KCNQ1 Variant R591C Detail

We estimate the penetrance of LQTS for KCNQ1 R591C is 68%. This variant was found in a total of 10 carriers in 8 papers or gnomAD, 7 had LQTS. R591C is present in 1 alleles in gnomAD. R591C has not been functionally characterized. This residue is located in a Hotspot region for LQT1. In silico predictions, functional data (if available), and location in structure are equivalent to observing 6 individuals with LQT1 and 4 unaffected individuals. These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 R591C around 68% (13/20).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-5.73 1.0 -4 0.937 72
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 LQT1 Other Disease
32893267 2020 1 None 1 None
31520628 2019 1 None 1 1 miscarriage
23631430 2013 1 None None None
22949429 2012 1 None 1 None
22429796 2012 3 2 1 None
19841300 2009 1 None 1 None
19716085 2009 1 None 1 None
17470695 2007 5 None 5 None
LITERATURE, COHORT, AND GNOMAD: - 10 3 7
VARIANT FEATURES ALONE: - 10 4 6 -
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.

R591C 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. This results from the fact that the functional KV7.1 channel 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
591 0 R591H, R591C, R591L,
590 4 A590T,
592 4
589 5 G589D, G589S,
593 5 N593S,
588 7 I588F,
594 7 R594Q, R594P,
587 8 T587M, T587R,
595 8 V595L, V595L,
586 8 N586D,
596 8 E596del, E596K,
585 9 S585N,
597 9
584 10 G584S,
598 10 K598R,
583 11 R583H, R583C, R583G,
599 11
582 11
600 11 T600M,
581 12
601 12
580 13 S580G, S580N,
602 13
579 13
603 13
578 14 E578K, E578V,
604 14
577 14
605 14
576 15 V576I,
606 15