KCNH2 Variant L86R Detail

We estimate the penetrance of LQTS for KCNH2 L86R is 87%. This variant was found in a total of 7 carriers in 2 papers or gnomAD, 7 had LQTS. L86R is not present in gnomAD. L86R has been functionally characterized in 3 papers. 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 7 individuals with LQT2 and 3 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 L86R around 87% (14/17).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-4.07 0.001 -3 0.898 79
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
11854117 2002 7 0 7
10973849 2000 1 0 1
LITERATURE, COHORT, AND GNOMAD: - 7 0 7 -
VARIANT FEATURES ALONE: - 10 3 7 -
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)
10187793 Xeno 1.7 9.0 None None
21536673 Xeno 0 None None None None
23721480 CHO None None None None

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)
10187793 Xeno None None None
21536673 Xeno None None None
23721480 CHO None None None

L86R has 51 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
86 0 L86R,
85 4 A85P, A85V,
87 5 L87P,
83 5 A83P, A83fsX,
125 6
88 7
82 7 I82dup, I82Del, I82Ins, I82T,
89 7 A89V, A89G,
64 7 C64R, C64Y,
84 7
112 8 V112M,
39 8 C39R, C39X,
90 8 E90K,
114 8 P114S,
65 9 T65P,
92 9 R92C, R92L,
122 9
34 9 A34T,
32 9 A32T,
127 10
80 10 A80P,
113 10 V113Del,
81 11 Q81P, Q81H, Q81X, Q81H, Q81E,
124 11 M124R, M124T,
126 11
33 11 N33T,
38 11
63 11 P63H,
79 11 A79fsX, A79S, A79Del, A79T,
123 12
110 12 V110A,
40 12
115 12 V115M,
36 12 V36X,
94 12 V94A, V94L, V94L,
66 12 C66G, C66Y, C66R,
91 12
35 12 R35W,
111 12 D111V,
30 13 I30T, I30Del,
31 13 I31S,
121 13 A121fsX,
116 13 K116Q,
41 13 V41A,
78 13 A78P, A78T,
37 13
93 14 K93X, K93R,
67 14
128 15 N128S,
129 15 F129C,
42 15 I42N,