KCNH2 Variant N996I Detail

We estimate the penetrance of LQTS for KCNH2 N996I is 32%. This variant was found in a total of 1 carriers in 1 papers or gnomAD (version 4), 1 had LQTS. N996I is not present in gnomAD. We have tested the trafficking efficiency of this variant, 1% of WT with a standard error of 7%; 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. N996I has been functionally characterized in 1 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 2 individuals with LQT2 and 8 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 N996I around 32% (3/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-2.984 0.937 -3 0.892 80
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
15840476 2005 1 0 1
LITERATURE, COHORT, AND GNOMAD: - 1 0 1 -
VARIANT FEATURES ALONE: - 10 8 2 -
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)
24213244 hiPSC-CM 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)
24213244 hiPSC-CM 50 None None None

N996I 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
996 0 N996X, N996I,
995 4
997 4 I997X,
994 5
998 5
993 7
999 7 S999X,
992 8
1000 8
991 8 F991fsX,
1001 8 W1001C, W1001C, W1001X,
990 9 A990T,
1002 9 G1002E,
989 10 G989S, G989D,
1003 10 D1003Y, D1003H,
988 11 S988P, S988A, S988L,
1004 11 S1004T, S1004I,
987 11 L987X, L987fsX, L987P,
1005 11 R1005Q, R1005fsX,
986 12 P986L, P986T, P986fsX,
1006 12 G1006V, G1006fsX,
985 13 N985X, N985S,
1007 13 R1007H, R1007C,
984 13 C984fsX,
1008 13
983 14 T983I, T983X,
1009 14 Y1009X,
982 14 D982N,
1010 14
981 15 S981X, S981N, S981G,
1011 15 E1011K,