KCNH2 Variant R148W Detail

We estimate the penetrance of LQTS for KCNH2 R148W is 0%. This variant was found in a total of 824 carriers in 8 papers or gnomAD (version 4), 6 had LQTS. R148W is present in 788 alleles in gnomAD. We have tested the trafficking efficiency of this variant, 79% 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. R148W 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 R148W around 0% (6/834).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
None None None 0.744 0
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 7 5 2
France Cohort 2020 12 10 2
19322600 2009 2 1 SIDS
24334129 2014 14 12 2 1 was baby with SIDS
23631430 2013 1 0
21410720 2011 1 0 VF at Cardiac Arrest
23465283 2013 1 0 SIDS
29650123 2018 1 0
LITERATURE, COHORT, AND GNOMAD: - 824 350 6 -
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)
24334129 Xeno 100 0.0 0.0 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)
24334129 Xeno 77 64 0.0 0.0 None

R148W 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
148 0 R148Q, R148fsX, R148W, R148Y,
147 4 H147X, H147R,
149 4 G149A, G149V,
146 5 N146X,
150 5 P150L,
145 7
151 7 P151fsX, P151X,
144 8 D144V,
152 8 T152fsX, T152X, T152I, T152S, T152S,
143 8
153 8 S153R, S153R, S153R,
142 9 A142T,
154 9 W154R, W154R, W154X,
141 10 P141L, P141fsX, P141S,
155 10
140 11 S140Y,
156 11
139 11 G139R, G139R, G139A,
157 11 P157X,
138 12
158 12
137 13
159 13
136 13
160 13
135 14
161 14
134 14 E134X,
162 14 T162X,
133 15 M133T,
163 15