KCNH2 Variant R791W Detail

We estimate the penetrance of LQTS for KCNH2 R791W is 4%. This variant was found in a total of 26 carriers in 2 papers or gnomAD, 0 had LQTS. R791W is present in 25 alleles in gnomAD. R791W has been functionally characterized in 2 papers. This residue is located in a Non_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 R791W around 4% (1/36).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-6.566 1.0 -3 0.881 9
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
Italy Cohort 2020 1 1 0
29752375 2018 1 0 SIDS
LITERATURE, COHORT, AND GNOMAD: - 26 26 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.

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)
25417810 HEK293 107 -12.2 None None 0.74251497
29752375 HEK293 83 6.0 None None 0.666666667

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)
25417810 HEK293 None None None
29752375 HEK293 100 None None None

R791W has 48 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
791 0 R791W, R791Q,
819 5 N819K, N819K,
794 6 V794I, V794D,
792 6
820 6 G820R, G820R,
790 6
796 7 V796L, V796L, V796Del,
821 8 D821E, D821E,
789 8
795 9 V795I,
793 9 D793N,
772 9
36 9 V36X,
818 10 S818W, S818A, S818L,
797 10 A797T,
862 10 L862P,
61 10 Q61R,
860 10
863 11 R863X, R863P,
822 11 V822M, V822L, V822L,
37 11
35 11 R35W,
40 11
33 11 N33T,
823 12 R823T, R823W, R823Q, R823fsX,
773 12
788 12 E788K, E788D, E788D,
42 12 I42N,
771 12 H771R, H771fsX,
770 12
861 13 N861H, N861I,
774 13 D774X, D774Y,
38 13
34 13 A34T,
60 13 M60T,
41 13 V41A,
817 14
39 14 C39R, C39X,
798 14 I798fsX,
748 14
806 14 G806R, G806R,
32 14 A32T,
12 15 N12D,
747 15
799 15 L799sp,
805 15 F805S, F805C,
768 15
787 15