KCNH2 Variant R835W Detail

We estimate the penetrance of LQTS for KCNH2 R835W is 23%. This variant was found in a total of 2 carriers in 1 papers or gnomAD (version 4), 1 had LQTS. R835W is present in 1 alleles in gnomAD. We have tested the trafficking efficiency of this variant, 92% of WT with a standard error of 16%; 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. R835W 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 R835W around 23% (2/12).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-7.185 0.977 -3 0.852 37
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
14998625 1 0 1
LITERATURE, COHORT, AND GNOMAD: - 2 1 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)
25417810 HEK293 18 16.1 None None 0.498203593

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

R835W has 47 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
835 0 R835fsX, R835W, R835Q,
836 5
777 5
809 6
834 6 H834R,
839 7
778 7 A778T,
815 7
838 7 L838R,
776 8 L776I, L776P,
837 8 D837Y, D837N, D837G,
779 8
813 8
833 8
816 9 G816V,
807 9 E807X,
775 9
808 9
840 10 E840Q,
814 10
806 10 G806R, G806R,
812 10 Y812S,
810 11
832 11
780 11
842 12
853 12 W853X,
757 12
841 12 V841L, V841L,
811 12
844 12 M844V,
843 13
817 13
862 13 L862P,
758 13
774 13 D774X, D774Y,
805 14 F805C, F805S,
818 14 S818W, S818A, S818L,
852 14
759 14 K759N, K759N,
861 14 N861I, N861H,
781 14
754 14
858 14 I858V, I858T,
770 15
804 15
849 15