KCNH2 Variant G604S Detail

We estimate the penetrance of LQTS for KCNH2 G604S is 72%. This variant was found in a total of 40 carriers in 13 papers or gnomAD (version 4), 36 had LQTS. G604S is not present in gnomAD. We have tested the trafficking efficiency of this variant, 0% of WT with a standard error of 9%; 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. G604S has been functionally characterized in 1 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 3 individuals with LQT2 and 7 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 G604S around 72% (39/50).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-3.85 1.0 0 0.958 91
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
Japan Cohort 2020 6 2 4
24103226 2014 1 0 1 Seizures
Italy Cohort 2020 5 0 5
11854117 2002 2 0 2
France Cohort 2020 9 1 8
10220144 1999 1 0 1
10973849 2000 1 0 1
14998624 2004 1 0 1
15840476 2005 4 0 4
17171344 2007 10 1 9
22402334 2012 1 0 1
22821100 2012 None 0 1
26496715 2015 2 0 2
LITERATURE, COHORT, AND GNOMAD: - 40 4 36 -
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.

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)
18386051 HEK293 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)
18386051 HEK293 31 -0.3 -9.3 1.0

G604S has 30 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
604 0 G604D, G604C, G604S,
605 3 P605L,
603 3 G603D,
595 5 K595E, K595N, K595N,
597 6 Y597H, Y597C,
596 6 P596L, P596T, P596R, P596S,
606 7 S606Del, S606F, S606P,
590 8 G590V, G590D,
594 8
610 9
593 9 I593R, I593X, I593K, I593T, I593V,
607 9
589 10 L589P,
586 10 L586M,
609 10 D609N, D609G,
587 10
591 11 D591N, D591H,
608 13
573 13
592 13 Q592X,
569 13 Y569C, Y569H, Y569X,
588 13 N588D, N588K, N588K,
576 13
585 13 W585C, W585C,
613 14 T613L, T613M, T613A, T613K,
431 14 F431L, F431L, F431L,
572 14 G572C, G572R, G572D, G572S,
635 14 N635I,
584 15 G584C, G584R, G584S,
612 15 V612L, V612A, V612L,