Key result
The novel heterozygous SCN5A mutation p.A1428S, identified in a family with Brugada syndrome, significantly reduced peak sodium current density from -220.82 pA/pF to -136.44 pA/pF compared to wild-type channels.
The identification and functional characterization of the novel SCN5A A1428S mutation supports the hypothesis that reduced Nav1.5 channel function contributes to Brugada syndrome pathogenesis.
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Novel A1428S SCN5A variant in resuscitated BrS patient; hypothesis-generating and should not yet alter management or counseling.
Brugada syndrome (BrS) is a rare, inherited arrhythmia syndrome. The most well‑known gene that is responsible for causing BrS is SCN5A, which encodes the human cardiac Na+ channel (Nav1.5) α subunit. To date, it has been reported that >100 mutations in SCN5A can cause BrS. In the present study, a novel BrS‑associated Nav1.5 mutation, A1428S, was identified in a proband who was successfully resuscitated from an episode of sudden collapse during walking. This mutation was further confirmed by polymerase chain reaction (PCR)‑restriction fragment length polymorphism analysis, which showed that the PCR fragment containing the mutation A1428S could be cut by the restriction enzyme Nsi1, yielding two shorter DNA fragments of 329 and 159 bp, which were not present in family members homozygous for the wild‑type (WT) allele. Furthermore, the electrophysiological properties were analyzed by patch clamp technique. Current density was decreased in the A1428S mutant compared that in the WT. However, neither the steady‑state activation or inactivation, nor the recovery from inactivation exhibited changes between the A1428S mutant and the WT. In conclusion, the results of this study are consistent with the hypothesis that a reduction in Nav1.5 channel function is involved in the pathogenesis of BrS. The structural‑functional study of the Nav1.5 channel enhances the present understanding the pathophysiological function of the channel.
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ZHU et al. (2015) studied Brugada syndrome (n=28). SCN5A p.A1428S mutation vs. Wild-type SCN5A was evaluated on Mean peak sodium current density at -30 mV (pA/pF) (p=<0.05). The novel heterozygous SCN5A mutation p.A1428S, identified in a family with Brugada syndrome, significantly reduced peak sodium current density from -220.82 pA/pF to -136.44 pA/pF compared to wild-type channels.
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