Diagnostic Exome Sequencing Identifies a Novel Gene, EMILIN1, Associated with Autosomal-Dominant Hereditary Connective Tissue Disease

Hum Mutat. 2016 Jan;37(1):84-97. doi: 10.1002/humu.22920. Epub 2015 Nov 4.


Heritable connective tissue diseases are a highly heterogeneous family of over 200 disorders that affect the extracellular matrix. While the genetic basis of several disorders is established, the etiology has not been discovered for a large portion of patients, likely due to rare yet undiscovered disease genes. By performing trio-exome sequencing of a 55-year-old male proband presenting with multiple symptoms indicative of a connective disorder, we identified a heterozygous missense alteration in exon 1 of the Elastin Microfibril Interfacer 1 (EMILIN1) gene, c.64G>A (p.A22T). The proband presented with ascending and descending aortic aneurysms, bilateral lower leg and foot sensorimotor peripheral neuropathy, arthropathy, and increased skin elasticity. Sanger sequencing confirmed that the EMILIN1 alteration, which maps around the signal peptide cleavage site, segregated with disease in the affected proband, mother, and son. The impaired secretion of EMILIN-1 in cells transfected with the mutant p.A22T coincided with abnormal protein accumulation within the endoplasmic reticulum. In skin biopsy of the proband, we detected less EMILIN-1 with disorganized and abnormal coarse fibrils, aggregated deposits underneath the epidermis basal lamina, and dermal cells apoptosis. These findings collectively suggest that EMILIN1 may represent a new disease gene associated with an autosomal-dominant connective tissue disorder.

Keywords: EMILIN-1; autosomal dominant; connective tissue; diagnostic exome sequencing; neuropathy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amino Acid Sequence
  • Animals
  • Biopsy
  • Cell Line
  • Cluster Analysis
  • Computational Biology / methods
  • Connective Tissue Diseases / diagnosis*
  • Connective Tissue Diseases / genetics*
  • DNA Mutational Analysis
  • Exome*
  • Female
  • Gene Expression
  • Genes, Dominant*
  • High-Throughput Nucleotide Sequencing*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Membrane Glycoproteins / chemistry
  • Membrane Glycoproteins / genetics*
  • Membrane Glycoproteins / metabolism
  • Mice
  • Molecular Sequence Data
  • Mutation
  • Pedigree
  • Phenotype
  • Sequence Alignment
  • Skin / pathology


  • Membrane Glycoproteins
  • elastin microfibril interface located protein