rs120074178

Positions:

Variant summary

Our verdict is Pathogenic. Variant got 16 ACMG points: 16P and 0B. PM1PM5PP3_StrongPP5_Very_Strong

The NM_000218.3(KCNQ1):c.569G>A(p.Arg190Gln) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0000118 in 1,612,150 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Likely pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R190L) has been classified as Pathogenic.

Frequency

Genomes: 𝑓 0.000020 ( 0 hom., cov: 33)

Exomes 𝑓: 0.000011 ( 0 hom. )

Consequence

KCNQ1
NM_000218.3 missense

Scores

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:13O:1

Conservation

PhyloP100: 9.36

Variant links:

Genes affected

KCNQ1 (HGNC:6294): (potassium voltage-gated channel subfamily Q member 1) This gene encodes a voltage-gated potassium channel required for repolarization phase of the cardiac action potential. This protein can form heteromultimers with two other potassium channel proteins, KCNE1 and KCNE3. Mutations in this gene are associated with hereditary long QT syndrome 1 (also known as Romano-Ward syndrome), Jervell and Lange-Nielsen syndrome, and familial atrial fibrillation. This gene exhibits tissue-specific imprinting, with preferential expression from the maternal allele in some tissues, and biallelic expression in others. This gene is located in a region of chromosome 11 amongst other imprinted genes that are associated with Beckwith-Wiedemann syndrome (BWS), and itself has been shown to be disrupted by chromosomal rearrangements in patients with BWS. Alternatively spliced transcript variants have been found for this gene. [provided by RefSeq, Aug 2011]

KCNQ1 links:

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 16 ACMG points.

PM1

In a helix (size 6) in uniprot entity KCNQ1_HUMAN there are 13 pathogenic changes around while only 1 benign (93%) in NM_000218.3

PM5

Other missense variant is known to change same aminoacid residue: Variant chr11-2570719-G-T is described in Lovd as [Pathogenic].

PP3

MetaRNN computational evidence supports a deleterious effect, 0.986

PP5

Variant 11-2570719-G-A is Pathogenic according to our data. Variant chr11-2570719-G-A is described in ClinVar as [Likely_pathogenic]. Clinvar id is 3117.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr11-2570719-G-A is described in Lovd as [Pathogenic].

Transcripts

RefSeq

Gene	Transcript	HGVSc	HGVSp	Effect	#exon/exons	MANE	Protein	UniProt
KCNQ1	NM_000218.3 linkuse as main transcript	c.569G>A	p.Arg190Gln	missense_variant	3/16	ENST00000155840.12	NP_000209.2

Ensembl

Gene	Transcript	HGVSc	HGVSp	Effect	#exon/exons	TSL	MANE	Protein	Appris	UniProt
KCNQ1	ENST00000155840.12 linkuse as main transcript	c.569G>A	p.Arg190Gln	missense_variant	3/16	1	NM_000218.3	ENSP00000155840	P1	P51787-1
KCNQ1	ENST00000335475.6 linkuse as main transcript	c.188G>A	p.Arg63Gln	missense_variant	3/16	1		ENSP00000334497		P51787-2
KCNQ1	ENST00000496887.7 linkuse as main transcript	c.308G>A	p.Arg103Gln	missense_variant	4/16	5		ENSP00000434560
KCNQ1	ENST00000646564.2 linkuse as main transcript	c.478-12716G>A		intron_variant				ENSP00000495806

Frequencies

GnomAD3 genomes

AF:

0.0000197

AC:

AN:

152204

Hom.:

Cov.:

show subpopulations

Gnomad AFR

AF:

0.0000483

Gnomad AMI

AF:

0.00

Gnomad AMR

AF:

0.00

Gnomad ASJ

AF:

0.00

Gnomad EAS

AF:

0.00

Gnomad SAS

AF:

0.00

Gnomad FIN

AF:

0.00

Gnomad MID

AF:

0.00

Gnomad NFE

AF:

0.0000147

Gnomad OTH

AF:

0.00

GnomAD3 exomes

AF:

0.00000401

AC:

AN:

249462

Hom.:

AF XY:

0.00

AC XY:

AN XY:

135274

show subpopulations

Gnomad AFR exome

AF:

0.00

Gnomad AMR exome

AF:

