TMED1 (transmembrane p24 trafficking protein 1) is a sorting receptor functioning in the early secretory pathway, particularly in bidirectional ER-Golgi transport 1. The protein contains a GOLD domain that mediates homodimer formation in a salt-dependent manner 1, facilitating its role as a cargo receptor for incorporation of secretory molecules into COPII-coated transport vesicles. Beyond vesicular trafficking, TMED1 participates in innate immune signaling through two distinct mechanisms: it associates with the IL-33 receptor (ST2L) via its GOLD domain to enhance IL-33-mediated IL-8 and IL-6 production 2, and modulates the cGAS-STING pathway through RNF26 interaction. TMED1 has emerged as clinically relevant in multiple disease contexts. In head and neck squamous carcinoma, TMED1 expression is significantly elevated and associated with poor prognosis 3. In autism spectrum disorder, TMED1 is identified as a gene closely related to ZIC family members implicated in cerebellar pathogenesis and demonstrates good diagnostic accuracy for ASD prediction 4. The TMED family more broadly shows involvement in diverse malignancies, immune dysfunction, and neurodegenerative diseases 5. These findings position TMED1 as a promising therapeutic target and prognostic biomarker.