KCNH2 Variant D591A Detail

We estimate the penetrance of LQTS for KCNH2 D591A is 27%. We are unaware of any observations of this variant in individuals. D591A is not present in gnomAD. D591A has been functionally characterized in 1 papers. 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 2 individuals with LQT2 and 8 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 D591A around 27% (2/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-2.89 0.009 -2 0.678 31
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 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)
15975984 Xeno 1.3 -2.0 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)
15975984 Xeno None None None

D591A has 35 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
591 0 D591N, D591H,
590 4 G590V, G590D,
592 5 Q592X,
588 5 N588D, N588K, N588K,
589 6 L589P,
596 7 P596R, P596S, P596T, P596L,
593 7 I593X, I593V, I593R, I593K, I593T,
594 7
587 8
595 8 K595E, K595N, K595N,
597 9 Y597C, Y597H,
586 10 L586M,
584 10 G584S, G584R, G584C,
605 11 P605L,
583 11 I583V,
633 11 N633I, N633D, N633S,
604 11 G604C, G604S, G604D,
585 11 W585C, W585C,
629 12 N629I, N629S, N629K, N629D, N629T, N629K,
583 12 I583V,
630 12 V630I, V630A, V630T,
631 13 S631F,
603 13 G603D,
633 13 N633I, N633D, N633S,
613 14 T613M, T613A, T613K, T613L,
628 14 G628S, G628Del, G628D, G628V, G628A, G628R,
584 14 G584S, G584R, G584C,
610 14
606 14 S606P, S606F, S606Del,
609 14 D609N, D609G,
592 14 Q592X,
588 14 N588D, N588K, N588K,
634 14 T634A, T634P, T634I, T634S, T634S,
631 15 S631F,
632 15 P632A, P632S,