0.00

Gnomad ASJ exome

AF:

0.00

Gnomad EAS exome

AF:

0.00

Gnomad SAS exome

AF:

0.00

Gnomad FIN exome

AF:

0.00

Gnomad NFE exome

AF:

0.00000885

Gnomad OTH exome

AF:

0.00

GnomAD4 exome

AF:

0.0000110

AC:

AN:

1459946

Hom.:

Cov.:

AF XY:

0.00000964

AC XY:

AN XY:

726396

show subpopulations

Gnomad4 AFR exome

AF:

0.00

Gnomad4 AMR exome

AF:

0.00

Gnomad4 ASJ exome

AF:

0.00

Gnomad4 EAS exome

AF:

0.00

Gnomad4 SAS exome

AF:

0.00

Gnomad4 FIN exome

AF:

0.00

Gnomad4 NFE exome

AF:

0.0000144

Gnomad4 OTH exome

AF:

0.00

GnomAD4 genome

AF:

0.0000197

AC:

AN:

152204

Hom.:

Cov.:

AF XY:

0.0000135

AC XY:

AN XY:

74348

show subpopulations

Gnomad4 AFR

AF:

0.0000483

Gnomad4 AMR

AF:

0.00

Gnomad4 ASJ

AF:

0.00

Gnomad4 EAS

AF:

0.00

Gnomad4 SAS

AF:

0.00

Gnomad4 FIN

AF:

0.00

Gnomad4 NFE

AF:

0.0000147

Gnomad4 OTH

AF:

0.00

Bravo

AF:

0.00000756

ClinVar

Significance: Pathogenic/Likely pathogenic

Submissions summary: Pathogenic:13Other:1

Revision: criteria provided, multiple submitters, no conflicts

LINK: link

Submissions by phenotype

Long QT syndrome 1

Pathogenic:4

Pathogenic, no assertion criteria provided	literature only	OMIM	Oct 07, 2010	- -
Pathogenic, criteria provided, single submitter	clinical testing	Clinical Genetics Laboratory, Region Ostergotland	May 26, 2020	PS3, PS4, PM1, PM2, PP1, PP3, PP5, BP2, BP5 -
Pathogenic, criteria provided, single submitter	research	Institute of Medical Genetics and Genomics, Sir Ganga Ram Hospital	Jan 01, 2013	- -
Pathogenic, criteria provided, single submitter	clinical testing	MGZ Medical Genetics Center	Nov 24, 2021	- -

