KCNH2 Variant A1116V Detail

We estimate the penetrance of LQTS for KCNH2 A1116V is 3%. This variant was found in a total of 26 carriers in 2 papers or gnomAD (version 4), 3 had LQTS. A1116V is present in 17 alleles in gnomAD. We have tested the trafficking efficiency of this variant, 117% of WT with a standard error of 11%; 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. A1116V has been functionally characterized in 2 papers. 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 0 individuals with LQT2 and 10 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 A1116V around 3% (3/36).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-1.227 0.007 -1 0.565 13
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 9 6 3
16116052 2005 4 3 1
LITERATURE, COHORT, AND GNOMAD: - 26 12 3 -
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)
16116052 CHO -6.2 None None None
19673885 HEK293 -0.1 -1.6 1.076923077 1.054421769

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)
16116052 CHO 67 None None None
19673885 HEK293 None None None

A1116V 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
1116 0 A1116V,
1115 4 M1115T,
1117 4 C1117fsX,
1114 5
1118 5
1113 7
1119 7 E1119V, E1119Q,
1112 8
1120 8
1111 8 V1111F,
1121 8
1110 9 Q1110P,
1122 9 P1122fsX, P1122R, P1122L,
1109 10
1123 10 G1123R, G1123R,
1108 11 L1108V,
1124 11
1107 11 S1107L,
1125 11 P1125A, P1125X,
1106 12
1126 12 E1126fsX,
1105 13 L1105S,
1127 13
1104 13 T1104I,
1128 13
1103 14 L1103P,
1129 14
1102 14
1130 14
1101 15 P1101fsX,
1131 15 G1131V,