KCNH2 Variant L170Ins Detail

We estimate the penetrance of LQTS for KCNH2 L170Ins is 20%. This variant was found in a total of 1 carriers in 0 papers or gnomAD (version 4), 1 had LQTS. L170Ins is not present in gnomAD. L170Ins has not been functionally characterized. 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 2 individuals with LQT2 and 8 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 L170Ins around 20% (3/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
None None None None 92
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
LITERATURE, COHORT, AND GNOMAD: - 1 0 1 -
VARIANT FEATURES ALONE: - 10 8 2 -
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.

L170Ins 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
170 0 L170Ins,
169 4 A169G,
171 4 L171Ins,
168 5
172 5 A172V,
167 7
173 7
166 8
174 8
165 8
175 8 A175X, A175S, A175D,
164 9 R164C, R164H,
176 9 R176W, R176X, R176Q,
163 10
177 10 E177X,
162 11 T162X,
178 11
161 11
179 11 S179W,
160 12
180 12
159 13
181 13 R181W, R181Q, R181fsX,
158 13
182 13 S182X,
157 14 P157X,
183 14 G183fsX,
156 14
184 14 G184Del,
155 15
185 15