KCNH2 Variant R954C Detail

We estimate the penetrance of LQTS for KCNH2 R954C is 2%. This variant was found in a total of 29 carriers in 2 papers or gnomAD (version 4), 0 had LQTS. R954C is present in 27 alleles in gnomAD. We have tested the trafficking efficiency of this variant, 81% of WT with a standard error of 6%; 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. R954C has been functionally characterized in 2 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 R954C around 2% (0/39).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-1.427 0.999 -2 0.671 0
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
17210839 1 0 SIDS
18675227 2008 2 2
LITERATURE, COHORT, AND GNOMAD: - 29 10 0 -
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)
18222468 CHO None None None None
18675227 CHO 52 40 14.1 None None 2.0

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)
18222468 CHO None None None
18675227 CHO 55 None None None

R954C 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
954 0 R954C, R954H,
953 4
955 4 L955V,
952 5 P952T, P952S,
956 5
951 7
957 7
950 8
958 8 F958L, F958L, F958L,
949 8 S949R, S949R, S949R,
959 8
948 9 R948C, R948H, R948S,
960 9 S960N,
947 10 G947D,
961 10 P961X,
946 11 P946R, P946fsX,
962 11
945 11
963 11 P963T,
944 12 E944D, E944D,
964 12 G964X,
943 13
965 13 G965fsX, G965R, G965R, G965X,
942 13
966 13 E966A, E966K,
941 14
967 14 P967X, P967L,
940 14
968 14 P968A, P968fsX, P968L,
939 15
969 15 G969X, G969D,