KCNH2 Variant P605L Detail

We estimate the penetrance of LQTS for KCNH2 P605L is 35%. This variant was found in a total of 2 carriers in 2 papers or gnomAD (version 4), 2 had LQTS. P605L is not present in gnomAD. We have tested the trafficking efficiency of this variant, 0% of WT with a standard error of 7%; 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. P605L 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 P605L around 35% (5/12).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-9.418 0.933 -3 0.949 88
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 1 0 1
France Cohort 2020 1 0 1
LITERATURE, COHORT, AND GNOMAD: - 2 0 2 -
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.

P605L has 41 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
605 0 P605L,
604 3 G604C, G604S, G604D,
606 4 S606F, S606Del, S606P,
595 5 K595N, K595N, K595E,
610 6
603 7 G603D,
609 7 D609G, D609N,
607 7
589 7 L589P,
590 7 G590D, G590V,
597 7 Y597C, Y597H,
586 8 L586M,
593 8 I593K, I593R, I593V, I593T, I593X,
596 8 P596L, P596S, P596T, P596R,
594 8
587 10
608 10
613 11 T613K, T613A, T613L, T613M,
569 11 Y569X, Y569H, Y569C,
591 11 D591H, D591N,
585 11 W585C, W585C,
592 11 Q592X,
635 11 N635I,
588 11 N588K, N588D, N588K,
573 12
612 12 V612L, V612L, V612A,
431 12 F431L, F431L, F431L,
572 12 G572C, G572D, G572R, G572S,
611 13 Y611D,
614 13 A614T, A614V,
634 13 T634S, T634P, T634S, T634I, T634A,
576 13
633 13 N633I, N633S, N633D,
584 13 G584C, G584S, G584R,
638 14 K638R, K638E, K638D, K638Del,
432 14
630 15 V630I, V630A, V630T,
568 15 W568C, W568C,
583 15 I583V,
570 15
430 15