KCNH2 Variant M844R Detail

We estimate the penetrance of LQTS for KCNH2 M844R is 10%. We are unaware of any observations of this variant in individuals. M844R is not present in gnomAD. We have tested the trafficking efficiency of this variant, 95% of WT with a standard error of 5%; 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. M844R 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 M844R around 10% (1/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-5.12 0.997 -2 0.86 25
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 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.

M844R has 46 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
844 0 M844V,
845 5
843 5
841 6 V841L, V841L,
775 6
815 6
842 7
840 7 E840Q,
846 8 P846S, P846T,
817 8
816 8 G816V,
750 9 C750X,
814 9
753 10 A753S,
839 10
773 10
774 10 D774X, D774Y,
749 10
848 10
849 10
838 11 L838R,
776 11 L776P, L776I,
847 11
777 11
754 11
818 12 S818A, S818W, S818L,
757 12
747 12
835 12 R835Q, R835W, R835fsX,
837 12 D837Y, D837N, D837G,
813 13
812 13 Y812S,
772 13
751 13 L751V,
850 14 D850N,
836 14
852 14
746 14 A746X, A746S,
752 14 R752W, R752P, R752Q,
836 14
756 14 M756V,
807 14 E807X,
863 15 R863P, R863X,
778 15 A778T,
755 15
853 15 W853X,