SCN5A Variant V232I Detail

We estimate the penetrance of LQTS for SCN5A V232I around 0% and the Brugada syndrome penetrance around 7%. SCN5A V232I was found in a total of 38 carriers in 3 papers and/or in gnomAD: 2 had Brugada syndrome, 0 had LQTS. V232I is present in 36 alleles in gnomAD. V232I 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 (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 V232I around 0% (0/48) and the Brugada syndrome penetrance around 7% (3/48).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-0.98 0.454 0.41 0.73 15 3
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
18599870 2008 1 0 1 0
20129283 2010 1 0 1 0
20129283 2010 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 38 36 0 2 -
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)
20129283 2010
18599870 2008 tsA201 100 0
20129283 2010

V232I has 43 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
848 11 I848F,
842 14
240 12 V240M,
231 4 c.692_693delCA,
131 12
193 13 W193X, W193R,
237 11
228 8 K228R,
138 7 M138I,
227 11 L227P,
143 14
137 11 I137V,
234 7 P234S,
142 10
197 15
229 6
845 11 c.2533delG,
232 0 V232F, V232I,
133 14
132 14 c.393-5C>A,
134 10 N134S,
849 15
226 11 A226G, A226V,
235 9 c.704-1G>C, G235R, c.703+1G>A,
840 12
843 14 T843A,
837 13
239 13 I239V , I239V,
230 7 I230M, I230T, I230V,
139 10 p.I137_C139dup,
841 10 N841K, p.N841TfsX2,
236 8
847 14
136 13 L136P,
238 14
233 5
838 14
141 11 I141N, I141V,
135 9 M135V,
225 13 R225W, R225Q,
844 9 L844RfsX3,
145 14
140 13