not provided

Pathogenic:4

Pathogenic, criteria provided, single submitter	clinical testing	Institute of Medical Genetics and Applied Genomics, University Hospital Tübingen	Oct 23, 2020	- -
Pathogenic, no assertion criteria provided	clinical testing	Stanford Center for Inherited Cardiovascular Disease, Stanford University	Dec 02, 2014	Note this variant was found in clinical genetic testing performed by one or more labs who may also submit to ClinVar. Thus any internal case data may overlap with the internal case data of other labs. The interpretation reviewed below is that of the Stanford Center for Inherited Cardiovascular Disease. KCNQ1 p.Arg190Gln Given the strong case data and absence in controls, we consider this variant to be very likely disease causing. This variant has been seen in at least 10 unrelated cases of Long QT syndrome with moderate segregation data. This variant was previously reported as p.Arg61Gln and p.Arg95Gln. Wang et al (1996) identified KCNQ1 as the LQT1 locus and reported the first KCNQ1 variants, including p.Arg190Gln in a family with two affected individuals (reported as p.Arg61Gln). Donger et al (1997) observed the the variant in a family with long QT from their French cohort. It appears that multiple affected family members had the variant, though it is unclear from the data presented how many. Chouabe et al (2000) reported a family with long QT syndrome and the p.Arg190Gln variant. Of the four individuals in the family who carried the variant, three had a prolonged QT interval (472-530ms). Larsen et al (2001) observed the variant in a long QT patient from their Dutch cohort. Westenskow et al (2004) (Keating's group) observed the variant in a family with long QT syndrome who also carried a variant in KCNE1. The variant is reported in the Familion compendium in 3 of 2500 patients referred for clinical long QT genetic testing (Kapplinger et al 2009, likely same cases as Kapa et al 2009). Of note in considering the other cases reported by Kapplinger et al (2009) is the lack of phenotypic data on this cohort, the low yield of 36% (vs. 70% in cohorts with firm diagnoses of long QT), and the lack of clarity regarding which variants were seen with another variant (9% of the cohort had multiple variants). Gao et al reported the variant in a patient from their Chinese cohort with JLNS who was a compound heterozygote. Hofman et al (2010) reported on 14 long QT syndrome variants, including this one, that were found recurrently in the Netherlands. The p.Arg190Gln variant was seen in three different probands. The variant was included in several papers on genotype-phenotype correlations, however the cases likely overlap with prior reports (Moss et al 2007, Barsheshet et al 2012). We have seen this variant in one other family in our center, present in both mother and son with long QT syndrome. (note that the cases reported by Wang et al, Zareba et al, Moss et al, and Horr et al may not be unique) Chouabe et al (2000) reported that the variant led to a non-functional channel in their studies. Moretti et al (2010) studied patient-specific IPS cells with the p.Arg190Gln variant and observed a dominant-negative trafficking defect associated with a reduction in the I(Ks) current and altered channel activation and deactivation properties. The variant occurs in the S2-S3 domain, one of the cytoplasmic loops. Variants in this region are likely to pathogenic (Kapa et al 2009). Moss et al (2007) classified the variant's effect as haploinsufficient and found that such variants confer a lower risk of arrhythmias than variants with a dominant negative effect. However, a later report from the same group re-classified the effect as dominant negative (Barsheshet et al 2012). This same study also found a higher risk of events, as well as a greater response to beta-blockers, associated with variants in the cytoplasmic loop. In silico analysis with PolyPhen-2 predicts the variant to be probably damaging; SIFT predicts it to be deleterious. Other variants have been reported in association with disease at this codon (p.Arg190Leu, p.Arg190Trp) and nearby codons (p.Lys183Arg, p.Lys183Met, p.Tyr184His, p.Tyr184Ser, p.Gly186Arg, p.Gly186Ser, p.Leu187Pro, p.Gly189Glu, p.Gly189Arg, p.Leu191Pro, p.Arg192His, p.Arg192Pro, p.Arg192Cys, p.Phe193Leu, p.Ala94Pr -
Pathogenic, criteria provided, single submitter	clinical testing	GeneDx	Nov 29, 2021	Not observed at a significant frequency in large population cohorts (Lek et al., 2016); Functional studies in both mammalian cultured cells and induced pluripotent stem cell-derived cardiomyocytes showed that the co-expression wild-type and R190Q mutant channels alters the delayed rectifier potassium current through a dominant negative effect (Chouabe et al., 2000; Moretti et al., 2010); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; This variant is associated with the following publications: (PMID: 23158531, 25825456, 27916777, 27041150, 22456477, 22629021, 10376919, 19862833, 10973849, 19716085, 17470695, 21350584, 15840476, 19841300, 14678125, 20660394, 27470144, 28182229, 22949429, 27485560, 28532774, 9386136, 8528244, 10728423, 28573431, 27917693, 30428582, 31737537, 32383558, 32665702) -
Pathogenic, criteria provided, single submitter	clinical testing	Mayo Clinic Laboratories, Mayo Clinic	Mar 19, 2020	PP1_Strong, PS3_Moderate; PS4_Moderate, PM2, PM3, PM5, PM1, PP3 -

