SCN5A Variant c.612-2A>G Detail

We estimate the penetrance of LQTS for SCN5A c.612-2A>G around 2% and the Brugada syndrome penetrance around 36%. SCN5A c.612-2A>G was found in a total of 8 carriers in 3 papers and/or in gnomAD: 3 had Brugada syndrome, 0 had LQTS. c.612-2A>G is not present in gnomAD. c.612-2A>G has been functionally characterized in 3 papers. This residue is located in a 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 (3 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 c.612-2A>G around 2% (0/18) and the Brugada syndrome penetrance around 36% (6/18).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA None 47 2
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
20031634 2009 6 0 3 0
20129283 2010 1 0 1 0
29672598 2018 3 0 0 1 SUDS
LITERATURE, COHORT, AND GNOMAD: - 8 5 0 3 -
VARIANT FEATURES ALONE: - 15 12 0 3 - -
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)
20031634 2009
20129283 2010
29672598 2018

c.612-2A>G has 35 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
198 12
164 14 F164L,
209 6 N209S, N209T,
170 14 F170I,
171 14
158 15 K158T,
197 14
163 13 c.486delC,
169 8
222 12 R222X, R222L, R222Q,
205 0 Y205X, c.612-2A>G,
206 5
166 10 A166T,
211 12
217 14
172 11
199 11 S199T,
165 8
210 11 I210T,
204 6 c.611+3_611+4dupAA, c.611+1G>A, A204T, A204V,
162 10 Y162H, Y162C,
203 9
208 6 E208K,
168 11
202 6 I202T,
167 13
161 12 E161K, E161Q,
201 7
219 14 c.656_657insATTCA, R219H, R219C, p.R219HfsX11,
225 15 R225Q, R225W,
218 10
207 7
212 14 L212P, L212Q,
173 13
200 11