KCNH2 Variant R823P Detail

We estimate the penetrance of LQTS for KCNH2 R823P is 26%. We are unaware of any observations of this variant in individuals. R823P is not present in gnomAD. We have tested the trafficking efficiency of this variant, 3% of WT with a standard error of 1%; 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. R823P 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 2 individuals with LQT2 and 8 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 R823P around 26% (2/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-6.193 1.0 -2 0.949 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
LITERATURE, COHORT, AND GNOMAD: - 0 0 0 -
VARIANT FEATURES ALONE: - 10 8 2 -
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.

R823P 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 R823fsX, R823W, R823T, R823Q,
822 5 V822L, V822L, V822M,
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 Q11H, Q11L, Q11H,
795 10 V795I,
797 10 A797T,
792 10
764 11
794 11 V794D, V794I,
763 11
786 11
796 11 V796L, V796Del, V796L,
772 11
723 11 C723X, C723G, C723R,
826 11 T826I, T826A,
791 12 R791Q, R791W,
696 12 R696H, R696C,
13 12 T13N,
828 12
798 12 I798fsX,
799 12 L799sp,
7 12
9 12 A9T, A9V,
805 13 F805C, F805S,
819 13 N819K, N819K,
8 13
15 13 L15V,
724 13 L724X,
774 14 D774Y, D774X,
748 14
818 14 S818A, S818W, S818L,
752 14 R752Q, R752P, R752W,
780 14
860 14
42 14 I42N,
785 14 G785D, G785S, G785fsX,
14 14
830 14
827 14
727 14
16 14 D16A,
800 14
862 14 L862P,
773 15
699 15 E699D, E699D,
782 15 I782fsX, I782N,