Tenascin-X, collagen, elastin, and the Ehlers-Danlos syndrome

James Bristow, William Carey, David Egging, Joost Schalkwijk

Research output: Contribution to journalReview articlepeer-review

70 Scopus citations


Tenascin-X is an extracellular matrix protein initially identified because the gene encoding it overlaps with the human CYP21B gene. Because studies of gene and protein function of other tenascins had been poorly predictive of essential functions in vivo, we used a genetic approach that critically relied on an understanding of the genomic locus to uncover an association between inactivating tenascin-X mutations and novel recessive and dominant forms of Ehlers-Danlos syndrome (EDS). Tenascin-X provides the first example of a gene outside of the fibrillar collagens and their processing enzymes that causes EDS. Tenascin-X null mice recapitulate the skin findings of the human disease, confirming a causative role for this gene in EDS. Further evaluation of these mice showed that tenascin-X is an important regulator of collagen deposition in vivo, suggesting a novel mechanism of disease in this form of EDS. Further studies suggest that tenascin-X may do this through both direct and indirect interactions with the collagen fibril. Recent studies show that TNX effects on matrix extend beyond the collagen to the elastogenic pathway and matrix remodeling enzymes. Tenascin-X serves as a compelling example of how human "experiments of nature" can guide us to an understanding of genes whose function may not be evident from their sequence or in vitro studies of their encoded proteins.

Original languageEnglish (US)
Pages (from-to)24-30
Number of pages7
JournalAmerican Journal of Medical Genetics - Seminars in Medical Genetics
Volume139 C
Issue number1
StatePublished - Nov 15 2005


  • Collagen
  • Ehlers-Danlos syndrome
  • Elastin
  • Tenascin-X

ASJC Scopus subject areas

  • Genetics
  • Genetics(clinical)


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