KCNH2 Variant E840Q Detail

We estimate the penetrance of LQTS for KCNH2 E840Q is 10%. This variant was found in a total of 1 carriers in 0 papers or gnomAD (version 4), 0 had LQTS. E840Q is present in 1 alleles in gnomAD. We have tested the trafficking efficiency of this variant, 83% of WT with a standard error of 8%; 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. E840Q has not been functionally characterized. 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 E840Q around 10% (1/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-2.762 0.939 2 0.828 32
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: - 1 1 0 -
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.

E840Q has 40 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
840 0 E840Q,
839 5
841 6 V841L, V841L,
837 6 D837N, D837G, D837Y,
843 6
836 6
838 7 L838R,
844 7 M844V,
842 8
757 8
753 10 A753S,
835 10 R835fsX, R835W, R835Q,
845 10
834 10 H834R,
754 11
775 11
833 12
815 12
756 12 M756V,
809 12
750 13 C750X,
846 13 P846T, P846S,
849 13
758 13
755 13
848 13
777 14
777 14
749 14
836 14
852 14
853 14 W853X,
813 14
814 14
779 14
778 14 A778T,
810 15
816 15 G816V,
774 15 D774Y, D774X,
759 15 K759N, K759N,