KCNH2 Variant T421M Detail

We estimate the penetrance of LQTS for KCNH2 T421M is 81%. This variant was found in a total of 1 carriers in 1 papers or gnomAD, 1 had LQTS. T421M is not present in gnomAD. T421M has been functionally characterized in 1 papers. This residue is located in a Hotspot region for LQT2. In silico predictions, functional data (if available), and location in structure are equivalent to observing 7 individuals with LQT2 and 3 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 T421M around 81% (8/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-5.71 1.0 -1 0.955 87
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 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 LQT2 Other Disease
15840476 2005 1 0 1
LITERATURE, COHORT, AND GNOMAD: - 1 0 1 -
VARIANT FEATURES ALONE: - 10 3 7 -
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 Homozygously Collected

Steady state (S.S.) and peak tail 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. Recovery from inactivation (Rec. inact.) and deactivation time (Deactivation) are the ratio of characteristic time constants with wildtype (unitless).

PubMed ID Cell Type S.S Peak (%WT) Peak Tail IKr (%WT) V1/2 Act. V1/2 Inact. Recov. Inact. Deactivation (%WT)
23136156 murine 22 41.8 None None None

Functional Data Heterozygously Collected

Functional parameters are the same as defined above.

PubMed ID Cell Type S.S Peak (%WT) Peak Tail IKr (%WT) V1/2 Act. V1/2 Inact. Deactivation (%WT)
23136156 murine 41 12.0 None None

T421M has 64 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. NOTE: some residues appear multiple times at different distances since the functional KV11.1 channel (protein product of KCNH2/hERG) is a homotetramer and occasionally the same residue from multiple subunits is present within the 15A window. 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
421 0 T421M, T421fsX,
422 4 A422T,
420 5 Y420C,
418 5
425 6
531 6 R531Q, R531W, R531Del,
528 6 R528X, R528P, R528W,
419 6
423 6
529 7
417 7
424 7
459 8
532 8
426 8 P426H,
456 9 D456Y,
463 9 F463L, F463L, F463L,
527 9
416 9
530 10
460 10 D460fsX,
526 10
559 10 L559H, L559F,
415 10
563 10 W563X, W563C, W563G, W563C,
504 10 A504V,
525 10 K525N, K525N,
414 10 I414fsX,
428 10 S428L, S428fsX, S428X,
534 11 R534C,
562 11 H562Q, H562Q, H562R, H562P,
455 11
533 12
427 12 Y427H, Y427C, Y427S,
535 12 V535M,
462 12 M462Ins,
458 12
429 12 A429P, A429V,
452 12
413 13 L413P,
457 13 L457P,
505 13 A505V,
555 13
501 13 D501N, D501Y, D501H,
453 13
556 13
503 13
461 13
558 14 A558P, A558V, A558E,
566 14 C566S, C566F, C566G, C566S, C566R,
466 14 D466E, D466E,
560 14 I560fsX, I560M,
507 14 P507L, P507S,
524 14
506 14 I506V,
464 14 I464X,
430 14
500 15 I500Del,
454 15
522 15 G522E,
552 15 L552S,
536 15 A536X,
561 15 A561T, A561P, A561V,
523 15