KCNH2 Variant R164C Detail

We estimate the penetrance of LQTS for KCNH2 R164C is 9%. This variant was found in a total of 2 carriers in 1 papers or gnomAD (version 4), 0 had LQTS. R164C is present in 1 alleles in gnomAD. We have tested the trafficking efficiency of this variant, 74% of WT with a standard error of 6%; 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. R164C has been functionally characterized in 1 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 R164C around 9% (0/12).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-3.837 1.0 -4 0.903 27
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
24400717 2014 1 0 BrS and SHORT QT
LITERATURE, COHORT, AND GNOMAD: - 2 1 0 -
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)
24400717 CHO 199 172 -3.5 3.1 0.851632047 -1.041218925

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)
24400717 CHO None None None

R164C 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
164 0 R164C, R164H,
163 4
165 4
162 5 T162X,
166 5
161 7
167 7
160 8
168 8
159 8
169 8 A169G,
158 9
170 9 L170Ins,
157 10 P157X,
171 10 L171Ins,
156 11
172 11 A172V,
155 11
173 11
154 12 W154X, W154R, W154R,
174 12
153 13 S153R, S153R, S153R,
175 13 A175X, A175D, A175S,
152 13 T152S, T152fsX, T152X, T152I, T152S,
176 13 R176Q, R176X, R176W,
151 14 P151fsX, P151X,
177 14 E177X,
150 14 P150L,
178 14
149 15 G149V, G149A,
179 15 S179W,