KCNH2 Variant L838R Detail

We estimate the penetrance of LQTS for KCNH2 L838R is 19%. This variant was found in a total of 1 carriers in 1 papers or gnomAD (version 4), 1 had LQTS. L838R is not present in gnomAD. We have tested the trafficking efficiency of this variant, 1% of WT with a standard error of 2%; 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. L838R 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 1 individuals with LQT2 and 9 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 L838R around 19% (2/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-5.254 1.0 -2 0.959 83
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 0 1
LITERATURE, COHORT, AND GNOMAD: - 1 0 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.

L838R has 58 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
838 0 L838R,
839 5
837 6 D837N, D837G, D837Y,
841 6 V841L, V841L,
842 6
833 6
840 7 E840Q,
757 7
754 7
835 7 R835W, R835Q, R835fsX,
836 7
834 8 H834R,
809 8
779 8
758 9
852 9
843 9
853 9 W853X,
753 9 A753S,
778 10 A778T,
849 10
848 10
777 11
845 11
755 11
844 11 M844V,
832 11
750 11 C750X,
810 11
743 11
781 11
808 11
759 12 K759N, K759N,
756 12 M756V,
856 12
780 12
751 13 L751V,
807 13 E807X,
742 13
806 13 G806R, G806R,
846 13 P846S, P846T,
813 13
776 13 L776P, L776I,
831 14
749 14
804 14
850 14 D850N,
737 14 L737P,
736 14
858 14 I858V, I858T,
733 14
815 14
851 14
805 15 F805C, F805S,
855 15 S855R, S855R, S855R,
746 15 A746X, A746S,
811 15
775 15