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Wikipedia

Apolipoprotein E

Apolipoprotein E (Apo-E) is a protein involved in the metabolism of fats in the body of mammals. A subtype is implicated in Alzheimer's disease and cardiovascular diseases.[5] It is encoded in humans by the gene APOE.

APOE
Available structures
PDBOrtholog search: PDBe RCSB
Identifiers
AliasesAPOE, AD2, APO-E, LDLCQ5, LPG, apolipoprotein E, ApoE4
External IDsOMIM: 107741 MGI: 88057 HomoloGene: 30951 GeneCards: APOE
Orthologs
SpeciesHumanMouse
Entrez
Ensembl
UniProt
RefSeq (mRNA)

NM_001302691
NM_000041
NM_001302688
NM_001302689
NM_001302690

NM_009696
NM_001305819
NM_001305843
NM_001305844

RefSeq (protein)

NP_000032
NP_001289617
NP_001289618
NP_001289619
NP_001289620

NP_001292748
NP_001292772
NP_001292773
NP_033826

Location (UCSC)Chr 19: 44.91 – 44.91 MbChr 7: 19.43 – 19.43 Mb
PubMed search[3][4]
Wikidata
View/Edit HumanView/Edit Mouse

Apo-E belongs to a family of fat-binding proteins called apolipoproteins. In the circulation, it is present as part of several classes of lipoprotein particles, including chylomicron remnants, VLDL, IDL, and some HDL.[6] APOE interacts significantly with the low-density lipoprotein receptor (LDLR), which is essential for the normal processing (catabolism) of triglyceride-rich lipoproteins.[7] In peripheral tissues, APOE is primarily produced by the liver and macrophages, and mediates cholesterol metabolism. In the central nervous system, Apo-E is mainly produced by astrocytes and transports cholesterol to neurons[8] via APOE receptors, which are members of the low density lipoprotein receptor gene family.[9] Apo-E is the principal cholesterol carrier in the brain.[10] APOE qualifies as a checkpoint inhibitor of the classical complement pathway by complex formation with activated C1q.[11]

Evolution edit

Apolipoproteins are not unique to mammals. Many terrestrial and marine vertebrates have versions of them.[12] It is believed that APOE arose via gene duplications of APOC1 before the fish-tetrapod split c. 400 million years ago. Proteins similar in function have been found in choanoflagellates, suggesting that they are a very old class of proteins predating the dawn of all living animals.[13]

The three major human alleles (E4, E3, E2) arose after the primate-human split around 7.5 million years ago. These alleles are the by-product of non-synonymous mutations which led to changes in functionality. The first allele to emerge was E4. After the primate-human split, there were four amino acid changes in the human lineage, three of which had no effect on protein function (V174L, A18T, A135V). The fourth substitution (T61R) traded a threonine for an arginine altering the protein's functionality. This substitution occurred somewhere in the 6 million year gap between the primate-human split and the Denisovan-human split, since exactly the same substitutions were found in Denisovan APOE.[14]

About 220,000 years ago, a cysteine to arginine substitution took place at amino acid 112 (Cys112Arg) of the APOE4 gene, and this resulted in the E3 allele. Finally, 80,000 years ago, another arginine to cysteine substitution at amino acid 158 (Arg158Cys) of the APOE3 gene created the E2 allele.[15][13]

Structure edit

Gene edit

The gene, APOE, is mapped to chromosome 19 in a cluster with apolipoprotein C1 (APOC1) and the apolipoprotein C2 (APOC2). The APOE gene consists of four exons and three introns, totaling 3597 base pairs. APOE is transcriptionally activated by the liver X receptor (an important regulator of cholesterol, fatty acid, and glucose homeostasis) and peroxisome proliferator-activated receptor γ, nuclear receptors that form heterodimers with retinoid X receptors.[16] In melanocytic cells APOE gene expression may be regulated by MITF.[17]

Protein edit

APOE is 299 amino acids long and contains multiple amphipathic α-helices. According to crystallography studies, a hinge region connects the N- and C-terminal regions of the protein. The N-terminal region (residues 1–167) forms an anti-parallel four-helix bundle such that the non-polar sides face inside the protein. Meanwhile, the C-terminal domain (residues 206–299) contains three α-helices which form a large exposed hydrophobic surface and interact with those in the N-terminal helix bundle domain through hydrogen bonds and salt-bridges. The C-terminal region also contains a low density lipoprotein receptor (LDLR)-binding site.[18]

Polymorphisms edit

SNP: rs429358
GeneApoE
Chromosome19
External databases
EnsemblHuman SNPView
dbSNP429358
HapMap429358
SNPedia429358

APOE is polymorphic,[19][20] with three major alleles (epsilon 2, epsilon 3, and epsilon 4): APOE-ε2 (cys112, cys158), APOE-ε3 (cys112, arg158), and APOE-ε4 (arg112, arg158).[5][21][22] Although these allelic forms differ from each other by only one or two amino acids at positions 112 and 158,[23][24][25] these differences alter APOE structure and function.

