KCNH2 Variant T618I Detail

We estimate the penetrance of LQTS for KCNH2 T618I is 49%. We are unaware of any observations of this variant in individuals. T618I is not present in gnomAD. T618I has been functionally characterized in 4 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 4 individuals with LQT2 and 6 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 T618I around 49% (4/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-5.691 0.993 -1 0.94 68
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
28491588 2015 3 0 Short QT
29759541 2017 18 0 Short QT
21130771 2011 4 0 Short QT, all 4
30582453 2018 1 0 Short QT
25974115 1 0 Short QT
LITERATURE, COHORT, AND GNOMAD: - 0 0 0 -
VARIANT FEATURES ALONE: - 10 6 4 -
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)
21130771 HEK293 614 149 -5.6 49.3 0.865853659 0.439759036
23300672 HEK293 155 57 15.1 22.9 1.684210526 0.668874172
29759541 HEK293 169 -16.29 None None None
30582453 hiPSC-CM 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)
21130771 HEK293 None None None
23300672 HEK293 None None None
29759541 HEK293 174 167 None None None
30582453 hiPSC-CM None None 0.502793296

T618I has 83 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
618 0 T618S, T618S,
617 4 F617V, F617L, F617L, F617L,
619 5
561 5 A561P, A561V, A561T,
564 5 L564L,
621 5 S621R, S621R, S621R, S621N,
615 5 L615F, L615V,
622 6 L622F,
620 6 S620I, S620G,
565 6
614 6 A614V, A614T,
644 7 V644F, V644I,
568 8 W568C, W568C,
616 8 Y616S,
640 8 F640L, F640V, F640L, F640Del, F640L,
623 8 T623I,
560 8 I560fsX, I560M,
641 9 S641F, S641P,
562 9 H562Q, H562Q, H562P, H562R,
613 9 T613L, T613M, T613A, T613K,
642 9 I642V, I642Del,
567 9 I567M, I567T,
558 9 A558V, A558P, A558E,
557 9
566 9 C566S, C566F, C566S, C566R, C566G,
645 9 M645R, M645L, M645V, M645L, M645I, M645I, M645I,
630 10 V630A, V630I, V630T,
648 10 G648A,
611 10 Y611D,
645 10 M645R, M645L, M645V, M645L, M645I, M645I, M645I,
612 10 V612L, V612A, V612L,
625 10 V625E,
647 10
626 11 G626S, G626V, G626A,
563 11 W563G, W563C, W563X, W563C,
643 11
624 11 S624R, S624R, S624R, S624N,
627 11 F627L, F627L, F627X, F627L, F627fsX,
627 11 F627L, F627L, F627X, F627L, F627fsX,
559 11 L559F, L559H,
641 12 S641F, S641P,
585 12 W585C, W585C,
625 12 V625E,
631 12 S631F,
638 12 K638D, K638R, K638E, K638Del,
646 12
632 12 P632A, P632S,
651 12 M651K,
637 12 E637G, E637X, E637K,
642 12 I642V, I642Del,
569 12 Y569X, Y569C, Y569H,
571 13 I571L, I571V,
652 13 Y652X,
628 13 G628S, G628A, G628V, G628D, G628R, G628Del,
649 13
570 13
629 13 N629I, N629D, N629T, N629K, N629S, N629K,
639 13 I639N, I639F,
646 13
556 13
626 14 G626S, G626V, G626A,
649 14
632 14 P632A, P632S,
610 14
623 14 T623I,
643 14
609 14 D609G, D609N,
639 14 I639N, I639F,
644 14 V644F, V644I,
638 14 K638D, K638R, K638E, K638Del,
624 14 S624R, S624R, S624R, S624N,
616 14 Y616S,
621 14 S621R, S621R, S621R, S621N,
620 14 S620I, S620G,
426 14 P426H,
624 15 S624R, S624R, S624R, S624N,
636 15
431 15 F431L, F431L, F431L,
423 15
554 15
572 15 G572D, G572S, G572R, G572C,
650 15 L650X,
626 15 G626S, G626V, G626A,