SCN5A Variant G319S Detail

We estimate the penetrance of LQTS for SCN5A G319S around 6% and the Brugada syndrome penetrance around 9%. SCN5A G319S was found in a total of 16 carriers in 4 papers and/or in gnomAD: 1 had Brugada syndrome, 1 had LQTS. G319S is present in 14 alleles in gnomAD. G319S has been functionally characterized in 4 papers. This residue is located in a Mild_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 (1 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 G319S around 6% (1/26) and the Brugada syndrome penetrance around 9% (2/26).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-5.29 0.058 -0.87 0.79 13 2
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
11076825 2000 1 0 1 0
11901046 2002 1 0 1 0
16712702 2006 1 0 0 1 Sudden adult death syndrome
24606995 2014 1 1 0 0
LITERATURE, COHORT, AND GNOMAD: - 16 14 1 1 -
VARIANT FEATURES ALONE: - 15 14 0 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.

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)
11076825 2000
11901046 2002
16712702 2006
24606995 2014

G319S has 24 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
287 14
341 15 C341Y,
342 12
339 12
346 13 E346D, E346K, E346X, E346G,
319 0 G319S, G319C, G319R,
317 7 K317E, K317M, K317N,
284 10
282 8 R282H, R282C,
279 11
321 7 S321Y,
344 11 A344S,
340 12 R340Q, R340W,
285 9 T285K,
338 13
345 11
322 11
280 11 C280Y,
318 5
281 8 V281M,
323 11
283 10
286 13 A286V, A286S,
320 3 T320N,