There are several low-frequency polymorphisms of APOE. APOE5 comes in two subtypes E5f and E5s, based on migration rates. APOE5 E5f and APOE7 combined were found in 2.8% of Japanese males.[26][unreliable medical source] APOE7 is a mutation of APOE3 with two lysine residues replacing glutamic acid residues at positions 244 and 245.[27]

Polymorphism Worldwide allele frequency Disease relevance
ε2 (rs7412-T, rs429358-T) 8.4%[9] This variant of the apoprotein binds poorly to cell surface receptors while E3 and E4 bind well.[28] E2 is associated with both increased and decreased risk for atherosclerosis. Individuals with an E2/E2 combination may clear dietary fat slowly and be at greater risk for early vascular disease and the genetic disorder type III hyperlipoproteinemia—94.4% of people with such disease are E2/E2 but only ~2% of E2/E2 develop it, so other environmental and genetic factors are likely to be involved (such as cholesterol in the diet and age).[29][30][31] E2 has also been implicated in Parkinson's disease,[32] but this finding was not replicated in a larger population association study.[33]
ε3 (rs7412-C, rs429358-T) 77.9%[9] This variant is considered the "neutral" APOE genotype.
ε4 (rs7412-C, rs429358-C) 13.7%[9]

E4 has been implicated in atherosclerosis,[34][35] Alzheimer's disease,[36][37] impaired cognitive function,[38][39] reduced hippocampal volume,[40] HIV,[41] faster disease progression in multiple sclerosis,[42][43] unfavorable outcome after traumatic brain injury,[44] ischemic cerebrovascular disease,[45] sleep apnea,[46][47] both the extension and shortening of telomeres,[48][49][50][51] reduced neurite outgrowth,[52] and COVID-19.[53] However, E4 has also been associated with enhanced vitamin D and calcium status,[54] higher fecundity,[55] protection against early childhood infection and malnutrition,[56] and decreased fetal, perinatal, and infant mortality.[57]

Much remains to be learned about the APOE isoforms, including the interaction of other protective genes.[58] Indeed, the apolipoprotein ε4 isoform is more protective against cognitive decline than other isoforms in some cases,[58] so caution is advised before making determinant statements about the influence of APOE polymorphisms on cognition, development of Alzheimer's disease, cardiovascular disease, telomere shortening, etc. Many of the studies cited that purport these adverse outcomes are from single studies that have not been replicated and the research is based on unchecked assumptions about this isoform. As of 2007, there was no evidence that APOE polymorphisms influence cognition in younger age groups (other than possible increased episodic memory ability and neural efficiency in younger APOE4 age groups), nor that the APOE4 isoform places individuals at increased risk for any infectious disease.[59]

However, the association between the APOE4 allele and Alzheimer's disease has been shown to be weaker in minority groups differently compared to their Caucasian counterparts.[9] Hispanics/Latinos and African Americans who were homozygous for the APOE4 allele had 2.2 and 5.7 times the odds, respectively of developing Alzheimer's disease.[60][9] The APOE4 allele has an even stronger effect in East Asian populations, with Japanese populations have 33 times the odds compared to other populations.[61] Caucasians who were homozygous for the allele had 12.5 times the odds.[60][9]

Function edit

As a component of the lipoprotein lipid transport system, APOE facilitates the transport of lipids, fat-soluble vitamins, and cholesterol via the blood. It interacts with the LDL receptor to facilitate endocytosis of VLDL remnants. It is synthesized principally in the liver, but has also been found in other tissues such as the brain, kidneys, and spleen.[21] APOE synthesized in the liver associates with HDL which can then distribute it to newly formed VLDL or chylomicron particles to facilitate their eventual uptake by the liver.

In the nervous system, non-neuronal cell types, most notably astroglia and microglia, are the primary producers of APOE, while neurons preferentially express the receptors for APOE.[62] There are seven currently identified mammalian receptors for APOE which belong to the evolutionarily conserved LDLR family.[63]

APOE was initially recognized for its importance in lipoprotein metabolism and cardiovascular disease. Defects in APOE result in familial dysbetalipoproteinemia aka type III hyperlipoproteinemia (HLP III), in which increased plasma cholesterol and triglycerides are the consequence of impaired clearance of chylomicron, VLDL and LDL.[64][7] More recently, it has been studied for its role in several biological processes not directly related to lipoprotein transport, including Alzheimer's disease (AD), immunoregulation, and cognition.[5] Though the exact mechanisms remain to be elucidated, isoform 4 of APOE, encoded by an APOE allele, has been associated with increased calcium ion levels and apoptosis following mechanical injury.[65]

In the field of immune regulation, a growing number of studies point to APOE's interaction with many immunological processes, including suppressing T cell proliferation, macrophage functioning regulation, lipid antigen presentation facilitation (by CD1)[66] to natural killer T cell as well as modulation of inflammation and oxidation.[67] APOE is produced by macrophages and APOE secretion has been shown to be restricted to classical monocytes in PBMC, and the secretion of APOE by monocytes is down regulated by inflammatory cytokines and upregulated by TGF-beta.[68]

