KCNH2 Variant R685C Detail

We estimate the penetrance of LQTS for KCNH2 R685C is 9%. This variant was found in a total of 5 carriers in 0 papers or gnomAD (version 4), 0 had LQTS. R685C is present in 5 alleles in gnomAD. We have tested the trafficking efficiency of this variant, 5% of WT with a standard error of 5%; 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. R685C has not been functionally characterized. This residue is located in a Mild_Hotspot region for LQT2. In silico predictions, functional data (if available), and location in structure are equivalent to observing 1 individuals with LQT2 and 9 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 R685C around 9% (1/15).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-7.775 1.0 -4 0.914 32
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: - 5 2 0 -
VARIANT FEATURES ALONE: - 10 9 1 -
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.

R685C has 36 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
685 0 R685C, R685H, R685P,
684 6
682 6 E682X,
681 7 R681W,
688 8
686 8
683 9
680 9
689 9
687 9
678 9
694 10 R694C, R694H,
709 10
545 12
677 12 M677T,
711 12 I711V,
708 12
690 12
544 12 E544A, E544fsX,
698 13 E698K, E698X,
679 13 R679W, R679Q,
707 13
710 13
691 13
697 13 L697X,
713 13 M713V,
546 14
666 14
706 14 S706C, S706F,
693 14 L693X,
731 14 H731R,
716 15 V716G,
669 15 G669X, G669R, G669C,
668 15 S668L,
705 15 W705fsX, W705X,
675 15