KCNH2 Variant E289K Detail

We estimate the penetrance of LQTS for KCNH2 E289K is 2%. This variant was found in a total of 64 carriers in 0 papers or gnomAD (version 4), 1 had LQTS. E289K is present in 62 alleles in gnomAD. We have tested the trafficking efficiency of this variant, 3% of WT with a standard error of 18%; 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. E289K has not been functionally characterized. 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 1 individuals with LQT2 and 9 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 E289K around 2% (2/74).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-1.461 0.367 2 0.694 11
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: - 64 8 1 -
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.

E289K 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
289 0 E289K,
288 4
290 4
287 5 D287fsX,
291 5
286 7 D286X,
292 7
285 8 A285fsX, A285V,
293 8
284 8 S284X,
294 8
283 9
295 9 V295fsX,
282 10 A282X,
296 10 L296fsX,
281 11 R281X, R281fsX,
297 11 P297S,
280 11
298 11 P298X,
279 12
299 12
278 13
300 13
277 13
301 13
276 14 C276X,
302 14 H302X, H302fsX, H302H,
275 14 S275R, S275R, S275R,
303 14
274 15 E274X,
304 15 S304R, S304R, S304R,