Clinical significance edit

Alzheimer's disease edit

As of 2012, the E4 variant was the largest known genetic risk factor for late-onset sporadic Alzheimer's disease (AD) in a variety of ethnic groups.[69] However, the E4 variant does not correlate with risk in every population. Nigerian people have the highest observed frequency of the APOE4 allele in world populations,[70] but AD is rare among them.[70][71] This may be due to their low cholesterol levels.[70][71][72][73] Caucasian and Japanese carriers of two E4 alleles have between 10 and 30 times the risk of developing AD by 75 years of age, as compared to those not carrying any E4 alleles. This may be caused by an interaction with amyloid.[74] Alzheimer's disease is characterized by build-ups of aggregates of the peptide beta-amyloid. Apolipoprotein E enhances proteolytic break-down of this peptide, both within and between cells. The isoform APOE-ε4 is not as effective as the others at promoting these reactions, resulting in increased vulnerability to AD in individuals with that gene variation.[75]

Recently, the amyloid hypothesis of Alzheimer's disease has been questioned, and an article in Science claimed that "Just as removing smoke does not extinguish a fire, reducing amyloid plaques may not affect the course of Alzheimer's disease."[76] The role that the E4 variant carries can still be fully explained even in the absence of a valid amyloid hypothesis given the fact that reelin signaling emerges to be one of the key processes involved in Alzheimer's disease[77] and the E4 variant is shown to interact with ApoER2, one of the neuronal reelin receptors, thereby obstructing reelin signaling.[77]

Although 40–65% of AD patients have at least one copy of the ε4 allele, APOE4 is not a determinant of the disease. At least one-third of patients with AD are APOE4 negative and some APOE4 homozygotes never develop the disease. Yet those with two ε4 alleles have up to 20 times the risk of developing AD.[78] There is also evidence that the APOE2 allele may serve a protective role in AD.[79] Thus, the genotype most at risk for Alzheimer's disease and at an earlier age is APOE4,4. Using genotype APOE3,3 as a benchmark (with the persons who have this genotype regarded as having a risk level of 1.0) and for white populations only, individuals with genotype APOE4,4 have an odds ratio of 14.9 of developing Alzheimer's disease. Individuals with the APOE3,4 genotype face an odds ratio of 3.2, and people with a copy of the 2 allele and the 4 allele (APOE2,4), have an odds ratio of 2.6. Persons with one copy each of the 2 allele and the 3 allele (APOE2,3) have an odds ratio of 0.6. Persons with two copies of the 2 allele (APOE2,2) also have an odds ratio of 0.6.[80]

Estimated worldwide human allele frequencies of APOE in Caucasian population[80]
Allele ε2 ε3 ε4
General frequency 8.4% 77.9% 13.7%
AD frequency 3.9% 59.4% 36.7%

While ApoE4 has been found to greatly increase the odds that an individual will develop Alzheimer's, a 2002 study concluded, that in persons with any combination of APOE alleles, high serum total cholesterol and high blood pressure in mid-life are independent risk factors which together can nearly triple the risk that the individual will later develop AD.[73] Projecting from their data, some researchers have suggested that lowering serum cholesterol levels may reduce a person's risk for Alzheimer's disease, even if they have two ApoE4 alleles, thus reducing the risk from nine or ten times the odds of getting AD down to just two times the odds.[73]

Women are more likely to develop AD than men across most ages and APOE genotypes. Premorbid women with the ε4 allele have significantly more neurological dysfunction than men.[81]

APOE-ε4 increases the risk not only for AD but also for dementia in pure alpha-synucleinopathies.[82] The influence of APOE-ε4 on hippocampal atrophy was suggested to be more predominant early in the course of AD at milder stages prior to more widespread neurodegeneration.[83]

Atherosclerosis edit

Knockout mice that lack the apolipoprotein-E gene (APOE−/−) develop extreme hypercholesterolemia when fed a high-fat diet.[84]

Malaria edit

APOE−/− knockout mice show marked attenuation of cerebral malaria and increased survival, as well as decreased sequestration of parasites and T cells within the brain, likely due to protection of the blood–brain barrier.[85] Human studies have shown that the APOE2 polymorphism correlates with earlier infection, and APOE3/4 polymorphisms increase likelihood of severe malaria.[86]

Lyme disease edit

Borrelia burgdorferi, the causative agent of Lyme disease, is a host-adapted pathogen that acquires environmental cholesterol to form glycolipids for use in cell membrane maintenance. In one experiment in 2015, mice engineered with apoE deficiency were infected with Borrelia spirochetes. The knockout mice suffered from an increased spirochete burden in joints, as well as inflamed ankles, when compared with wild-type mice. This study suggests that apoE deficiency (and potentially other hyperlipidemias) may be a risk factor in the pathogenicity of Lyme disease.

Interactions edit

Interactive pathway map edit

Click on genes, proteins and metabolites below to link to respective articles. [§ 1]

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|alt=Statin Pathway edit]]
Statin Pathway edit
  1. ^ The interactive pathway map can be edited at WikiPathways: "Statin_Pathway_WP430".

