3-38630420-C-T

Variant summary

Our verdict is Likely pathogenic. Variant got 6 ACMG points: 6P and 0B. PM1PM2PP2PP3

The NM_000335.5(SCN5A):​c.283G>A​(p.Val95Ile) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0000137 in 1,608,614 control chromosomes in the GnomAD database, including 1 homozygotes. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Uncertain significance (★★).

Frequency

Genomes: 𝑓 0.000020 ( 0 hom., cov: 32)
Exomes 𝑓: 0.000013 ( 1 hom. )

Consequence

SCN5A
NM_000335.5 missense

Scores

10
7
3

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts P:1U:6O:1

Conservation

PhyloP100: 7.90
Variant links:
Genes affected
SCN5A (HGNC:10593): (sodium voltage-gated channel alpha subunit 5) The protein encoded by this gene is an integral membrane protein and tetrodotoxin-resistant voltage-gated sodium channel subunit. This protein is found primarily in cardiac muscle and is responsible for the initial upstroke of the action potential in an electrocardiogram. Defects in this gene have been associated with long QT syndrome type 3 (LQT3), atrial fibrillation, cardiomyopathy, and Brugada syndrome 1, all autosomal dominant cardiac diseases. Alternative splicing results in several transcript variants encoding different isoforms. [provided by RefSeq, May 2022]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Likely_pathogenic. Variant got 6 ACMG points.

PM1
In a topological_domain Cytoplasmic (size 130) in uniprot entity SCN5A_HUMAN there are 19 pathogenic changes around while only 2 benign (90%) in NM_000335.5
PM2
Very rare variant in population databases, with high coverage;
PP2
Missense variant in gene, where missense usually causes diseases (based on misZ statistic), SCN5A. . Gene score misZ 2.7504 (greater than the threshold 3.09). Trascript score misZ 4.8279 (greater than threshold 3.09). GenCC has associacion of gene with progressive familial heart block, type 1A, Brugada syndrome, familial sick sinus syndrome, short QT syndrome, paroxysmal familial ventricular fibrillation, progressive familial heart block, long QT syndrome 3, familial atrial fibrillation, catecholaminergic polymorphic ventricular tachycardia, dilated cardiomyopathy, dilated cardiomyopathy 1E, arrhythmogenic right ventricular cardiomyopathy, Brugada syndrome 1, atrial standstill, familial isolated dilated cardiomyopathy, familial long QT syndrome, sick sinus syndrome 1.
PP3
MetaRNN computational evidence supports a deleterious effect, 0.794

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
SCN5ANM_001099404.2 linkuse as main transcriptc.283G>A p.Val95Ile missense_variant 3/28 ENST00000413689.6 NP_001092874.1 Q14524H9KVD2
SCN5ANM_000335.5 linkuse as main transcriptc.283G>A p.Val95Ile missense_variant 3/28 ENST00000423572.7 NP_000326.2 Q14524-2Q86V90

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
SCN5AENST00000413689.6 linkuse as main transcriptc.283G>A p.Val95Ile missense_variant 3/285 NM_001099404.2 ENSP00000410257.1 H9KVD2
SCN5AENST00000423572.7 linkuse as main transcriptc.283G>A p.Val95Ile missense_variant 3/281 NM_000335.5 ENSP00000398266.2 Q14524-2

Frequencies

GnomAD3 genomes
AF:
0.0000197
AC:
3
AN:
152174
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0000441
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000281
AC:
7
AN:
249414
Hom.:
1
AF XY:
0.00
AC XY:
0
AN XY:
135290
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.000166
Gnomad SAS exome
AF:
0.0000653
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000177
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000130
AC:
19
AN:
1456324
Hom.:
1
Cov.:
28
AF XY:
0.00000552
AC XY:
4
AN XY:
724920
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.00
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.0000504
Gnomad4 SAS exome
AF:
0.0000464
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.00000994
Gnomad4 OTH exome
AF:
0.0000332
GnomAD4 genome
AF:
0.0000197
AC:
3
AN:
152290
Hom.:
0
Cov.:
32
AF XY:
0.00
AC XY:
0
AN XY:
74456
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.0000441
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.0000673
Hom.:
1
Bravo
AF:
0.0000416
ExAC
AF:
0.0000330
AC:
4
EpiCase
AF:
0.0000545
EpiControl
AF:
0.00

