KCNH2 Variant T623A Detail

We estimate the penetrance of LQTS for KCNH2 T623A is 69%. We are unaware of any observations of this variant in individuals. T623A is not present in gnomAD. T623A has been functionally characterized in 2 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 6 individuals with LQT2 and 4 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 T623A around 69% (6/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-4.876 0.93 0 0.956 77
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 4 6 -
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)
16769794 HEK293 None None None None
17325511 Xeno 8.2 -28.2 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)
16769794 HEK293 None None None
17325511 Xeno None None None

T623A has 88 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
623 0 T623I,
624 4 S624R, S624R, S624R, S624N,
622 5 L622F,
620 5 S620G, S620I,
645 6 M645I, M645V, M645I, M645L, M645I, M645L, M645R,
625 6 V625E,
621 6 S621R, S621N, S621R, S621R,
619 6
652 6 Y652X,
649 7
624 7 S624R, S624R, S624R, S624N,
648 8 G648A,
648 8 G648A,
625 8 V625E,
557 8
626 8 G626A, G626S, G626V,
618 8 T618S, T618S,
646 8
621 9 S621R, S621N, S621R, S621R,
624 9 S624R, S624R, S624R, S624N,
642 10 I642V, I642Del,
656 10 F656L, F656L, F656L,
627 10 F627L, F627L, F627fsX, F627X, F627L,
649 10
644 10 V644I, V644F,
644 10 V644I, V644F,
623 10 T623I,
623 10 T623I,
622 10 L622F,
617 10 F617V, F617L, F617L, F617L,
645 10 M645I, M645V, M645I, M645L, M645I, M645L, M645R,
625 10 V625E,
652 10 Y652X,
641 10 S641F, S641P,
651 10 M651K,
561 10 A561V, A561T, A561P,
624 10 S624R, S624R, S624R, S624N,
616 11 Y616S,
626 11 G626A, G626S, G626V,
647 11
626 11 G626A, G626S, G626V,
650 11 L650X,
653 11
615 11 L615V, L615F,
620 11 S620G, S620I,
647 11
627 12 F627L, F627L, F627fsX, F627X, F627L,
560 12 I560M, I560fsX,
558 12 A558E, A558P, A558V,
655 12
653 12
625 12 V625E,
643 12
652 12 Y652X,
554 12
641 12 S641F, S641P,
620 12 S620G, S620I,
564 13 L564L,
650 13 L650X,
626 13 G626A, G626S, G626V,
651 13 M651K,
646 13
654 14
614 14 A614V, A614T,
630 14 V630T, V630I, V630A,
628 14 G628Del, G628R, G628D, G628V, G628S, G628A,
618 14 T618S, T618S,
556 14
617 14 F617V, F617L, F617L, F617L,
643 14
565 14
640 14 F640L, F640L, F640Del, F640L, F640V,
623 14 T623I,
638 14 K638D, K638R, K638E, K638Del,
640 14 F640L, F640L, F640Del, F640L, F640V,
621 15 S621R, S621N, S621R, S621R,
657 15 G657S, G657V,
622 15 L622F,
656 15 F656L, F656L, F656L,
652 15 Y652X,
627 15 F627L, F627L, F627fsX, F627X, F627L,
632 15 P632A, P632S,
642 15 I642V, I642Del,
659 15
619 15
559 15 L559F, L559H,
639 15 I639F, I639N,
619 15