References edit

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Further reading edit

  • Ashford JW (2004). "APOE genotype effects on Alzheimer's disease onset and epidemiology". Journal of Molecular Neuroscience. 23 (3): 157–165. doi:10.1385/JMN:23:3:157. PMID 15181244. S2CID 14864342.
  • Beffert U, Danik M, Krzywkowski P, Ramassamy C, Berrada F, Poirier J (July 1998). "The neurobiology of apolipoproteins and their receptors in the CNS and Alzheimer's disease". Brain Research. Brain Research Reviews. 27 (2): 119–142. doi:10.1016/S0165-0173(98)00008-3. PMID 9622609. S2CID 28731779.
  • Bennet AM, Di Angelantonio E, Ye Z, Wensley F, Dahlin A, Ahlbom A, et al. (September 2007). "Association of apolipoprotein E genotypes with lipid levels and coronary risk". JAMA. 298 (11): 1300–1311. doi:10.1001/jama.298.11.1300. PMID 17878422.
  • Bocksch L, Stephens T, Lucas A, Singh B (December 2001). "Apolipoprotein E: possible therapeutic target for atherosclerosis". Current Drug Targets - Cardiovascular & Hematological Disorders. 1 (2): 93–106. doi:10.2174/1568006013337944. PMID 12769659.
  • de Knijff P, van den Maagdenberg AM, Frants RR, Havekes LM (1995). "Genetic heterogeneity of apolipoprotein E and its influence on plasma lipid and lipoprotein levels". Human Mutation. 4 (3): 178–194. doi:10.1002/humu.1380040303. PMID 7833947. S2CID 41959843.
  • Gunzburg MJ, Perugini MA, Howlett GJ (December 2007). "Structural basis for the recognition and cross-linking of amyloid fibrils by human apolipoprotein E". The Journal of Biological Chemistry. 282 (49): 35831–35841. doi:10.1074/jbc.M706425200. PMID 17916554.
  • Huang Y, Weisgraber KH, Mucke L, Mahley RW (2004). "Apolipoprotein E: diversity of cellular origins, structural and biophysical properties, and effects in Alzheimer's disease". Journal of Molecular Neuroscience. 23 (3): 189–204. doi:10.1385/JMN:23:3:189. PMID 15181247. S2CID 40135107.
  • Itzhaki RF, Dobson CB, Shipley SJ, Wozniak MA (June 2004). "The role of viruses and of APOE in dementia". Annals of the New York Academy of Sciences. 1019 (1): 15–18. Bibcode:2004NYASA1019...15I. doi:10.1196/annals.1297.003. PMID 15246985. S2CID 28979273.
  • Kolbe D, da Silva NA, Dose J, Torres GG, Caliebe A, Krause-Kyora B, Nebel A (May 2023). "Current allele distribution of the human longevity gene APOE in Europe can mainly be explained by ancient admixture". Aging Cell. 22 (5). Wiley: e13819. doi:10.1111/acel.13819. PMC 10186601. PMID 36951219.
  • Kolovou GD, Anagnostopoulou KK (August 2007). "Apolipoprotein E polymorphism, age and coronary heart disease". Ageing Research Reviews. 6 (2): 94–108. doi:10.1016/j.arr.2006.11.001. PMID 17224309. S2CID 35607578.
  • Lambert JC, Amouyel P (August 2007). "Genetic heterogeneity of Alzheimer's disease: complexity and advances". Psychoneuroendocrinology. 32 (Suppl 1): S62–S70. doi:10.1016/j.psyneuen.2007.05.015. PMID 17659844. S2CID 8114580.
  • Liu CC, Liu CC, Kanekiyo T, Xu H, Bu G (February 2013). "Apolipoprotein E and Alzheimer disease: risk, mechanisms and therapy". Nature Reviews. Neurology. 9 (2): 106–118. doi:10.1038/nrneurol.2012.263. PMC 3726719. PMID 23296339.
  • Mahley RW, Ji ZS (January 1999). "Remnant lipoprotein metabolism: key pathways involving cell-surface heparan sulfate proteoglycans and apolipoprotein E". Journal of Lipid Research. 40 (1): 1–16. doi:10.1016/S0022-2275(20)33334-4. PMID 9869645.
  • Mahley RW, Rall SC (2002). "Apolipoprotein E: far more than a lipid transport protein". Annual Review of Genomics and Human Genetics. 1 (1): 507–537. doi:10.1146/annurev.genom.1.1.507. PMID 11701639.
  • Mahley RW (April 1988). "Apolipoprotein E: cholesterol transport protein with expanding role in cell biology". Science. 240 (4852): 622–630. Bibcode:1988Sci...240..622M. doi:10.1126/science.3283935. PMID 3283935.
  • Masterman T, Hillert J (June 2004). "The telltale scan: APOE epsilon4 in multiple sclerosis". The Lancet. Neurology. 3 (6): 331. doi:10.1016/S1474-4422(04)00763-X. PMID 15157846. S2CID 54404547.
  • Moriyama K, Sasaki J, Matsunaga A, Arakawa F, Takada Y, Araki K, et al. (September 1992). "Apolipoprotein E1 Lys-146----Glu with type III hyperlipoproteinemia". Biochimica et Biophysica Acta. 1128 (1): 58–64. doi:10.1016/0005-2760(92)90257-V. PMID 1356443.
  • Parasuraman R, Greenwood PM, Sunderland T (April 2002). "The apolipoprotein E gene, attention, and brain function". Neuropsychology. 16 (2): 254–274. doi:10.1037/0894-4105.16.2.254. PMC 1350934. PMID 11949718.
  • Raber J (2007). "Role of apolipoprotein E in anxiety". Neural Plasticity. 2007: 91236. doi:10.1155/2007/91236. PMC 1940061. PMID 17710250.
  • Roses AD, Einstein G, Gilbert J, Goedert M, Han SH, Huang D, et al. (January 1996). "Morphological, biochemical, and genetic support for an apolipoprotein E effect on microtubular metabolism". Annals of the New York Academy of Sciences. 777 (1): 146–157. Bibcode:1996NYASA.777..146R. doi:10.1111/j.1749-6632.1996.tb34413.x. PMID 8624078. S2CID 9145181.
  • Strittmatter WJ, Roses AD (May 1995). "Apolipoprotein E and Alzheimer disease". Proceedings of the National Academy of Sciences of the United States of America. 92 (11): 4725–4727. Bibcode:1995PNAS...92.4725S. doi:10.1073/pnas.92.11.4725. PMC 41779. PMID 7761390.
  • Utermann G, Pruin N, Steinmetz A (January 1979). "Polymorphism of apolipoprotein E. III. Effect of a single polymorphic gene locus on plasma lipid levels in man". Clinical Genetics. 15 (1): 63–72. doi:10.1111/j.1399-0004.1979.tb02028.x. PMID 759055. S2CID 34127430.
  • Ye J (August 2007). "Reliance of host cholesterol metabolic pathways for the life cycle of hepatitis C virus". PLOS Pathogens. 3 (8): e108. doi:10.1371/journal.ppat.0030108. PMC 1959368. PMID 17784784.

