SCN5A Variant E208K Detail

We estimate the penetrance of LQTS for SCN5A E208K around 1% and the Brugada syndrome penetrance around 14%. SCN5A E208K was found in a total of 1 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. E208K is present in 1 alleles in gnomAD. E208K has been functionally characterized in 0 papers. This residue is located in a Non_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 E208K around 1% (0/11) and the Brugada syndrome penetrance around 14% (1/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-3.25 0.993 -2.83 0.932 10 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
LITERATURE, COHORT, AND GNOMAD: - 1 1 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.

E208K has 39 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
147 15
164 11 F164L,
209 6 N209T, N209S,
156 14 W156R, W156X,
158 9 K158T,
163 11 c.486delC,
216 14 S216L, S216X,
169 11
222 10 R222X, R222L, R222Q,
213 14
157 14 T157I,
160 12 p.V160fs,
205 6 c.612-2A>G, Y205X,
206 6
166 10 A166T,
214 15
211 10
144 15
217 13
199 14 S199T,
165 7
210 7 I210T,
204 6 A204T, c.611+1G>A, A204V, c.611+3_611+4dupAA,
162 6 Y162C, Y162H,
203 10
208 0 E208K,
168 12
202 10 I202T,
167 13
161 8 E161K, E161Q,
201 10
219 11 p.R219HfsX11, c.656_657insATTCA, R219H, R219C,
218 10
159 13 Y159C, Y159X,
207 5
212 10 L212P, L212Q,
215 15 p.L215CfsX10,
200 12
220 15 T220I,