KCNH2 Variant L69P Detail

We estimate the penetrance of LQTS for KCNH2 L69P is 41%. This variant was found in a total of 1 carriers in 1 papers or gnomAD (version 4), 1 had LQTS. L69P is not present in gnomAD. We have tested the trafficking efficiency of this variant, 0% of WT with a standard error of 2%; 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. L69P has been functionally characterized in 1 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 3 individuals with LQT2 and 7 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 L69P around 41% (4/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-4.5 1.0 -3 0.949 78
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
32253972 2020 1 0 1
LITERATURE, COHORT, AND GNOMAD: - 1 0 1 -
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.

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)
32253972 HEK293 100 0 -3.0 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)
32253972 HEK293 10 None None None

L69P has 59 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
69 0 L69Del, L69P,
68 4 F68L, F68L, F68L, F68V,
70 5 H70R, H70Q, H70Q,
98 5
66 5 C66Y, C66R, C66G,
67 7
99 7 Y99N, Y99S,
52 7 C52W,
71 8 G71R, G71W, G71R, G71E,
54 8 Y54X, Y54N,
97 8
100 8 R100Q, R100P, R100G,
65 9 T65P,
106 9 F106V, F106L, F106L, F106L,
96 9 I96V, I96T,
74 9 T74fsX, T74M,
48 9
51 10
101 10 K101E,
59 10
53 10 G53R, G53S,
105 10
108 10 C108Y,
63 10 P63H,
62 11 R62Q,
129 11 F129C,
64 11 C64R, C64Y,
103 11
104 11
72 11 P72T, P72Q, P72S, P72R,
79 11 A79S, A79fsX, A79T, A79Del,
73 11 R73G, R73C, R73fsX, R73H,
58 11 E58D, E58K, E58D,
110 12 V110A,
30 12 I30Del, I30T,
102 12 D102H, D102X, D102V,
82 12 I82Del, I82T, I82dup, I82Ins,
49 12 C49R, C49G,
127 12
107 12 L107P,
55 13 S55L,
78 13 A78P, A78T,
75 13 Q75X,
41 13 V41A,
28 13 K28E,
109 14 L109X, L109P, L109Q,
94 14 V94L, V94L, V94A,
44 14 C44F, C44X, C44W,
47 14 G47C, G47V,
95 14 E95G, E95K,
76 14
60 14 M60T,
50 14 E50X,
80 15 A80P,
83 15 A83P, A83fsX,
128 15 N128S,
57 15 A57P,
131 15 V131fsX, V131L, V131L,
29 15 F29S, F29L, F29L, F29L, F29V,