KCNH2 Variant P917L Detail

We estimate the penetrance of LQTS for KCNH2 P917L is 2%. This variant was found in a total of 47 carriers in 5 papers or gnomAD (version 4), 1 had LQTS. P917L is present in 36 alleles in gnomAD. We have tested the trafficking efficiency of this variant, 106% of WT with a standard error of 31%; 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. P917L has been functionally characterized in 1 papers. This residue is located in a Non_Hotspot region for LQT2. In silico predictions, functional data (if available), and location in structure are equivalent to observing 0 individuals with LQT2 and 10 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 P917L around 2% (1/57).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-1.747 0.0 -1 0.556 8
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 6 5 1
11854117 2002 1 0 1
France Cohort 2020 2 2 0
10973849 2000 1 0 1
14661677 2003 3 3
LITERATURE, COHORT, AND GNOMAD: - 47 17 1 -
VARIANT FEATURES ALONE: - 10 10 0 -
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)
19673885 HEK293 -1.8 -1.7 1.096153846 1.049319728

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)
19673885 HEK293 None None None

P917L has 31 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
917 0 P917L,
916 4
918 4
915 5 A915V, A915X, A915fsX,
919 5
914 7
920 7 R920fsX, R920Q, R920G, R920W,
913 8 A913V,
921 8
912 8 R912W, R912X, R912Q,
922 8 R922W, R922fsX, R922Q,
911 9 G911X,
923 9 P923Q, P923fsX, P923X, P923L,
910 10 P910fsX, P910L,
924 10 G924X, G924E, G924W, G924V, G924A,
909 11 G909X,
925 11 G925X, G925A, G925V, G925R, G925E, G925fsX, G925R,
908 11 L908X, L908fsX,
926 11 P926X, P926S, P926fsX, P926L,
907 12 A907X,
927 12 W927C, W927L, W927G, W927X, W927C, W927S,
906 13 S906L,
928 13 G928E, G928fsX,
905 13 V905M,
929 13
904 14 E904X,
930 14
903 14 G903R, G903R,
931 14 P931L,
902 15
932 15