SCN5A Variant F2004V Detail

We estimate the penetrance of LQTS for SCN5A F2004V around 8% and the Brugada syndrome penetrance around 16%. SCN5A F2004V was found in a total of 9 carriers in 3 papers and/or in gnomAD: 1 had Brugada syndrome, 1 had LQTS. F2004V is present in 7 alleles in gnomAD. F2004V has been functionally characterized in 3 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 (2 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 F2004V around 8% (1/19) and the Brugada syndrome penetrance around 16% (3/19).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-0.54 0.004 0.27 0.566 23 5
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
24631775 2014 1 0 0 1 SD
19716085 2009 1 1 0 0
20129283 2010 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 9 7 1 1 -
VARIANT FEATURES ALONE: - 15 13 0 2 - -
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)
24631775 2014
19716085 2009
20129283 2010

F2004V has 28 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
1989 15
1990 14 V1990L,
1991 14 R1991W, R1991Q,
1992 13 G1992A,
1993 13
1994 12
1995 11 Y1995X,
1996 11 S1996N, S1996R,
1997 10 H1997R,
1998 9
1999 8
2000 8 D2000Y,
2001 7
2002 5 A2002T,
2003 4 D2003N,
2004 0 F2004I, F2004V, p.F2004dup, F2004L,
2005 4 P2005L, P2005S, P2005A,
2006 5 P2006A, P2006T, p.P2006LfsX32, p.Pro2006del,
2007 7 p.S2007FfsX7,
2008 8 P2008L,
2009 8 D2009E,
2010 9 R2010G,
2011 10
2012 11 R2012H, R2012C,
2013 11
2014 12
2015 13
2016 13 V2016M, V2016L,