KCNH2 Variant R181Q Detail

We estimate the penetrance of LQTS for KCNH2 R181Q is 0%. This variant was found in a total of 564 carriers in 3 papers or gnomAD (version 4), 0 had LQTS. R181Q is present in 560 alleles in gnomAD. We have tested the trafficking efficiency of this variant, 84% 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. R181Q has been functionally characterized in 1 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 1 individuals with LQT2 and 9 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 R181Q around 0% (1/574).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
0.103 0.981 1 0.331 46
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
14661677 2003 4 4
15913580 2005 1 0
29752375 2018 1 0 SIDS
LITERATURE, COHORT, AND GNOMAD: - 564 92 0 -
VARIANT FEATURES ALONE: - 10 9 1 -
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)
19673885 HEK293 -0.5 -1.9 1.019230769 0.967687075

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)
19673885 HEK293 None None None

R181Q 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
181 0 R181W, R181Q, R181fsX,
180 4
182 4 S182X,
179 5 S179W,
183 5 G183fsX,
178 7
184 7 G184Del,
177 8 E177X,
185 8
176 8 R176W, R176X, R176Q,
186 8 G186fsX,
175 9 A175X, A175S, A175D,
187 9 G187A, G187S, G187Del, G187X,
174 10
188 10 A188P, A188X, A188S,
173 11
189 11 G189Ins,
172 11 A172V,
190 11 A190V, A190T,
171 12 L171Ins,
191 12 P191fsX, P191Q,
170 13 L170Ins,
192 13 G192fsX,
169 13 A169G,
193 13 A193T, A193X, A193V, A193fsX,
168 14
194 14 V194M,
167 14
195 14
166 15
196 15