External links edit

  • Apolipoproteins+E at the U.S. National Library of Medicine Medical Subject Headings (MeSH)
  • apoe4.info – website for APOE-epsilon-4 carriers
  • Human APOE genome location and APOE gene details page in the UCSC Genome Browser.
  • Overview of all the structural information available in the PDB for UniProt: P02649 (Apolipoprotein E) at the PDBe-KB.

apolipoprotein, protein, involved, metabolism, fats, body, mammals, subtype, implicated, alzheimer, disease, cardiovascular, diseases, encoded, humans, gene, apoe, apoeavailable, structurespdbortholog, search, pdbe, rcsblist, codes1b68, 1bz4, 1ea8, 1gs9, 1h7i,. Apolipoprotein E Apo E is a protein involved in the metabolism of fats in the body of mammals A subtype is implicated in Alzheimer s disease and cardiovascular diseases 5 It is encoded in humans by the gene APOE APOEAvailable structuresPDBOrtholog search PDBe RCSBList of PDB id codes1B68 1BZ4 1EA8 1GS9 1H7I 1LE2 1LE4 1LPE 1NFN 1NFO 1OEF 1OEG 1OR2 1OR3 2KC3 2KNY 2L7BIdentifiersAliasesAPOE AD2 APO E LDLCQ5 LPG apolipoprotein E ApoE4External IDsOMIM 107741 MGI 88057 HomoloGene 30951 GeneCards APOEGene location Human Chr Chromosome 19 human 1 Band19q13 32Start44 905 791 bp 1 End44 909 393 bp 1 Gene location Mouse Chr Chromosome 7 mouse 2 Band7 A3 7 9 94 cMStart19 430 034 bp 2 End19 433 113 bp 2 RNA expression patternBgeeHumanMouse ortholog Top expressed inleft adrenal glandright lobe of livernucleus accumbensamygdalahypothalamuscaudate nucleusputamenspinal gangliaexternal globus palliduskidneyTop expressed inentorhinal cortexleft lobe of liveryolk sacgallbladdersuperior frontal gyruslipmedian eminencearcuate nucleusoptic nerveglobus pallidusMore reference expression dataBioGPSMore reference expression dataGene ontologyMolecular functionheparin binding very low density lipoprotein particle receptor binding low density lipoprotein particle receptor binding lipoprotein particle binding phosphatidylcholine sterol O acyltransferase activator activity phospholipid binding cholesterol transfer activity protein homodimerization activity amyloid beta binding protein binding tau protein binding metal chelating activity lipid transporter activity cholesterol binding antioxidant activity identical protein binding lipid bindingCellular componentcytoplasm membrane chylomicron extracellular region nucleus extracellular vesicle endocytic vesicle lumen very low density lipoprotein particle extracellular fluid endoplasmic reticulum extracellular exosome Golgi apparatus blood microparticle extracellular matrix plasma membrane neuronal cell body early endosome low density lipoprotein particle dendrite high density lipoprotein particle intermediate density lipoprotein particleBiological processnegative regulation of neuron apoptotic process response to dietary excess negative regulation of lipid transport across blood brain barrier lipid transport positive regulation of lipid biosynthetic process regulation of axon extension positive regulation of postsynaptic membrane organization positive regulation of cholesterol esterification phospholipid efflux cholesterol catabolic process positive regulation of dendritic spine development receptor mediated endocytosis retinoid metabolic process positive regulation of amyloid beta formation lipid homeostasis lipoprotein biosynthetic process cholesterol homeostasis negative regulation of inflammatory response triglyceride metabolic process negative regulation of canonical Wnt signaling pathway negative regulation of dendritic spine maintenance negative regulation of blood vessel endothelial cell migration NMDA glutamate receptor clustering response to reactive oxygen species negative regulation of blood coagulation response to oxidative stress positive regulation of nitric oxide synthase activity negative regulation of phospholipid efflux positive regulation of cholesterol efflux negative regulation of MAP kinase activity artery morphogenesis very low density lipoprotein particle remodeling regulation of neuronal synaptic plasticity negative regulation of dendritic spine development negative regulation of cholesterol biosynthetic process positive regulation of dendritic spine maintenance positive regulation of phospholipid efflux negative regulation of presynaptic membrane organization negative regulation of neuron death high density lipoprotein particle clearance long chain fatty acid transport lipoprotein metabolic process regulation of tau protein kinase activity G protein coupled receptor signaling pathway chylomicron remnant clearance cellular calcium ion homeostasis cholesterol metabolic process very low density lipoprotein particle clearance virion assembly negative regulation of lipid biosynthetic process cGMP mediated signaling triglyceride catabolic process positive regulation of presynaptic membrane organization positive regulation of neurofibrillary tangle assembly AMPA glutamate receptor clustering positive regulation of low density lipoprotein particle receptor catabolic process positive regulation of lipid transport across blood brain barrier fatty acid homeostasis nitric oxide mediated signal transduction transport cholesterol efflux regulation of gene expression negative regulation of cholesterol efflux regulation of amyloid beta clearance