SCN5A Variant T320N Detail

We estimate the penetrance of LQTS for SCN5A T320N around 4% and the Brugada syndrome penetrance around 26%. SCN5A T320N was found in a total of 3 carriers in 1 papers and/or in gnomAD: 1 had Brugada syndrome, 0 had LQTS. T320N is present in 2 alleles in gnomAD. T320N has been functionally characterized in 1 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 (2 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 T320N around 4% (0/13) and the Brugada syndrome penetrance around 26% (3/13).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-2.36 0.997 0.53 0.443 32 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
20129283 2010 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 3 2 0 1 -
VARIANT FEATURES ALONE: - 15 13 0 2 - -
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)
20129283 2010

T320N has 30 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 12
277 12
341 13 C341Y,
342 10
326 14
339 12
346 10 E346D, E346X, E346K, E346G,
319 3 G319S, G319C, G319R,
325 14 L325R,
348 14 P348A,
317 6 K317N, K317E, K317M,
284 13
282 9 R282H, R282C,
279 8
324 13
321 4 S321Y,
344 8 A344S,
340 12 R340W, R340Q,
285 12 T285K,
338 14
345 8
322 9
278 13 H278D, H278R,
280 10 C280Y,
318 7
281 7 V281M,
323 9
347 13
283 11
320 0 T320N,