SCN5A Variant M254I Detail

We estimate the penetrance of LQTS for SCN5A M254I around 43% and the Brugada syndrome penetrance around 10%. SCN5A M254I was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. M254I is not present in gnomAD. M254I 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 (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 M254I around 43% (2/10) and the Brugada syndrome penetrance around 10% (0/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.9 3 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
LITERATURE, COHORT, AND GNOMAD: - 0 0 0 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.

M254I has 54 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
403 14
1643 10 I1643L,
404 9 L404V, L404Q,
249 11 K249X,
247 9 V247L,
254 0
401 13 S401P,
926 15
250 5
409 14 L409P, L409V,
928 10 L928P,
925 13 I925F,
1650 15 L1650F,
260 10
366 11
365 14
258 7 V258A,
246 11
412 13 V412D,
924 9 V924I,
927 14 N927S, N927K,
245 14 Q245K,
369 11 M369K,
1640 14
262 13 S262G,
256 7
921 12
405 11
362 12
248 12
261 10
920 12
255 6
917 14 L917V, L917R,
251 5
410 13 A410V,
929 12
259 11
408 8
253 4
407 9
263 15 V263I,
1775 15 p.F1775LfsX15, F1775V,
370 14 T370M,
1642 12 G1642E,
923 13
406 14 N406K, N406S,
252 7
411 11 V411M,
932 14
1647 13
257 5
400 13 G400R, G400A, G400E,
1646 12