neuron projection regeneration negative regulation of postsynaptic membrane organization steroid metabolic process regulation of Cdc42 protein signal transduction lipid metabolism negative regulation of amyloid beta formation positive regulation of membrane protein ectodomain proteolysis vasodilation intracellular transport synaptic transmission cholinergic positive regulation of neuron death high density lipoprotein particle assembly protein import high density lipoprotein particle remodeling negative regulation of endothelial cell proliferation maintenance of location in cell negative regulation of platelet activation low density lipoprotein particle remodeling positive regulation by host of viral process cytoskeleton organization regulation of neuron death reverse cholesterol transport lipoprotein catabolic process triglyceride homeostasis cellular oxidant detoxification lipid transport involved in lipid storageSources Amigo QuickGOOrthologsSpeciesHumanMouseEntrez34811816EnsemblENSG00000130203ENSMUSG00000002985UniProtP02649P08226RefSeq mRNA NM 001302691NM 000041NM 001302688NM 001302689NM 001302690NM 009696NM 001305819NM 001305843NM 001305844RefSeq protein NP 000032NP 001289617NP 001289618NP 001289619NP 001289620NP 001292748NP 001292772NP 001292773NP 033826Location UCSC Chr 19 44 91 44 91 MbChr 7 19 43 19 43 MbPubMed search 3 4 WikidataView Edit HumanView Edit MouseApo E belongs to a family of fat binding proteins called apolipoproteins In the circulation it is present as part of several classes of lipoprotein particles including chylomicron remnants VLDL IDL and some HDL 6 APOE interacts significantly with the low density lipoprotein receptor LDLR which is essential for the normal processing catabolism of triglyceride rich lipoproteins 7 In peripheral tissues APOE is primarily produced by the liver and macrophages and mediates cholesterol metabolism In the central nervous system Apo E is mainly produced by astrocytes and transports cholesterol to neurons 8 via APOE receptors which are members of the low density lipoprotein receptor gene family 9 Apo E is the principal cholesterol carrier in the brain 10 APOE qualifies as a checkpoint inhibitor of the classical complement pathway by complex formation with activated C1q 11 Contents 1 Evolution 2 Structure 2 1 Gene 2 2 Protein 2 3 Polymorphisms 3 Function 4 Clinical significance 4 1 Alzheimer s disease 4 2 Atherosclerosis 4 3 Malaria 4 4 Lyme disease 5 Interactions 5 1 Interactive pathway map 6 References 7 Further reading 8 External linksEvolution editApolipoproteins are not unique to mammals Many terrestrial and marine vertebrates have versions of them 12 It is believed that APOE arose via gene duplications of APOC1 before the fish tetrapod split c 400 million years ago Proteins similar in function have been found in choanoflagellates suggesting that they are a very old class of proteins predating the dawn of all living animals 13 The three major human alleles E4 E3 E2 arose after the primate human split around 7 5 million years ago These alleles are the by product of non synonymous mutations which led to changes in functionality The first allele to emerge was E4 After the primate human split there were four amino acid changes in the human lineage three of which had no effect on protein function V174L A18T A135V The fourth substitution T61R traded a threonine for an arginine altering the protein s functionality This substitution occurred somewhere in the 6 million year gap between the primate human split and the Denisovan human split since exactly the same substitutions were found in Denisovan APOE 14 About 220 000 years ago a cysteine to arginine substitution took place at amino acid 112 Cys112Arg of the APOE4 gene and this resulted in the E3 allele Finally 80 000 years ago another arginine to cysteine substitution at amino acid 158 Arg158Cys of the APOE3 gene created the E2 allele 15 13 Structure editGene edit The gene APOE is mapped to chromosome 19 in a cluster with apolipoprotein C1 APOC1 and the apolipoprotein C2 APOC2 The APOE gene consists of four exons and three introns totaling 3597 base pairs APOE is transcriptionally activated by the liver X receptor an important regulator of cholesterol fatty acid and glucose homeostasis and peroxisome proliferator activated receptor g nuclear receptors that form heterodimers with retinoid X receptors 16 In melanocytic cells APOE gene expression may be regulated by MITF 17 Protein edit APOE is 299 amino acids long and contains multiple amphipathic a helices According to crystallography studies a hinge region connects the N and C terminal regions of the protein The N terminal region residues 1 167 forms an anti parallel four helix bundle such that the non polar sides face inside the protein Meanwhile the C terminal domain residues 206 299 contains three a helices which form a large exposed hydrophobic surface and interact with those in the N terminal helix bundle domain through hydrogen bonds and salt bridges The C terminal region also contains a low density lipoprotein receptor LDLR binding site 18 Polymorphisms edit SNP rs429358GeneApoEChromosome19External databasesEnsemblHuman SNPViewdbSNP429358HapMap429358SNPedia429358APOE is polymorphic 19 20 with three major alleles epsilon 2 epsilon 3 and epsilon 