KCNH2 Variant L856P Detail

We estimate the penetrance of LQTS for KCNH2 L856P is 20%. We are unaware of any observations of this variant in individuals. L856P is not present in gnomAD. We have tested the trafficking efficiency of this variant, 0% of WT with a standard error of 3%; 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. L856P 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 L856P around 20% (1/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-6.485 1.0 -3 0.972 75
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.

L856P has 50 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
856 0
855 4 S855R, S855R, S855R,
857 5 E857X,
852 5
853 6 W853X,
742 6
854 6
858 6 I858V, I858T,
741 7 K741R,
804 8
743 9
851 9
808 9
740 9 C740W, C740G,
859 10 T859M, T859R,
781 10
779 10
849 11
57 11 A57P,
810 11
848 11
809 11
806 11 G806R, G806R,
850 11 D850N,
803 11 D803Y, D803X,
745 12 G745X, G745A,
55 12 S55L,
744 12 R744P, R744G, R744Q, R744X, R744fsX,
861 12 N861H, N861I,
807 12 E807X,
736 12
805 12 F805S, F805C,
838 12 L838R,
802 12
56 13 R56Q,
842 13
58 13 E58D, E58K, E58D,
737 13 L737P,
811 13
860 13
833 13
780 14
782 14 I782fsX, I782N,
746 14 A746S, A746X,
754 14
778 14 A778T,
839 14
739 14 H739fsX,
758 15
862 15 L862P,