Autosomal dominant Emery–Dreifuss muscular dystrophy is caused by mutations in LMNA gene encoding lamins A and C. The disease is characterized by early onset joint contractures during childhood associated
with humero-peroneal muscular wasting and weakness, and by the development of a cardiac disease in adulthood. Important intra-familial
variability characterized by a wide range of age at onset of myopathic symptoms (AOMS) has been recurrently reported, suggesting
the contribution of a modifier gene. Our objective was to identify a modifier locus of AOMS in relation with the LMNA mutation. To map the modifier locus, we genotyped 291 microsatellite markers in 59 individuals of a large French family,
where 19 patients carrying the same LMNA mutation, exhibited wide range of AOMS. We performed Bayesian Markov Chain Monte Carlo-based joint segregation and linkage
methods implemented in the Loki© software, and detected a strong linkage signal on chromosome 2 between markers D2S143 and D2S2244 (211 cM) with a Bayes factor
of 28.7 (empirical p value = 0.0032). The linked region harbours two main candidate genes, DES and MYL1 encoding desmin and light chain of myosin. Importantly, the impact of the genotype on the phenotype for this locus showed
an overdominant effect with AOMS 2 years earlier for the homozygotes of the rare allele and 37 years earlier for the heterozygotes
than the homozygotes for the common allele. These results provide important highlights for the natural history and for the
physiopathology of Emery–Dreifuss muscular dystrophy.
The authors wish it to be known that, in their opinion, the B. Granger, L. Gueneau authors should be regarded as joint first
authors and the S. Tezenas du Montcel, G. Bonne authors should be regarded as joint last authors.