ClinVar

Significance: Uncertain significance
Submissions summary: Pathogenic:1Uncertain:6Other:1
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Cardiac arrhythmia Uncertain:2
Uncertain significance, criteria provided, single submitterclinical testingAll of Us Research Program, National Institutes of HealthNov 02, 2023This missense variant replaces valine with isoleucine at codon 95 of the SCN5A protein. Computational prediction suggests that this variant may have deleterious impact on protein structure and function (internally defined REVEL score threshold >= 0.7, PMID: 27666373). An experimental functional study has shown that this variant does not change sodium channel function in vitro (PMID: 23805106). This variant has been identified in an individual affected with Brugada syndrome (PMID: 17081365, 20877689), in an individual affected with sudden death (PMID: 24529773), and in another individual affected with left ventricular noncompaction (PMID: 33500567). This variant has been identified in 7/249414 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -
Uncertain significance, criteria provided, single submitterclinical testingColor Diagnostics, LLC DBA Color HealthMay 26, 2023This missense variant replaces valine with isoleucine at codon 95 of the SCN5A protein. Computational prediction suggests that this variant may have deleterious impact on protein structure and function (internally defined REVEL score threshold >= 0.7, PMID: 27666373). An experimental functional study has shown that this variant does not change sodium channel function in vitro (PMID: 23805106). This variant has been identified in an individual affected with Brugada syndrome (PMID: 17081365, 20877689), in an individual affected with sudden death (PMID: 24529773), and in another individual affected with left ventricular noncompaction (PMID: 33500567). This variant has been identified in 7/249414 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -
Brugada syndrome Uncertain:1Other:1
not provided, no classification providedliterature onlyCardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust-This variant has been reported as associated with Brugada syndrome in the following publications (PMID:17081365;PMID:20877689). This is a literature report, and does not necessarily reflect the clinical interpretation of the Imperial College / Royal Brompton Cardiovascular Genetics laboratory. -
Uncertain significance, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpSep 01, 2022This sequence change replaces valine, which is neutral and non-polar, with isoleucine, which is neutral and non-polar, at codon 95 of the SCN5A protein (p.Val95Ile). This variant is present in population databases (rs199473054, gnomAD 0.02%). This missense change has been observed in individual(s) with Brugada syndrome or left ventricular noncompaction cardiomyopathy (PMID: 20877689, 31397097, 33500567). ClinVar contains an entry for this variant (Variation ID: 67761). Algorithms developed to predict the effect of missense changes on protein structure and function are either unavailable or do not agree on the potential impact of this missense change (SIFT: "Deleterious"; PolyPhen-2: "Benign"; Align-GVGD: "Class C25"). Experimental studies have shown that this missense change does not substantially affect SCN5A function (PMID: 23805106). In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. -
not provided Pathogenic:1
Likely pathogenic, flagged submissionclinical testingGeneDxNov 07, 2013p.Val95Ile (GTA>ATA): c.283 G>A in exon 3 of the SCN5A gene (NM_198056.2) The Val95Ile variant in the SCN5A gene has been reported previously in one Chinese individual diagnosed with Brugada syndrome, who also harbored the Ala1649Val variant in SCN5A (Liang P et al., 2006). Both variants were inherited from this patient's father who was asymptomatic and had a normal ECG, however, suggesting that V95I may not be pathogenic (Liang P et al., 2006). Additionally, Val95Ile was reported in one individual from a cohort of 120 sudden adult death cases in the Han Chinese (Hou Y et al., 2013). Mutations