4 APOE e2 cys112 cys158 APOE e3 cys112 arg158 and APOE e4 arg112 arg158 5 21 22 Although these allelic forms differ from each other by only one or two amino acids at positions 112 and 158 23 24 25 these differences alter APOE structure and function There are several low frequency polymorphisms of APOE APOE5 comes in two subtypes E5f and E5s based on migration rates APOE5 E5f and APOE7 combined were found in 2 8 of Japanese males 26 unreliable medical source APOE7 is a mutation of APOE3 with two lysine residues replacing glutamic acid residues at positions 244 and 245 27 Polymorphism Worldwide allele frequency Disease relevancee2 rs7412 T rs429358 T 8 4 9 This variant of the apoprotein binds poorly to cell surface receptors while E3 and E4 bind well 28 E2 is associated with both increased and decreased risk for atherosclerosis Individuals with an E2 E2 combination may clear dietary fat slowly and be at greater risk for early vascular disease and the genetic disorder type III hyperlipoproteinemia 94 4 of people with such disease are E2 E2 but only 2 of E2 E2 develop it so other environmental and genetic factors are likely to be involved such as cholesterol in the diet and age 29 30 31 E2 has also been implicated in Parkinson s disease 32 but this finding was not replicated in a larger population association study 33 e3 rs7412 C rs429358 T 77 9 9 This variant is considered the neutral APOE genotype e4 rs7412 C rs429358 C 13 7 9 E4 has been implicated in atherosclerosis 34 35 Alzheimer s disease 36 37 impaired cognitive function 38 39 reduced hippocampal volume 40 HIV 41 faster disease progression in multiple sclerosis 42 43 unfavorable outcome after traumatic brain injury 44 ischemic cerebrovascular disease 45 sleep apnea 46 47 both the extension and shortening of telomeres 48 49 50 51 reduced neurite outgrowth 52 and COVID 19 53 However E4 has also been associated with enhanced vitamin D and calcium status 54 higher fecundity 55 protection against early childhood infection and malnutrition 56 and decreased fetal perinatal and infant mortality 57 Much remains to be learned about the APOE isoforms including the interaction of other protective genes 58 Indeed the apolipoprotein e4 isoform is more protective against cognitive decline than other isoforms in some cases 58 so caution is advised before making determinant statements about the influence of APOE polymorphisms on cognition development of Alzheimer s disease cardiovascular disease telomere shortening etc Many of the studies cited that purport these adverse outcomes are from single studies that have not been replicated and the research is based on unchecked assumptions about this isoform As of 2007 there was no evidence that APOE polymorphisms influence cognition in younger age groups other than possible increased episodic memory ability and neural efficiency in younger APOE4 age groups nor that the APOE4 isoform places individuals at increased risk for any infectious disease 59 However the association between the APOE4 allele and Alzheimer s disease has been shown to be weaker in minority groups differently compared to their Caucasian counterparts 9 Hispanics Latinos and African Americans who were homozygous for the APOE4 allele had 2 2 and 5 7 times the odds respectively of developing Alzheimer s disease 60 9 The APOE4 allele has an even stronger effect in East Asian populations with Japanese populations have 33 times the odds compared to other populations 61 Caucasians who were homozygous for the allele had 12 5 times the odds 60 9 Function editAs a component of the lipoprotein lipid transport system APOE facilitates the transport of lipids fat soluble vitamins and cholesterol via the blood It interacts with the LDL receptor to facilitate endocytosis of VLDL remnants It is synthesized principally in the liver but has also been found in other tissues such as the brain kidneys and spleen 21 APOE synthesized in the liver associates with HDL which can then distribute it to newly formed VLDL or chylomicron particles to facilitate their eventual uptake by the liver In the nervous system non neuronal cell types most notably astroglia and microglia are the primary producers of APOE while neurons preferentially express the receptors for APOE 62 There are seven currently identified mammalian receptors for APOE which belong to the evolutionarily conserved LDLR family 63 APOE was initially recognized for its importance in lipoprotein metabolism and cardiovascular disease Defects in APOE result in familial dysbetalipoproteinemia aka type III hyperlipoproteinemia HLP III in which increased plasma cholesterol and triglycerides are the consequence of impaired clearance of chylomicron VLDL and LDL 64 7 More recently it has been studied for its role in several biological processes not directly related to lipoprotein transport including Alzheimer s disease AD immunoregulation and cognition 5 Though the exact mechanisms remain to be elucidated isoform 4 of APOE encoded by an APOE allele has been associated with increased calcium ion levels and apoptosis following mechanical injury 65 In the field of immune regulation a growing number of studies point to APOE s interaction with many immunological processes including suppressing T cell proliferation macrophage functioning