SCN5A Variant Q245K Detail

We estimate the penetrance of LQTS for SCN5A Q245K around 52% and the Brugada syndrome penetrance around 5%. SCN5A Q245K was found in a total of 5 carriers in 2 papers and/or in gnomAD: 0 had Brugada syndrome, 3 had LQTS. Q245K is present in 2 alleles in gnomAD. Q245K has been functionally characterized in 3 papers. This residue is located in a Non_Hotspot region for Brugada syndrome and a Hotspot region for LQTS. In silico predictions, functional data (if available), and location in structure are equivalent to phenotyping 10 individuals for Brugada syndrome (0 diagnosed with Brugada syndrome) and 5 individuals for LQTS (2 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A Q245K around 52% (5/15) and the Brugada syndrome penetrance around 5% (0/15).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-3.4 0.953 2.39 0.906 1 56
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
15840476 2005 1 1 0 0
27566755 2016 3 3 0 0
LITERATURE, COHORT, AND GNOMAD: - 5 2 3 0 -
VARIANT FEATURES ALONE: - 15 13 2 0 - -
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)
15840476 2005
27566755 2016
25904541 2015 HEK 84 -4 1

Q245K has 48 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
414 9 M414V,
249 5 K249X,
247 7 V247L,
240 9 V240M,
254 14
193 14 W193X, W193R,
418 8 E418K,
250 9
409 14 L409V, L409P,
237 12
928 15 L928P,
925 14 I925F,
417 12
933 12
246 5
1779 14 T1779M,
412 9 V412D,
924 15 V924I,
245 0 Q245K,
244 5
415 6 A415T,
420 13
248 5
241 6
419 8 Q419X,
930 14 c.2788-6C>T, c.2787+17_2787+18insACACACACACACACACACACACA,
423 14
239 11 I239V , I239V,
251 11
410 13 A410V,
242 6 A242D,
929 11
416 10 Y416C,
413 11 A413T, A413E,
236 14
408 13
253 13
192 15
936 14
238 11
422 12
1775 15 p.F1775LfsX15, F1775V,
1642 14 G1642E,
421 14
252 13
411 9 V411M,
243 7
932 14