KCNH2 Variant L248H Detail

We estimate the penetrance of LQTS for KCNH2 L248H is 8%. We are unaware of any observations of this variant in individuals. L248H is not present in gnomAD. We have tested the trafficking efficiency of this variant, 79% of WT with a standard error of 33%; 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. L248H has not been functionally characterized. 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 L248H around 8% (0/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
2.446 0.0 4 0.345 4
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: - 0 0 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.

L248H 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
248 0
247 4 Q247X, Q247R,
249 4
246 5
250 5
245 7 P245R,
251 7 P251A,
244 8 A244G, A244E,
252 8 R252fsX, R252Q,
243 8 S243X, S243R, S243R, S243R,
253 8
242 9 R242C, R242X,
254 9 H254Q, H254Q, H254X,
241 10 P241S, P241fsX, P241L,
255 10
240 11 P240L,
256 11
239 11 S239X, S239P,
257 11 N257H,
238 12 G238R, G238D, G238S,
258 12 P258L,
237 13
259 13 D259X, D259N,
236 13 G236V,
260 13 A260V,
235 14
261 14 S261X,
234 14 L234Del,
262 14 G262fsX, G262X,
233 15 A233S,
263 15