中国神经再生研究(英文版) ›› 2024, Vol. 19 ›› Issue (1): 80-83.doi: 10.4103/1673-5374.375316

• 综述:退行性病与再生 • 上一篇    下一篇

载脂蛋白E亚型对散发性阿尔茨海默病的影响:超越淀粉样蛋白β的作用

  

  • 出版日期:2024-01-15 发布日期:2023-08-02

Impact of apolipoprotein E isoforms on sporadic Alzheimer’s disease: beyond the role of amyloid beta

Madia Lozupone1, *, Francesco Panza2, *   

  1. 1Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy; 2Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, Bari, Italy
  • Online:2024-01-15 Published:2023-08-02
  • Contact: Madia Lozupone, MD, PhD, madia.lozupone@gmail.com; Francesco Panza, MD, PhD, f_panza@hotmail.com.

摘要: https://orcid.org/0000-0002-1674-9724 (Madia Lozupone); https://orcid.org/0000-0002-7220-0656 (Francesco Panza)

Abstract: The impact of apolipoprotein E (ApoE) isoforms on sporadic Alzheimer’s disease has long been studied; however, the influences of apolipoprotein E gene (APOE) on healthy and pathological human brains are not fully understood. ApoE exists as three common isoforms (ApoE2, ApoE3, and ApoE4), which differ in two amino acid residues. Traditionally, ApoE binds cholesterol and phospholipids and ApoE isoforms display different affinities for their receptors, lipids transport and distribution in the brain and periphery. The role of ApoE in the human depends on ApoE isoforms, brain regions, aging, and neural injury. APOE ε4 is the strongest genetic risk factor for sporadic Alzheimer’s disease, considering its role in influencing amyloid-beta metabolism. The exact mechanisms by which APOE gene variants may increase or decrease Alzheimer’s disease risk are not fully understood, but APOE was also known to affect directly and indirectly tau-mediated neurodegeneration, lipids metabolism, neurovascular unit, and microglial function. Consistent with the biological function of ApoE, ApoE4 isoform significantly altered signaling pathways associated with cholesterol homeostasis, transport, and myelination. Also, the rare protective APOE variants confirm that ApoE plays an important role in Alzheimer’s disease pathogenesis. The objectives of the present mini-review were to describe classical and new roles of various ApoE isoforms in Alzheimer’s disease pathophysiology beyond the deposition of amyloid-beta and to establish a functional link between APOE, brain function, and memory, from a molecular to a clinical level. APOE genotype also exerted a heterogeneous effect on clinical Alzheimer’s disease phenotype and its outcomes. Not only in learning and memory but also in neuropsychiatric symptoms that occur in a premorbid condition. Clarifying the relationships between Alzheimer’s disease-related pathology with neuropsychiatric symptoms, particularly suicidal ideation in Alzheimer’s disease patients, may be useful for elucidating also the underlying pathophysiological process and its prognosis. Also, the effects of anti-amyloid-beta drugs, recently approved for the treatment of Alzheimer’s disease, could be influenced by the APOE genotype.

Key words: Alzheimer’s disease, amyloid-beta, apolipoprotein E, dementia, glymphatic transport, lipids, neuropsychiatric symptoms, neurovascular unit, tau protein