KCNH2 Variant L717P Detail

We estimate the penetrance of LQTS for KCNH2 L717P is 15%. This variant was found in a total of 4 carriers in 2 papers or gnomAD (version 4), 2 had LQTS. L717P is present in 1 alleles in gnomAD. We have tested the trafficking efficiency of this variant, 3% of WT with a standard error of 6%; 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. L717P has not been functionally characterized. 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 1 individuals with LQT2 and 9 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 L717P around 15% (3/14).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-6.686 1.0 -3 0.951 53
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 1 0 1
France Cohort 2020 2 1 1
LITERATURE, COHORT, AND GNOMAD: - 4 1 2 -
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.

L717P has 49 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
717 0 L717P,
716 4 V716G,
725 5 Q725fsX, Q725R,
718 5
720 5
714 6
715 6 A715T, A715A, A715sp, A715V,
719 6
728 7
713 8 M713V,
683 8
721 8 P721L,
729 8
724 9 L724X,
756 9 M756V,
726 9
722 10
712 10 D712N,
697 10 L697X,
680 10
732 11
727 11
687 11
679 11 R679Q, R679W,
723 11 C723G, C723R, C723X,
755 12
711 12 I711V,
700 12
684 12
759 12 K759N, K759N,
701 12
676 12 Q676fsX, Q676X,
693 12 L693X,
731 13 H731R,
760 13
686 13
689 13
730 13
757 13
733 13
752 14 R752P, R752W, R752Q,
696 14 R696H, R696C,
758 14
682 14 E682X,
708 14
753 14 A753S,
677 15 M677T,
698 15 E698X, E698K,
704 15 A704T, A704V,