KCNH2 Variant S999R Detail

We estimate the penetrance of LQTS for KCNH2 S999R is 11%. We are unaware of any observations of this variant in individuals. S999R is not present in gnomAD. We have tested the trafficking efficiency of this variant, 70% of WT with a standard error of 17%; 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. S999R has not been functionally characterized. This residue is located in a Mild_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 S999R around 11% (1/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-1.605 0.994 -1 0.782 12
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.

S999R 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
999 0 S999X,
998 4
1000 4
997 5 I997X,
1001 5 W1001X, W1001C, W1001C,
996 7 N996X, N996I,
1002 7 G1002E,
995 8
1003 8 D1003H, D1003Y,
994 8
1004 8 S1004I, S1004T,
993 9
1005 9 R1005fsX, R1005Q,
992 10
1006 10 G1006V, G1006fsX,
991 11 F991fsX,
1007 11 R1007C, R1007H,
990 11 A990T,
1008 11
989 12 G989D, G989S,
1009 12 Y1009X,
988 13 S988A, S988L, S988P,
1010 13
987 13 L987P, L987X, L987fsX,
1011 13 E1011K,
986 14 P986T, P986fsX, P986L,
1012 14 L1012fsX,
985 14 N985X, N985S,
1013 14
984 15 C984fsX,
1014 15 R1014fsX, R1014X,