in nearby residues (Phe93Ser, Ile94Ser, Arg104Gln) have been reported in association with Brugada syndrome, further supporting the functional importance of this region of the protein. Furthermore, the Val95Ile variant was not observed in approximately 6300 individuals of European and African American ancestry in the NHLBI Exome Sequencing Project, indicating it is not a common benign variant in these populations. However, one in vitro functional study showed that this variant does not affect sodium channel function (Gutter C et al., 2013). In summary, Val95Ile is a good candidate for a disease-causing mutation. The variant is found in ARRHYTHMIA panel(s). -
not specified Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingLaboratory for Molecular Medicine, Mass General Brigham Personalized MedicineJan 10, 2017Variant identified in a genome or exome case(s) and assessed due to predicted null impact of the variant or pathogenic assertions in the literature or databases. Disclaimer: This variant has not undergone full assessment. The following are preliminary notes: This variant has been reported in 3 papers in HGMD, classified as DM related to Brugada syndrome. It has been seen in affected and unaffected patients. It is classified in ClinVar with 1 star as Likely Pathogenic by GeneDx (in 2013). -
Brugada syndrome 1 Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingMendelicsMay 28, 2019- -
Cardiovascular phenotype Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingAmbry GeneticsSep 10, 2024The c.283G>A (p.V95I) alteration is located in exon 3 (coding exon 2) of the SCN5A gene. This alteration results from a G to A substitution at nucleotide position 283, causing the valine (V) at amino acid position 95 to be replaced by an isoleucine (I). Based on data from gnomAD, the A allele has an overall frequency of 0.003% (7/249414) total alleles studied. The highest observed frequency was 0.017% (3/18028) of East Asian alleles. This variant was reported in multiple individuals with sudden unexplained or heart failure-related death, clinical features consistent with SCN5A-related arrhythmias and/or cardiomyopathy and/or a personal or family history of Brugada syndrome (Liang, 2010; Liu, 2014; Li, 2018; Amin, 2018; Mazzarotto, 2021). This amino acid position is highly conserved in available vertebrate species. This alteration is predicted to be deleterious by in silico analysis. Based on insufficient or conflicting evidence, the clinical significance of this alteration remains unclear. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.20
CardioboostCm
Pathogenic
0.93
BayesDel_addAF
Pathogenic
0.22
D
BayesDel_noAF
Pathogenic
0.34
CADD
Pathogenic
26
DANN
Uncertain
1.0
DEOGEN2
Uncertain
0.55
.;.;.;.;.;D;.;.;.;T
Eigen
Pathogenic
0.83
Eigen_PC
Pathogenic
0.79
FATHMM_MKL
Pathogenic
0.98
D
LIST_S2
Uncertain
0.93
.;D;D;D;D;D;D;.;D;D
M_CAP
Pathogenic
0.70
D
MetaRNN
Pathogenic
0.79
D;D;D;D;D;D;D;D;D;D
MetaSVM
Pathogenic
1.1
D
MutationAssessor
Uncertain
2.5
.;M;.;.;.;M;.;.;.;.
PrimateAI
Uncertain
0.75
T
PROVEAN
Benign
-0.95
N;N;N;N;N;N;N;N;N;.
REVEL
Pathogenic
0.86
Sift
Uncertain
0.016
D;D;D;D;D;D;D;D;D;.
Sift4G
Uncertain
0.026
D;D;D;D;D;D;D;D;D;D
Polyphen
1.0
D;D;.;D;.;D;D;.;.;.
Vest4
0.67
MutPred
0.76
Loss of catalytic residue at V95 (P = 0.0895);Loss of catalytic residue at V95 (P = 0.0895);Loss of catalytic residue at V95 (P = 0.0895);Loss of catalytic residue at V95 (P = 0.0895);Loss of catalytic residue at V95 (P = 0.0895);Loss of catalytic residue at V95 (P = 0.0895);Loss of catalytic residue at V95 (P = 0.0895);Loss of catalytic residue at V95 (P = 0.0895);Loss of catalytic residue at V95 (P = 0.0895);Loss of catalytic residue at V95 (P = 0.0895);
MVP
0.94
MPC
1.0
ClinPred
0.50
D
GERP RS
5.1
Varity_R
0.28
gMVP
0.72

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.070
Details are displayed if max score is > 0.2

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Publications

LitVar

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs199473054; hg19: chr3-38671911; COSMIC: COSV60067323; COSMIC: COSV60067323; API