KCNH2 Variant Q1068R Detail

We estimate the penetrance of LQTS for KCNH2 Q1068R is 4%. This variant was found in a total of 41 carriers in 5 papers or gnomAD (version 4), 1 had LQTS. Q1068R is present in 31 alleles in gnomAD. We have tested the trafficking efficiency of this variant, 88% of WT with a standard error of 10%; 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. Q1068R 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 Q1068R around 4% (1/51).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-2.632 0.675 0 0.703 3
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 5 5 0
28049825 2016 4 3 1
14661677 2003 1 1
15913580 2005 1 0
29752375 2018 1 0 SIDS
LITERATURE, COHORT, AND GNOMAD: - 41 21 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)
14975928 HEK293 132 -1.9 None 1.0 1.0

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)
14975928 HEK293 None None None

Q1068R 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
1068 0 Q1068R, Q1068X,
1067 4
1069 4 R1069S, R1069S,
1066 5
1070 5 Q1070X, Q1070P,
1065 7
1071 7 M1071V,
1064 8 L1064X,
1072 8 T1072M, T1072S,
1063 8 V1063I, V1063L,
1073 8 L1073P,
1062 9 T1062P, T1062X, T1062I,
1074 9
1061 10 A1061P,
1075 10 P1075L,
1060 11 M1060I, M1060I, M1060V, M1060I,
1076 11
1059 11 D1059E, D1059E,
1077 11 A1077D, A1077T,
1058 12 A1058T, A1058E,
1078 12 Y1078C,
1057 13 S1057N, S1057fsX,
1079 13 S1079N,
1056 13 L1056fsX,
1080 13
1055 14 R1055W, R1055Q,
1081 14
1054 14 T1054fsX,
1082 14
1053 15 E1053fsX, E1053X,
1083 15 T1083A, T1083fsX,