KCNH2 Variant R5M Detail

We estimate the penetrance of LQTS for KCNH2 R5M is 12%. We are unaware of any observations of this variant in individuals. R5M is not present in gnomAD. We have tested the trafficking efficiency of this variant, 87% of WT with a standard error of 18%; in our analysis we used SE < 20% as 'high quality'. Approximately below 50% of WT is considered PS3 moderate and below 30% is PS3 strong. R5M has not been functionally characterized. This residue is located in a Mild_Hotspot region for LQT2. In silico predictions, functional data (if available), and location in structure are equivalent to observing 1 individuals with LQT2 and 9 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 R5M around 12% (1/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-3.182 0.749 -2 0.883 29
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
LITERATURE, COHORT, AND GNOMAD: - 0 0 0 -
VARIANT FEATURES ALONE: - 10 9 1 -
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.

R5M has 53 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
5 0
6 5 G6R,
403 6
695 6
698 7 E698K, E698X,
699 7 E699D, E699D,
4 7
3 7
402 7 H402R,
7 8
481 9
482 9 V482A,
476 9 V476I,
8 9
702 9
694 9 R694H, R694C,
401 10
404 10
691 11
474 11 T474I,
696 11 R696C, R696H,
697 11 L697X,
692 11
541 12 R541H, R541C,
480 12 E480V,
483 12 V483I,
475 12 Y475Del, Y475C,
693 13 L693X,
9 13 A9V, A9T,
405 13
703 13
765 13
701 13
544 13 E544fsX, E544A,
540 13 D540fsX,
477 13
700 13
478 13 A478D,
408 13
681 13 R681W,
677 14 M677T,
407 14
766 14
764 14
690 14
484 14
473 14 T473P,
400 14 I400N,
680 15
684 15
689 15
10 15
767 15 D767X,