KCNH2 Variant R312C Detail

We estimate the penetrance of LQTS for KCNH2 R312C is 4%. This variant was found in a total of 65 carriers in 3 papers or gnomAD (version 4), 4 had LQTS. R312C is present in 60 alleles in gnomAD. We have tested the trafficking efficiency of this variant, 132% 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. R312C 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 0 individuals with LQT2 and 10 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 R312C around 4% (4/75).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-2.921 1.0 -4 0.791 17
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
Japan Cohort 2020 3 1 2
10973849 2000 1 0 1
30246897 2018 1 0 1
LITERATURE, COHORT, AND GNOMAD: - 65 27 4 -
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.

R312C 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
312 0 R312Del, R312C, R312H,
311 4 L311R,
313 4
310 5 P310X, P310L,
314 5 G314S,
309 7 H309Q, H309Y, H309Q,
315 7
308 8 M308I, M308V, M308T, M308R, M308I, M308I,
316 8
307 8 A307P,
317 8 N317S,
306 9 G306W,
318 9
305 10
319 10 T319T,
304 11 S304R, S304R, S304R,
320 11 S320W, S320L, S320X,
303 11
321 11 D321Y,
302 12 H302fsX, H302H, H302X,
322 12
301 13
323 13 D323E, D323E, D323N,
300 13
324 13 L324L,
299 14
325 14 V325M,
298 14 P298X,
326 14 R326H, R326C, R326fsX,
297 15 P297S,
327 15 Y327H,