1/14).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-1.18 0.966 1.36 0.381 11 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
26164358 2015 1 0 0 1 SUDS
LITERATURE, COHORT, AND GNOMAD: - 4 4 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.

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)
26164358 2015

D2003N has 29 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
1988 15 L1988R,
1989 14
1990 14 V1990L,
1991 13 R1991W, R1991Q,
1992 13 G1992A,
1993 12
1994 11
1995 11 Y1995X,
1996 10 S1996R, S1996N,
1997 9 H1997R,
1998 8
1999 8
2000 7 D2000Y,
2001 5
2002 4 A2002T,
2003 0 D2003N,
2004 4 F2004L, p.F2004dup, F2004I, F2004V,
2005 5 P2005A, P2005S, P2005L,
2006 7 p.Pro2006del, P2006A, p.P2006LfsX32, P2006T,
2007 8 p.S2007FfsX7,
2008 8 P2008L,
2009 9 D2009E,
2010 10 R2010G,
2011 11
2012 11 R2012H, R2012C,
2013 12
2014 13
2015 13
2016 14 V2016L, V2016M,