SCN5A Variant D322A Detail

We estimate the penetrance of LQTS for SCN5A D322A around 4% and the Brugada syndrome penetrance around 38%. SCN5A D322A was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. D322A is not present in gnomAD. D322A 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 D322A around 4% (0/10) and the Brugada syndrome penetrance around 38% (3/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.861 54 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.

D322A has 37 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
277 12
326 13
276 13 L276Q, L276P,
348 8 P348A,
317 14 K317M, K317N, K317E,
279 8
278 14 H278R, H278D,
318 15
339 14
376 13 R376H, R376C,
871 13
354 15
282 14 R282C, R282H,
349 9 D349N,
319 11 G319C, G319S, G319R,
325 10 L325R,
324 8
321 4 S321Y,
872 10 D872N,
345 10
383 14
280 10 C280Y,
323 5
347 9
351 11 G351V, G351D, G351S, G351C,
320 9 T320N,
350 11 H350Q,
342 14
346 9 E346K, E346G, E346D, E346X,
344 11 A344S,
322 0
352 14 Y352C,
380 12
908 15
873 13 S873A,
281 12 V281M,
353 13 T353I,