SCN5A Variant V281E Detail

We estimate the penetrance of LQTS for SCN5A V281E around 5% and the Brugada syndrome penetrance around 36%. SCN5A V281E was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. V281E is not present in gnomAD. V281E has been functionally characterized in 0 papers. This residue is located in a 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 (3 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 V281E around 5% (0/10) and the Brugada syndrome penetrance around 36% (3/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.948 50 1
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 12 0 3 - -
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.

V281E has 40 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
343 11
328 13
277 13
341 7 C341Y,
274 15 G274C,
342 5
326 9
335 10 C335S, C335R,
327 11
339 6
346 13 E346X, E346G, E346K, E346D,
319 8 G319S, G319R, G319C,
384 14 S384T,
325 11 L325R,
348 15 P348A,
317 11 K317M, K317N, K317E,
284 10
336 10 P336L,
282 6 R282H, R282C,
279 6
324 11
321 9 S321Y,
344 8 A344S,
340 6 R340W, R340Q,
338 8
285 11 T285K,
345 10
322 12
278 10 H278R, H278D,
334 13 c.999-424_1338+81del,
383 14
280 5 C280Y,
318 11
281 0 V281M,
323 9
347 15
283 6
337 13
286 14 A286V, A286S,
320 7 T320N,