KCNH2 Variant P596L Detail

We estimate the penetrance of LQTS for KCNH2 P596L is 89%. This variant was found in a total of 3 carriers in 2 papers or gnomAD, 3 had LQTS. P596L is not present in gnomAD. P596L 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 8 individuals with LQT2 and 2 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 P596L around 89% (11/13).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-4.468 0.888 -3 0.726 92
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
24667783 2015 1 0 1
11854117 2002 2 0 2
LITERATURE, COHORT, AND GNOMAD: - 3 0 3 -
VARIANT FEATURES ALONE: - 10 2 8 -
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.

P596L has 23 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
596 0 P596S, P596T, P596L, P596R,
597 5 Y597C, Y597H,
590 5 G590V, G590D,
595 5 K595N, K595E, K595N,
594 6
604 6 G604C, G604S, G604D,
591 7 D591H, D591N,
603 7 G603D,
605 8 P605L,
593 8 I593T, I593X, I593K, I593V, I593R,
587 9
589 9 L589P,
592 11 Q592X,
586 11 L586M,
588 11 N588K, N588K, N588D,
606 12 S606F, S606P, S606Del,
610 13
584 13 G584R, G584S, G584C,
583 14 I583V,
609 14 D609G, D609N,
583 14 I583V,
576 14
585 14 W585C, W585C,