KCNH2 Variant R823W Detail

We estimate the penetrance of LQTS for KCNH2 R823W is 77%. This variant was found in a total of 20 carriers in 9 papers or gnomAD, 16 had LQTS. R823W is present in 1 alleles in gnomAD. R823W 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 7 individuals with LQT2 and 3 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 R823W around 77% (23/30).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-7.105 1.0 -3 0.934 72
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
19695459 2009 1 0
23631430 2013 1 0
Japan Cohort 2020 6 0 6
Italy Cohort 2020 5 1 4
11854117 2002 8 0 8
France Cohort 2020 4 2 2
10973849 2000 2 0 2
26496715 2015 3 0 3
27871843 2017 1 0 1
LITERATURE, COHORT, AND GNOMAD: - 20 4 16 -
VARIANT FEATURES ALONE: - 10 3 7 -
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)
11278781 CHO 0 None None None None
11741928 HEK293 0 None None None None
15961404 HEK293 0 None None None None
16432067 HEK293 5 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)
11278781 CHO 48 0.0 None None
11741928 HEK293 None None None
15961404 HEK293 None None None
16432067 HEK293 30 None None None

R823W has 63 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
823 0 R823T, R823fsX, R823Q, R823W,
822 5 V822L, V822M, V822L,
768 6
790 6
824 6
821 6 D821E, D821E,
766 6
788 7 E788D, E788D, E788K,
767 7 D767X,
789 8
769 8
825 8
787 8
771 9 H771R, H771fsX,
770 9
12 9 N12D,
10 9
820 9 G820R, G820R,
793 9 D793N,
765 9
11 10 Q11L, Q11H, Q11H,
795 10 V795I,
797 10 A797T,
792 10
764 11
794 11 V794I, V794D,
763 11
786 11
796 11 V796L, V796Del, V796L,
772 11
723 11 C723G, C723R, C723X,
826 11 T826I, T826A,
791 12 R791W, R791Q,
696 12 R696H, R696C,
13 12 T13N,
828 12
798 12 I798fsX,
799 12 L799sp,
7 12
9 12 A9V, A9T,
805 13 F805S, F805C,
819 13 N819K, N819K,
8 13
15 13 L15V,
724 13 L724X,
774 14 D774Y, D774X,
748 14
818 14 S818A, S818L, S818W,
752 14 R752P, R752Q, R752W,
780 14
860 14
42 14 I42N,
785 14 G785fsX, G785D, G785S,
14 14
830 14
827 14
727 14
16 14 D16A,
800 14
862 14 L862P,
773 15
699 15 E699D, E699D,
782 15 I782N, I782fsX,