KCNH2 Variant V822M Detail

We estimate the penetrance of LQTS for KCNH2 V822M is 65%. This variant was found in a total of 42 carriers in 6 papers or gnomAD, 27 had LQTS. V822M is not present in gnomAD. V822M has been functionally characterized in 4 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 6 individuals with LQT2 and 4 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 V822M around 65% (33/52).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-2.745 1.0 1 0.915 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
11854117 2002 18 0 18
France Cohort 2020 5 2 3
11844290 2002 21 13 8
8914737 1996 30 0 16
10086971 1999 4 2 2
15840476 2005 1 0 1
LITERATURE, COHORT, AND GNOMAD: - 42 15 27 -
VARIANT FEATURES ALONE: - 10 4 6 -
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)
9694858 HEK293 0 0 None None None None
11278781 CHO 0 None None None None
12070109 HEK293 0 None None None None
15961404 HEK293 0 None 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)
9694858 HEK293 None None None
11278781 CHO 44 0.0 None None
12070109 HEK293 None None None
15961404 HEK293 None None None

V822M has 75 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
822 0 V822L, V822L, V822M,
770 5
821 5 D821E, D821E,
823 5 R823fsX, R823Q, R823T, R823W,
769 5
789 5
768 6
820 7 G820R, G820R,
790 7
787 7
771 7 H771R, H771fsX,
824 7
788 7 E788K, E788D, E788D,
805 8 F805C, F805S,
767 9 D767X,
797 9 A797T,
780 9
766 9
799 9 L799sp,
772 9
819 10 N819K, N819K,
862 10 L862P,
818 10 S818A, S818L, S818W,
860 10
763 10
825 10
723 10 C723X, C723G, C723R,
774 10 D774X, D774Y,
796 11 V796L, V796L, V796Del,
806 11 G806R, G806R,
786 11
791 11 R791Q, R791W,
828 11
795 11 V795I,
798 11 I798fsX,
776 11 L776I, L776P,
830 11
764 12
782 12 I782N, I782fsX,
792 12
794 12 V794D, V794I,
778 12 A778T,
773 12
765 12
793 12 D793N,
800 12
12 13 N12D,
761 13
826 13 T826A, T826I,
859 13 T859R, T859M,
803 13 D803X, D803Y,
804 13
832 13
752 13 R752Q, R752P, R752W,
785 13 G785S, G785fsX, G785D,
779 13
10 13
42 14 I42N,
861 14 N861H, N861I,
722 14
748 14
777 14
724 14 L724X,
807 14 E807X,
775 14
749 14
781 14
721 14 P721L,
11 14 Q11H, Q11L, Q11H,
696 14 R696H, R696C,
829 15 D829E, D829A, D829E,
762 15
858 15 I858V, I858T,
817 15
831 15