chr3-38566414-C-T

Variant summary

Our verdict is Uncertain significance. Variant got 5 ACMG points: 5P and 0B. PM2PP2PP3_Moderate

The NM_001099404.2(SCN5A):​c.3835G>A​(p.Val1279Ile) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.000128 in 1,613,294 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Uncertain significance (★★).

Frequency

Genomes: 𝑓 0.00011 ( 0 hom., cov: 33)
Exomes 𝑓: 0.00013 ( 0 hom. )

Consequence

SCN5A
NM_001099404.2 missense

Scores

9
9
2

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:10B:1O:1

Conservation

PhyloP100: 7.91
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]

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ACMG classification

Classification made for transcript

Verdict is Uncertain_significance. Variant got 5 ACMG points.

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 4.7729 (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, 0.881

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE UniProt
SCN5ANM_001099404.2 linkuse as main transcriptc.3835G>A p.Val1279Ile missense_variant 21/28 ENST00000413689.6
SCN5ANM_000335.5 linkuse as main transcriptc.3832G>A p.Val1278Ile missense_variant 21/28 ENST00000423572.7

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Appris UniProt
SCN5AENST00000413689.6 linkuse as main transcriptc.3835G>A p.Val1279Ile missense_variant 21/285 NM_001099404.2 P4
SCN5AENST00000423572.7 linkuse as main transcriptc.3832G>A p.Val1278Ile missense_variant 21/281 NM_000335.5 A1Q14524-2

Frequencies

GnomAD3 genomes
AF:
0.000105
AC:
16
AN:
152212
Hom.:
0
Cov.:
33
show subpopulations
Gnomad AFR
AF:
0.0000724
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.0000654
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.000207
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00316
Gnomad NFE
AF:
0.000147
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000915
AC:
23
AN:
251278
Hom.:
0
AF XY:
0.000103
AC XY:
14
AN XY:
135820
show subpopulations
Gnomad AFR exome
AF:
0.0000616
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.0000654
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.000150
Gnomad OTH exome
AF:
0.000490
GnomAD4 exome
AF:
0.000131
AC:
191
AN:
1461082
Hom.:
0
Cov.:
31
AF XY:
0.000135
AC XY:
98
AN XY:
726814
show subpopulations
Gnomad4 AFR exome
AF:
0.0000897
Gnomad4 AMR exome
AF:
0.00
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.0000504
Gnomad4 SAS exome
AF:
0.0000232
Gnomad4 FIN exome
AF:
0.0000188
Gnomad4 NFE exome
AF:
0.000151
Gnomad4 OTH exome
AF:
0.000232
GnomAD4 genome
AF:
0.000105
AC:
16
AN:
152212
Hom.:
0
Cov.:
33
AF XY:
0.0000941
AC XY:
7
AN XY:
74364
show subpopulations
Gnomad4 AFR
AF:
0.0000724
Gnomad4 AMR
AF:
0.0000654
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.000207
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.000147
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.000128
Hom.:
0
Bravo
AF:
0.0000793
TwinsUK
AF:
0.00
AC:
0
ALSPAC
AF:
0.000259
AC:
1
ESP6500AA
AF:
0.00
AC:
0
ESP6500EA
AF:
0.000116
AC:
1
ExAC
AF:
0.000165
AC:
20
Asia WGS
AF:
0.000289
AC:
1
AN:
3478
EpiCase
AF:
0.000164
EpiControl
AF:
0.0000593