Cardiovascular phenotype

Pathogenic:2

Pathogenic, criteria provided, single submitter	clinical testing	Ambry Genetics	May 21, 2018	The p.R190Q pathogenic mutation (also known as c.569G>A), located in coding exon 3 of the KCNQ1 gene, results from a G to A substitution at nucleotide position 569. The arginine at codon 190 is replaced by glutamine, an amino acid with highly similar properties, and is located in the S2/S3 transmembrane spanning region of the protein. This mutation has been reported numerous times in individuals with long QT syndrome (LQTS) and in LQTS cohorts, and it has segregated with disease in several families (Wang Q et al. Nat. Genet. 1996;12:17-23; Chouabe C et al. Cardiovasc. Res. 2000;45:971-80; Moss AJ et al. Circulation. 2007;115:2481-9; Kapplinger JD et al. Heart Rhythm. 2009;6:1297-303; Moretti A et al. N. Engl. J. Med. 2010;363:1397-409). The p.R190Q mutation has also been detected in the homozygous and compound heterozygous states in Jervell and Lange-Nielsen syndrome (JLNS) patients (Gao Y et al. J Cardiovasc Dis Res. 2012;3:67-75; Vyas B et al. Am. J. Med. Genet. A. 2016;170:1510-9). Functional studies have demonstrated that p.R190Q disrupts KCNQ1 protein function, likely as a result of a trafficking defect, causing a reduction in the potassium current (Chouabe C et al. Cardiovasc. Res. 2000;45:971-80; Moretti A et al. N. Engl. J. Med. 2010;363:1397-409; Barsheshet A et al. Circulation. 2012;125:1988-96; Chen Z et al. Eur. Heart J. 2016;epub:ehw189). Based on the supporting evidence, this alteration is interpreted as a disease-causing mutation. -
Pathogenic, criteria provided, single submitter	clinical testing	Women's Health and Genetics/Laboratory Corporation of America, LabCorp	May 05, 2017	Variant summary: The KCNQ1 c.569G>A (p.Arg190Gln) variant causes a missense change involving the alteration of a highly conserved nucleotide. The variant is located within S2S3 cytoplasmic loop of transmembrane domain and 4/5 in silico tools predict a damaging outcome for this variant. The Arg190Gln was to proven to be a functionally abrogated by experimental studies where mutation led to a non-functional channel, independently of the presence of stimulation subunit IsK (Chouabe, 2000; Wang, 1999). The c.1550G>A was not identified in large, broad control datasets of ExAC and gnomAD (~120332 and ~246272 chrs tested, respectively), but is found in multiple LQTS individuals and segregated with the disease in several families (Wang, 1996; Chouabe, 2000; Gao, 2012). In addition, Arg190 appears to be a mutational hot-spot, as other alterations of this codon have been reported in association with LQTS (p.Arg190Leu, p.Arg190Trp). Lastly, multiple clinical diagnostic laboratories/reputable databases classified this variant as Pathogenic. Taken together, this variant is classified as Pathogenic. -

Congenital long QT syndrome

Pathogenic:1Other:1

not provided, no classification provided	literature only	Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust	-	This variant has been reported as associated with Long QT syndrome in the following publications (PMID:8528244;PMID:9386136;PMID:10728423;PMID:11668638;PMID:14678125;PMID:15051636;PMID:15840476;PMID:19716085;PMID:19841300;PMID:10376919;PMID:17470695;PMID:9693036;PMID:22456477;PMID:22629021). This is a literature report, and does not necessarily reflect the clinical interpretation of the Imperial College / Royal Brompton Cardiovascular Genetics laboratory. -
Likely pathogenic, criteria provided, single submitter	clinical testing	Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine	Jun 30, 2022	The p.Arg190Gln variant in KCNQ1 has been reported in at least 10 individuals with Long QT syndrome (LQTS) and segregated with disease in 6 affected individuals from 2 families (Wang 1996 PMID: 8528244, Wang 1999 PMID: 10376919, Chouabe 2000 PMID: 10728423, Barsheshet 2012 PMID: 22456477, Gao 2012 PMID: 22629021, Giudicessi 2012 PMID: 22949429, Ebrahim 2017 PMID: 28532774, Marschall 2019 PMID: 31737537, Westphal 2020 PMID: 32383558, Choi 2021 PMID: 34319147). It has also been identified in 1/113014 of European chromosomes by gnomAD (http://gnomad.broadinstitute.org). This variant has also been reported in ClinVar (Variation ID 3117). Computational prediction tools and conservation analyses suggest that this variant may impact the protein, though this information is not predictive enough to determine pathogenicity. In vitro and in vivo functional studies support an impact on protein function (Wang 1999 PMID: 10376919, Chouabe 2000 PMID: 10728423, Barsheshet 2012 PMID: 22456477). Another variant involving this codon (p.Arg190Leu) has been identified in individuals with LQTS and is classified as likely pathogenic by this laboratory. In summary, although additional studies are required to fully establish its clinical significance, this variant meets criteria to be classified as likely pathogenic for autosomal dominant LQTS. ACMG/AMP Criteria applied: PS4_Moderate, PM5, PP1_Moderate, PM2_Supporting, PP3, PS3_Moderate. -

