KCNH2 Variant T65P Detail

We estimate the penetrance of LQTS for KCNH2 T65P is 58%. This variant was found in a total of 15 carriers in 5 papers or gnomAD, 8 had LQTS. T65P is not present in gnomAD. T65P 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 T65P around 58% (14/25).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-3.567 0.997 -1 0.862 71
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
12354768 2002 5 2 3
15840476 2005 1 0 1
16922724 2006 1 1
29766883 2016 2 2
LITERATURE, COHORT, AND GNOMAD: - 15 7 8 -
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)
12354768 HEK293 21 -3.72 None None None
23721480 CHO 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)
12354768 HEK293 50 None None None
23721480 CHO None None None

T65P has 61 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
65 0 T65P,
66 4 C66G, C66R, C66Y,
64 4 C64Y, C64R,
63 5 P63H,
67 6
82 7 I82T, I82Ins, I82Del, I82dup,
83 7 A83P, A83fsX,
70 8 H70Q, H70Q, H70R,
79 8 A79fsX, A79Del, A79S, A79T,
39 8 C39R, C39X,
69 9 L69Del, L69P,
86 9 L86R,
68 9 F68V, F68L, F68L, F68L,
38 9
62 9 R62Q,
80 10 A80P,
127 10
40 10
41 10 V41A,
98 10
85 10 A85P, A85V,
32 11 A32T,
125 11
30 11 I30Del, I30T,
110 11 V110A,
78 11 A78T, A78P,
96 11 I96T, I96V,
59 11
84 11
112 12 V112M,
81 12 Q81X, Q81H, Q81E, Q81H, Q81P,
87 12 L87P,
94 12 V94A, V94L, V94L,
129 12 F129C,
74 12 T74M, T74fsX,
76 12
71 13 G71W, G71R, G71E, G71R,
31 13 I31S,
77 13 R77S,
34 13 A34T,
48 13
97 13
33 13 N33T,
36 13 V36X,
126 14
60 14 M60T,
61 14 Q61R,
37 14
108 14 C108Y,
92 14 R92C, R92L,
75 14 Q75X,
42 14 I42N,
111 14 D111V,
54 14 Y54N, Y54X,
52 14 C52W,
99 15 Y99N, Y99S,
128 15 N128S,
124 15 M124T, M124R,
88 15
113 15 V113Del,
114 15 P114S,