KCNH2 Variant L586M Detail

We estimate the penetrance of LQTS for KCNH2 L586M is 41%. This variant was found in a total of 3 carriers in 2 papers or gnomAD (version 4), 3 had LQTS. L586M is not present in gnomAD. We have tested the trafficking efficiency of this variant, 0% of WT with a standard error of 2%; 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. L586M has not been functionally characterized. 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 3 individuals with LQT2 and 7 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 L586M around 41% (6/13).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-1.897 0.999 2 0.791 86
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
Italy Cohort 2020 2 0 2
22402334 2012 1 0 1
LITERATURE, COHORT, AND GNOMAD: - 3 0 3 -
VARIANT FEATURES ALONE: - 10 7 3 -
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.

L586M 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
586 0 L586M,
585 4 W585C, W585C,
587 5
589 6 L589P,
572 6 G572C, G572D, G572R, G572S,
584 6 G584C, G584S, G584R,
610 7
588 7 N588K, N588D, N588K,
590 7 G590D, G590V,
573 8
605 8 P605L,
569 8 Y569X, Y569H, Y569C,
597 8 Y597C, Y597H,
576 8
568 9 W568C, W568C,
613 9 T613K, T613A, T613L, T613M,
583 9 I583V,
604 10 G604C, G604S, G604D,
571 10 I571V, I571L,
591 10 D591H, D591N,
609 10 D609G, D609N,
614 10 A614T, A614V,
630 10 V630I, V630A, V630T,
570 10
637 10 E637G, E637X, E637K,
592 10 Q592X,
593 10 I593K, I593R, I593V, I593T, I593X,
606 11 S606F, S606Del, S606P,
595 11 K595N, K595N, K595E,
596 11 P596L, P596S, P596T, P596R,
631 11 S631F,
575 11 E575K,
607 11
633 11 N633I, N633S, N633D,
603 11 G603D,
634 11 T634S, T634P, T634S, T634I, T634A,
577 12
632 12 P632A, P632S,
431 12 F431L, F431L, F431L,
617 12 F617L, F617L, F617V, F617L,
574 12 M574V, M574L, M574L,
594 12
612 12 V612L, V612L, V612A,
565 13
629 13 N629S, N629K, N629K, N629D, N629I, N629T,
611 13 Y611D,
636 13
566 13 C566S, C566R, C566G, C566F, C566S,
430 14
616 14 Y616S,
567 14 I567M, I567T,
633 14 N633I, N633S, N633D,
638 14 K638R, K638E, K638D, K638Del,
615 14 L615V, L615F,
608 14
628 14 G628R, G628Del, G628A, G628V, G628S, G628D,
640 14 F640Del, F640V, F640L, F640L, F640L,
635 15 N635I,