KCNH2 Variant L564A Detail

We estimate the penetrance of LQTS for KCNH2 L564A is 62%. We are unaware of any observations of this variant in individuals. L564A is not present in gnomAD. L564A has been functionally characterized in 2 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 6 individuals with LQT2 and 4 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 L564A around 62% (6/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
None None None None 65
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 4 6 -
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)
19892737 Xeno -45.9 None None None
22573844 HEK293 1.0 31.0 None 1.074074074

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)
19892737 Xeno None None None
22573844 HEK293 None None None

L564A has 66 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
564 0 L564L,
565 5
561 5 A561V, A561T, A561P,
567 5 I567T, I567M,
618 5 T618S, T618S,
560 6 I560fsX, I560M,
563 6 W563C, W563G, W563X, W563C,
566 6 C566F, C566S, C566S, C566R, C566G,
640 7 F640Del, F640L, F640L, F640L, F640V,
644 7 V644F, V644I,
562 7 H562P, H562Q, H562R, H562Q,
568 8 W568C, W568C,
615 8 L615F, L615V,
614 8 A614T, A614V,
617 8 F617V, F617L, F617L, F617L,
622 9 L622F,
643 9
619 9
647 9
559 9 L559H, L559F,
621 9 S621R, S621N, S621R, S621R,
558 10 A558P, A558E, A558V,
641 10 S641P, S641F,
570 10
571 11 I571V, I571L,
557 11
648 11 G648A,
426 11 P426H,
611 11 Y611D,
620 11 S620I, S620G,
569 11 Y569X, Y569C, Y569H,
645 12 M645I, M645R, M645I, M645L, M645L, M645V, M645I,
651 12 M651K,
556 12
613 12 T613M, T613K, T613A, T613L,
430 12
637 12 E637X, E637K, E637G,
642 12 I642Del, I642V,
423 12
422 12 A422T,
616 13 Y616S,
623 13 T623I,
646 13
639 13 I639N, I639F,
431 13 F431L, F431L, F431L,
585 13 W585C, W585C,
612 13 V612A, V612L, V612L,
636 13
427 13 Y427H, Y427C, Y427S,
642 14 I642Del, I642V,
572 14 G572R, G572C, G572D, G572S,
630 14 V630T, V630A, V630I,
632 14 P632A, P632S,
649 14
529 14
429 14 A429P, A429V,
425 14
650 14 L650X,
645 14 M645I, M645R, M645I, M645L, M645L, M645V, M645I,
555 15
610 15
624 15 S624N, S624R, S624R, S624R,
638 15 K638E, K638R, K638Del, K638D,
631 15 S631F,
627 15 F627L, F627fsX, F627L, F627L, F627X,
573 15