KCNH2 Variant M124R Detail

We estimate the penetrance of LQTS for KCNH2 M124R is 63%. This variant was found in a total of 31 carriers in 4 papers or gnomAD, 19 had LQTS. M124R is not present in gnomAD. M124R has been functionally characterized in 4 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 6 individuals with LQT2 and 4 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 M124R around 63% (25/41).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-4.27 0.003 -4 0.896 66
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
11854117 2002 17 0 17
France Cohort 2020 1 0 1
11844290 2002 14 5 9
16029385 2005 16 7 9
LITERATURE, COHORT, AND GNOMAD: - 31 12 19 -
VARIANT FEATURES ALONE: - 10 4 6 -
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)
16029385 CHO 34 -6.8 None None 0.404494382
21536673 Xeno 10 0.0 13.6 None 0.583333333
23721480 CHO None None None None
25417810 HEK293 22 1.0 None None 0.51497006

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)
16029385 CHO None None None
21536673 Xeno None None None
23721480 CHO None None None
25417810 HEK293 None None None

M124R has 63 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
124 0 M124T, M124R,
123 4
32 5 A32T,
33 5 N33T,
125 5
115 6 V115M,
31 6 I31S,
34 6 A34T,
122 7
126 7
15 8 L15V,
114 8 P114S,
795 8 V795I,
14 8
42 8 I42N,
35 9 R35W,
116 9 K116Q,
121 9 A121fsX,
39 9 C39R, C39X,
113 10 V113Del,
40 10
12 10 N12D,
18 10 I18M,
36 10 V36X,
117 10
30 10 I30Del, I30T,
41 10 V41A,
127 10
796 11 V796L, V796Del, V796L,
794 11 V794D, V794I,
86 11 L86R,
64 11 C64Y, C64R,
798 11 I798fsX,
43 11 Y43D, Y43C,
112 12 V112M,
797 12 A797T,
89 12 A89G, A89V,
29 12 F29S, F29V, F29L, F29L, F29L,
19 12 I19F,
788 12 E788D, E788K, E788D,
120 12
13 12 T13N,
11 13 Q11L, Q11H, Q11H,
17 13
90 13 E90K,
16 13 D16A,
85 13 A85V, A85P,
87 14 L87P,
790 14
22 14 F22Y, F22S,
793 14 D793N,
38 14
88 14
118 14 E118D, E118X, E118D, E118K,
119 14 D119G, D119H,
128 14 N128S,
111 14 D111V,
63 14 P63H,
44 14 C44X, C44F, C44W,
60 14 M60T,
789 14
37 14
65 15 T65P,