Long QT syndrome

Pathogenic:1

Pathogenic, criteria provided, single submitter

clinical testing

Labcorp Genetics (formerly Invitae), Labcorp

Jan 17, 2024

This sequence change replaces arginine, which is basic and polar, with glutamine, which is neutral and polar, at codon 190 of the KCNQ1 protein (p.Arg190Gln). The frequency data for this variant in the population databases is considered unreliable, as metrics indicate poor data quality at this position in the gnomAD database. This missense change has been observed in individual(s) with Jervell and Lange-Nielsen syndrome and/or long QT syndrome (PMID: 8528244, 10728423, 17470695, 20660394, 22629021). In at least one individual the data is consistent with being in trans (on the opposite chromosome) from a pathogenic variant. It has also been observed to segregate with disease in related individuals. This variant is also known as p.Arg61Gln. ClinVar contains an entry for this variant (Variation ID: 3117). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is expected to disrupt KCNQ1 protein function with a positive predictive value of 95%. Experimental studies have shown that this missense change affects KCNQ1 function (PMID: 10376919, 10728423). For these reasons, this variant has been classified as Pathogenic. -

Cardiac arrhythmia

Pathogenic:1

Pathogenic, criteria provided, single submitter

clinical testing

Color Diagnostics, LLC DBA Color Health

Nov 26, 2019

This missense variant replaces arginine with glutamine at codon 190 of the KCNQ1 protein. Computational prediction suggests that this variant may have deleterious impact on protein structure and function (internally defined REVEL score threshold >= 0.7, PMID: 27666373). Functional studies have shown that this variant causes a loss of KCNQ1 channel activity (PMID: 10376919, 10728423, 20660394). This variant has been reported in individuals affected with long QT syndrome (PMID: 17470695, 19841300, 21350584, 22949429, 23075154, 8528244, 10728423, 20660394) and in individuals affected with Jervell and Lange-Nielsen syndrome (PMID: 22629021, 27485560). This variant has been shown to segregate with disease in multiple families affected with long QT syndrome (PMID: 8528244, 10728423, 20660394). This variant has been identified in 1/249462 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Based on the available evidence, this variant is classified as Pathogenic. -

Computational scores

Source: dbNSFP v4.3

Name

Calibrated prediction

Score

Prediction

AlphaMissense

Pathogenic

0.90

BayesDel_addAF

Pathogenic

0.58

BayesDel_noAF

Pathogenic

0.60

CADD

Pathogenic

DANN

Pathogenic

1.0

DEOGEN2

Pathogenic

0.99

.;D;.

Eigen

Pathogenic

0.90

Eigen_PC

Pathogenic

0.81

FATHMM_MKL

Pathogenic

0.99

LIST_S2

Pathogenic

1.0

D;D;D

M_CAP

Pathogenic

0.76

MetaRNN

Pathogenic

0.99

D;D;D

MetaSVM

Pathogenic

1.1

MutationAssessor

Pathogenic

3.7

.;H;.

MutationTaster

Benign

1.0

D;D

PrimateAI

Uncertain

0.64

PROVEAN

Uncertain

-3.8

D;D;D

REVEL

Pathogenic

0.95

Sift

Pathogenic

0.0

D;D;D

Sift4G

Pathogenic

0.0

D;D;D

Polyphen

1.0

.;D;.

Vest4

0.99, 0.97

MutPred

0.91

.;Loss of methylation at R190 (P = 0.0273);.;

MVP

0.98

MPC

1.3

ClinPred

1.0

GERP RS

4.4

Varity_R

0.94

gMVP

0.96

Splicing

Name

Calibrated prediction

Score

Prediction

SpliceAI score (max)

0.0

Details are displayed if max score is > 0.2

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Publications

LitVar

Below is the list of publications found by LitVar. It may be empty.

Variant summary

Frequency

Consequence

Scores

Clinical Significance

Conservation

ACMG classification

Transcripts

RefSeq

Ensembl

Frequencies

ClinVar

Submissions by phenotype

Computational scores

Splicing

Publications

LitVar

Other links and lift over