KCNH2 Variant A293T Detail

We estimate the penetrance of LQTS for KCNH2 A293T is 5%. This variant was found in a total of 7 carriers in 0 papers or gnomAD (version 4), 0 had LQTS. A293T is present in 7 alleles in gnomAD. We have tested the trafficking efficiency of this variant, 63% of WT with a standard error of 20%; 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. A293T 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 A293T around 5% (0/17).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-0.447 0.001 0 0.573 6
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: - 7 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.

A293T 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
293 0
292 4
294 4
291 5
295 5 V295fsX,
290 7
296 7 L296fsX,
289 8 E289K,
297 8 P297S,
288 8
298 8 P298X,
287 9 D287fsX,
299 9
286 10 D286X,
300 10
285 11 A285V, A285fsX,
301 11
284 11 S284X,
302 11 H302fsX, H302H, H302X,
283 12
303 12
282 13 A282X,
304 13 S304R, S304R, S304R,
281 13 R281fsX, R281X,
305 13
280 14
306 14 G306W,
279 14
307 14 A307P,
278 15
308 15 M308I, M308T, M308V, M308R, M308I, M308I,