KCNH2 Variant R784W Detail

We estimate the penetrance of LQTS for KCNH2 R784W is 6%. This variant was found in a total of 12 carriers in 2 papers or gnomAD (version 4), 1 had LQTS. R784W is present in 10 alleles in gnomAD. We have tested the trafficking efficiency of this variant, 37% of WT with a standard error of 15%; 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. R784W has been functionally characterized in 1 papers. 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 R784W around 6% (2/22).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-7.715 1.0 -3 0.944 15
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
11997281 2002 1 1
15840476 2005 1 0 1
LITERATURE, COHORT, AND GNOMAD: - 12 4 1 -
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.

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)
11997281 CHO 25 13.3 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)
11997281 CHO None None None

R784W has 46 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
784 0 R784W, R784G, R784Q,
783 4 S783P,
829 4 D829E, D829A, D829E,
785 6 G785fsX, G785D, G785S,
801 7 K801T,
828 7
782 8 I782fsX, I782N,
830 9
735 9 S735L,
826 9 T826A, T826I,
800 9
762 9
802 10
786 10
827 10
831 10
763 11
734 11 R734H, R734C,
736 11
803 12 D803Y, D803X,
787 12
761 12
760 12
739 12 H739fsX,
20 12 R20L, R20G,
479 12
707 12
781 13
733 13
764 13
799 13 L799sp,
732 13
825 13
824 13
16 13 D16A,
688 13
687 14
765 14
740 14 C740W, C740G,
686 14
731 14 H731R,
738 14 Q738X,
703 15
19 15 I19F,
804 15
478 15 A478D,