KCNH2 Variant D323E Detail

We estimate the penetrance of LQTS for KCNH2 D323E is 9%. This variant was found in a total of 1 carriers in 1 papers or gnomAD (version 4), 1 had LQTS. D323E is not present in gnomAD. We have tested the trafficking efficiency of this variant, 125% 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. D323E has not been functionally characterized. 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 0 individuals with LQT2 and 10 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 D323E around 9% (1/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-2.149 0.896 1 0.729 54
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
Italy Cohort 2020 1 0 1
LITERATURE, COHORT, AND GNOMAD: - 1 0 1 -
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.

D323E 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
323 0 D323N, D323E, D323E,
322 4
324 4 L324L,
321 5 D321Y,
325 5 V325M,
320 7 S320X, S320L, S320W,
326 7 R326H, R326C, R326fsX,
319 8 T319T,
327 8 Y327H,
318 8
328 8 R328H, R328C, R328fsX,
317 9 N317S,
329 9
316 10
330 10 I330V,
315 11
331 11 S331T, S331N,
314 11 G314S,
332 11
313 12
333 12
312 13 R312Del, R312H, R312C,
334 13 P334L,
311 13 L311R,
335 13 Q335X,
310 14 P310L, P310X,
336 14
309 14 H309Q, H309Q, H309Y,
337 14 T337S, T337X, T337S,
308 15 M308I, M308R, M308I, M308I, M308T, M308V,
338 15