SCN5A Variant D252A Detail

We estimate the penetrance of LQTS for SCN5A D252A around 34% and the Brugada syndrome penetrance around 10%. SCN5A D252A was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. D252A is not present in gnomAD. D252A has been functionally characterized in 0 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 (1 diagnosed with Brugada syndrome) and 5 individuals for LQTS (1 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A D252A around 34% (1/10) and the Brugada syndrome penetrance around 10% (1/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.964 4 43
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: - 0 0 0 0 -
VARIANT FEATURES ALONE: - 15 13 1 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.

D252A 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
414 13 M414V,
1643 6 I1643L,
404 13 L404V, L404Q,
249 8 K249X,
247 11 V247L,
254 7
1634 14 L1634P,
250 7
1650 14 L1650F,
260 13
1641 11
258 11 V258A,
1639 10 G1639A,
246 12
1779 14 T1779M,
412 14 V412D,
245 13 Q245K,
415 15 A415T,
1649 15 A1649V,
1640 7
1644 12 R1644H, R1644C, R1644L,
256 8
248 10
261 15
255 6
1645 11 T1645M,
251 4
410 13 A410V,
1638 15 R1638Q, R1638X,
259 12
1633 14
1637 10
408 12
253 5
1636 15
407 11
1775 13 p.F1775LfsX15, F1775V,
1642 6 G1642E,
252 0
411 11 V411M,
1647 11
257 10
1646 9