KCNH2 Variant N588K Detail

We estimate the penetrance of LQTS for KCNH2 N588K is 23%. This variant was found in a total of 1 carriers in 5 papers or gnomAD (version 4), 0 had LQTS. N588K is not present in gnomAD. We have tested the trafficking efficiency of this variant, 132% of WT with a standard error of 23%; 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. N588K has been functionally characterized in 8 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 2 individuals with LQT2 and 8 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 N588K around 23% (2/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-3.896 0.071 0 0.601 59
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
29759541 2017 16 0 Short QT
14676148 2004 7 0 short QT syndrome
29574456 2018 1 0 short QT
25335996 2014 1 1 Short QT
29016797 2018 1 0 Short QT
LITERATURE, COHORT, AND GNOMAD: - 1 1 0 -
VARIANT FEATURES ALONE: - 10 8 2 -
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)
14676148 HEK293 300 None None None None
15673388 HEK293 None None None None
16011830 CHO -2.34 61.91 None None
16039272 HEK293 514 None 102.3 None None
18724381 None 100 None None None None
19088443 HEK293 350 44.2 129.2 None None
19439805 CHO 71 None None None None
31072576 hiPSC-CM 400 None 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)
14676148 HEK293 None None None
15673388 HEK293 None None None
16011830 CHO None None None
16039272 HEK293 None None None
18724381 None None None None
19088443 HEK293 18.7 112.2 None
19439805 CHO None None None
31072576 hiPSC-CM None None None

N588K has 57 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
588 0 N588K, N588D, N588K,
589 5 L589P,
591 5 D591H, D591N,
592 6 Q592X,
584 6 G584C, G584S, G584R,
590 6 G590D, G590V,
587 6
585 7 W585C, W585C,
586 7 L586M,
631 8 S631F,
630 8 V630I, V630A, V630T,
583 8 I583V,
633 9 N633I, N633S, N633D,
629 9 N629S, N629K, N629K, N629D, N629I, N629T,
593 9 I593K, I593R, I593V, I593T, I593X,
628 10 G628R, G628Del, G628A, G628V, G628S, G628D,
632 10 P632A, P632S,
592 11 Q592X,
613 11 T613K, T613A, T613L, T613M,
629 11 N629S, N629K, N629K, N629D, N629I, N629T,
597 11 Y597C, Y597H,
596 11 P596L, P596S, P596T, P596R,
633 11 N633I, N633S, N633D,
637 11 E637G, E637X, E637K,
594 11
634 11 T634S, T634P, T634S, T634I, T634A,
605 11 P605L,
595 12 K595N, K595N, K595E,
572 12 G572C, G572D, G572R, G572S,
568 12 W568C, W568C,
610 12
617 13 F617L, F617L, F617V, F617L,
628 13 G628R, G628Del, G628A, G628V, G628S, G628D,
593 13 I593K, I593R, I593V, I593T, I593X,
614 13 A614T, A614V,
609 13 D609G, D609N,
604 13 G604C, G604S, G604D,
616 13 Y616S,
576 13
632 13 P632A, P632S,
631 13 S631F,
627 14 F627L, F627fsX, F627L, F627X, F627L,
638 14 K638R, K638E, K638D, K638Del,
569 14 Y569X, Y569H, Y569C,
571 14 I571V, I571L,
573 14
638 14 K638R, K638E, K638D, K638Del,
591 14 D591H, D591N,
606 14 S606F, S606Del, S606P,
627 14 F627L, F627fsX, F627L, F627X, F627L,
577 14
634 15 T634S, T634P, T634S, T634I, T634A,
612 15 V612L, V612L, V612A,
594 15
583 15 I583V,
628 15 G628R, G628Del, G628A, G628V, G628S, G628D,
636 15