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:10Benign:1Other:1
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Uncertain:3
Uncertain significance, criteria provided, single submitterclinical testingGeneDxDec 28, 2020Reported in a patient with DCM and arrhythmia (McNair et al., 2011) and in a patient with Brugada syndrome who also harbors a nonsense variant in the SCN5A gene (Catalano et al., 2009); Reported in ClinVar as a variant of uncertain significance (ClinVar Variant ID# 67829; Landrum et al., 2016); In silico analysis supports that this missense variant does not alter protein structure/function; This variant is associated with the following publications: (PMID: 24772081, 24300601, 25637381, 30930557, 29871609, 23299917, 25351510, 26916278, 27554632, 19561025, 21596231, 22581653, 28706299, 25904541, 32533946, 32880476) -
Uncertain significance, no assertion criteria providedclinical testingJoint Genome Diagnostic Labs from Nijmegen and Maastricht, Radboudumc and MUMC+-- -
Uncertain significance, no assertion criteria providedclinical testingClinical Genetics, Academic Medical Center-- -
Brugada syndrome Uncertain:3
Uncertain significance, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpOct 18, 2022This sequence change replaces valine, which is neutral and non-polar, with isoleucine, which is neutral and non-polar, at codon 1279 of the SCN5A protein (p.Val1279Ile). This variant is present in population databases (rs199473341, gnomAD 0.02%). This missense change has been observed in individual(s) with dilated cardiomyopathy or Brugada syndrome (PMID: 19561025, 21596231, 32880476). ClinVar contains an entry for this variant (Variation ID: 67829). Algorithms developed to predict the effect of missense changes on protein structure and function (SIFT, PolyPhen-2, Align-GVGD) all suggest that this variant is likely to be disruptive. Experimental studies have shown that this missense change does not substantially affect SCN5A function (PMID: 32533946). 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. -
Uncertain significance, criteria provided, single submitterclinical testingMolecular Genetics, Royal Melbourne HospitalJan 05, 2024This sequence change in SCN5A is predicted to replace valine with isoleucine at codon 1278, p.(Val1278Ile). This variant has been reported as p.Val1279Ile in the literature. The valine residue is highly conserved (100 vertebrates, Multiz alignments), and is located in the transmembrane region, a region, amino acids 1207-1466, that is defined as a mutational hotspot (PMID: 32893267). There is a small physicochemical difference between valine and isoleucine. The highest population minor allele frequency in the population database gnomAD v4.0 is 0.013% (178/1,179,534 alleles) in the European non-Finnish population. This variant has been reported in individuals with dilated cardiomyopathy (PMID: 32880476, 21596231). This variant has been observed in an individual with a clinical diagnosis of Brugada syndrome and a pathogenic SCN5A truncating variant (PMID: 19561025). A high-throughput patch-clamp study in HEK293T cells investigating the function of suspected Brugada syndrome variants showed that this variant had no impact on protein function (PMID: 32533946). Computational evidence predicts a deleterious effect for the missense substitution (REVEL = 0.868). Based on the classification scheme RMH Modified ACMG/AMP Guidelines v1.6.1, this variant is classified as a VARIANT OF UNCERTAIN SIGNIFICANCE. Following criteria are met: BP5, BS3_Supporting, PM1, PP3. -
Uncertain significance, criteria provided, single submitterclinical testingMolecular Genetics Laboratory, BC Children's and BC Women's HospitalsJun 21, 2019- -
Cardiac arrhythmia Uncertain:2
Uncertain significance, criteria provided, single submitterclinical testingAll of Us Research Program, National Institutes of HealthJan 11, 2024This missense variant replaces valine with isoleucine at codon 1279 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). A functional study using a patch clamp method has determined this variant to be benign (PMID 32533946). This variant has been reported in an individual affected with Brugada syndrome, who also carried a pathogenic truncation variant in the same gene (PMID: 19561025). This variant has been reported in an individual affected with dilated cardiomyopathy (PMID: 21596231). This variant has been identified in 27/282678 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 HealthDec 21, 2022This missense variant replaces valine with isoleucine at codon 1279 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). A high-throughput functional study suggested this variant may be benign (PMID 32533946). This variant has been reported in an individual affected with Brugada syndrome, who also carried a pathogenic truncation variant in the same gene (PMID: 19561025). This variant has been reported in an individual affected with dilated cardiomyopathy (PMID: 21596231). This variant has been identified in 27/282678 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. -
Primary dilated cardiomyopathy Benign: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 Dilated cardiomyopathy in the following publications (PMID:21596231). This is a literature report, and does not necessarily reflect the clinical interpretation of the Imperial College / Royal Brompton Cardiovascular Genetics laboratory. -
Likely benign, no assertion criteria providedresearchCSER _CC_NCGL, University of WashingtonJun 01, 2014- -
SUDDEN INFANT DEATH SYNDROME;C1832680:Dilated cardiomyopathy 1E;C1837845:Sick sinus syndrome 1;C1859062:Long QT syndrome 3;C1879286:Progressive familial heart block, type 1A;C2751898:Ventricular fibrillation, paroxysmal familial, type 1;C3151464:Atrial fibrillation, familial, 10;C4551804:Brugada syndrome 1 Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingFulgent Genetics, Fulgent GeneticsOct 12, 2021- -
Cardiovascular phenotype Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingAmbry GeneticsJul 12, 2021The c.3835G>A (p.V1279I) alteration is located in exon 21 (coding exon 20) of the SCN5A gene. This alteration results from a G to A substitution at nucleotide position 3835, causing the valine (V) at amino acid position 1279 to be replaced by an isoleucine (I). 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
Uncertain
0.45
CardioboostCm
Pathogenic
0.98
BayesDel_addAF
Pathogenic
0.36
D
BayesDel_noAF
Pathogenic
0.54
CADD
Uncertain
25
DANN
Uncertain
1.0
DEOGEN2
Uncertain
0.78
.;.;.;.;.;D;.;.;.
Eigen
Uncertain
0.61
Eigen_PC
Uncertain
0.49
FATHMM_MKL
Pathogenic
0.98
D
LIST_S2
Uncertain
0.95
.;D;D;D;D;D;D;.;D
M_CAP
Pathogenic
0.62
D
MetaRNN
Pathogenic
0.88
D;D;D;D;D;D;D;D;D
MetaSVM
Pathogenic
1.1
D
MutationAssessor
Pathogenic
3.3
.;.;.;.;.;M;.;.;.
MutationTaster
Benign
1.0
D;D;D;D;D;D;D;D;D;D
PrimateAI
Uncertain
0.76
T
PROVEAN
Benign
-0.95
N;N;N;N;N;N;N;N;N
REVEL
Pathogenic
0.87
Sift
Uncertain
0.016
D;D;D;D;D;D;D;D;D
Sift4G
Uncertain
0.0060
D;D;D;D;D;D;D;D;D
Polyphen
0.97
D;D;.;D;.;D;D;.;.
Vest4
0.96
MVP
0.99
MPC
1.3
ClinPred
0.71
D
GERP RS
3.9
Varity_R
0.28
gMVP
0.94

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.0
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: rs199473341; hg19: chr3-38607905; COSMIC: COSV61117804; API