KCNH2 Variant R528P Detail

We estimate the penetrance of LQTS for KCNH2 R528P is 12%. This variant was found in a total of 1 carriers in 1 papers or gnomAD (version 4), 0 had LQTS. R528P is not present in gnomAD. We have tested the trafficking efficiency of this variant, 24% of WT with a standard error of 21%; 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. R528P 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 R528P around 12% (1/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-6.709 0.741 -2 0.96 39
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
16922724 2006 1 1
LITERATURE, COHORT, AND GNOMAD: - 1 1 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.

R528P has 58 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
528 0 R528P, R528X, R528W,
527 5
525 5 K525N, K525N,
531 6 R531Q, R531Del, R531W,
425 6
421 6 T421fsX, T421M,
504 6 A504V,
526 6
529 7
460 7 D460fsX,
456 8 D456Y,
530 8
459 8
505 9 A505V,
507 9 P507L, P507S,
524 9
463 9 F463L, F463L, F463L,
506 9 I506V,
420 9 Y420C,
422 9 A422T,
503 9
426 9 P426H,
428 10 S428L, S428X, S428fsX,
418 10
508 10
424 10
522 10 G522E,
457 11 L457P,
429 11 A429V, A429P,
417 11
523 11
423 11
532 11
502 12 M502I, M502I, M502I,
501 12 D501N, D501H, D501Y,
461 12
464 12 I464X,
534 12 R534C,
453 12
458 12
419 12
455 12
500 13 I500Del,
462 13 M462Ins,
533 13
452 13
563 13 W563C, W563C, W563X, W563G,
427 13 Y427S, Y427C, Y427H,
521 14
414 14 I414fsX,
430 14
454 14
509 14 D509N,
466 14 D466E, D466E,
432 15
467 15
416 15
562 15 H562Q, H562R, H562Q, H562P,