SCN5A Variant V247L Detail

We estimate the penetrance of LQTS for SCN5A V247L around 8% and the Brugada syndrome penetrance around 2%. SCN5A V247L was found in a total of 17 carriers in 1 papers and/or in gnomAD: 0 had Brugada syndrome, 1 had LQTS. V247L is present in 16 alleles in gnomAD. V247L has been functionally characterized in 1 papers. This residue is located in a Non_Hotspot region for Brugada syndrome and a Mild_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 (0 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A V247L around 8% (1/27) and the Brugada syndrome penetrance around 2% (0/27).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-2.93 0.997 3.29 0.895 1 16
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
19716085 2009 1 1 0 0
LITERATURE, COHORT, AND GNOMAD: - 17 16 1 0 -
VARIANT FEATURES ALONE: - 15 15 0 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)
19716085 2009

V247L has 51 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 12 M414V,
404 15 L404Q, L404V,
249 7 K249X,
247 0 V247L,
240 11 V240M,
254 9
193 15 W193X, W193R,
418 14 E418K,
926 11
250 5
409 13 L409V, L409P,
928 10 L928P,
925 8 I925F,
933 11
246 4
412 9 V412D,
924 9 V924I,
927 13 N927K, N927S,
245 7 Q245K,
845 15 c.2533delG,
244 6
415 10 A415T,
849 14
921 11
922 14 V922I,
405 14
248 5
241 9
920 14
419 14 Q419X,
930 11 c.2788-6C>T, c.2787+17_2787+18insACACACACACACACACACACACA,
255 13
239 13 I239V, I239V ,
251 7
410 12 A410V,
242 8 A242D,
929 7
416 13 Y416C,
413 13 A413E, A413T,
408 10
253 10
407 13
192 15
1642 15 G1642E,
923 14
252 11
411 9 V411M,
243 7
932 12
257 14
931 14