regulation lipid antigen presentation facilitation by CD1 66 to natural killer T cell as well as modulation of inflammation and oxidation 67 APOE is produced by macrophages and APOE secretion has been shown to be restricted to classical monocytes in PBMC and the secretion of APOE by monocytes is down regulated by inflammatory cytokines and upregulated by TGF beta 68 Clinical significance editAlzheimer s disease edit As of 2012 the E4 variant was the largest known genetic risk factor for late onset sporadic Alzheimer s disease AD in a variety of ethnic groups 69 However the E4 variant does not correlate with risk in every population Nigerian people have the highest observed frequency of the APOE4 allele in world populations 70 but AD is rare among them 70 71 This may be due to their low cholesterol levels 70 71 72 73 Caucasian and Japanese carriers of two E4 alleles have between 10 and 30 times the risk of developing AD by 75 years of age as compared to those not carrying any E4 alleles This may be caused by an interaction with amyloid 74 Alzheimer s disease is characterized by build ups of aggregates of the peptide beta amyloid Apolipoprotein E enhances proteolytic break down of this peptide both within and between cells The isoform APOE e4 is not as effective as the others at promoting these reactions resulting in increased vulnerability to AD in individuals with that gene variation 75 Recently the amyloid hypothesis of Alzheimer s disease has been questioned and an article in Science claimed that Just as removing smoke does not extinguish a fire reducing amyloid plaques may not affect the course of Alzheimer s disease 76 The role that the E4 variant carries can still be fully explained even in the absence of a valid amyloid hypothesis given the fact that reelin signaling emerges to be one of the key processes involved in Alzheimer s disease 77 and the E4 variant is shown to interact with ApoER2 one of the neuronal reelin receptors thereby obstructing reelin signaling 77 Although 40 65 of AD patients have at least one copy of the e4 allele APOE4 is not a determinant of the disease At least one third of patients with AD are APOE4 negative and some APOE4 homozygotes never develop the disease Yet those with two e4 alleles have up to 20 times the risk of developing AD 78 There is also evidence that the APOE2 allele may serve a protective role in AD 79 Thus the genotype most at risk for Alzheimer s disease and at an earlier age is APOE4 4 Using genotype APOE3 3 as a benchmark with the persons who have this genotype regarded as having a risk level of 1 0 and for white populations only individuals with genotype APOE4 4 have an odds ratio of 14 9 of developing Alzheimer s disease Individuals with the APOE3 4 genotype face an odds ratio of 3 2 and people with a copy of the 2 allele and the 4 allele APOE2 4 have an odds ratio of 2 6 Persons with one copy each of the 2 allele and the 3 allele APOE2 3 have an odds ratio of 0 6 Persons with two copies of the 2 allele APOE2 2 also have an odds ratio of 0 6 80 Estimated worldwide human allele frequencies of APOE in Caucasian population 80 Allele e2 e3 e4General frequency 8 4 77 9 13 7 AD frequency 3 9 59 4 36 7 While ApoE4 has been found to greatly increase the odds that an individual will develop Alzheimer s a 2002 study concluded that in persons with any combination of APOE alleles high serum total cholesterol and high blood pressure in mid life are independent risk factors which together can nearly triple the risk that the individual will later develop AD 73 Projecting from their data some researchers have suggested that lowering serum cholesterol levels may reduce a person s risk for Alzheimer s disease even if they have two ApoE4 alleles thus reducing the risk from nine or ten times the odds of getting AD down to just two times the odds 73 Women are more likely to develop AD than men across most ages and APOE genotypes Premorbid women with the e4 allele have significantly more neurological dysfunction than men 81 APOE e4 increases the risk not only for AD but also for dementia in pure alpha synucleinopathies 82 The influence of APOE e4 on hippocampal atrophy was suggested to be more predominant early in the course of AD at milder stages prior to more widespread neurodegeneration 83 Atherosclerosis edit Knockout mice that lack the apolipoprotein E gene APOE develop extreme hypercholesterolemia when fed a high fat diet 84 Malaria edit APOE knockout mice show marked attenuation of cerebral malaria and increased survival as well as decreased sequestration of parasites and T cells within the brain likely due to protection of the blood brain barrier 85 Human studies have shown that the APOE2 polymorphism correlates with earlier infection and APOE3 4 polymorphisms increase likelihood of severe malaria 86 Lyme disease edit Borrelia burgdorferi the causative agent of Lyme disease is a host adapted pathogen that acquires environmental cholesterol to form glycolipids for use in cell membrane maintenance In one experiment in 2015 mice engineered with apoE deficiency were infected with Borrelia spirochetes The knockout mice suffered from an increased spirochete burden in joints as well as inflamed ankles when compared with wild type mice This study suggests that apoE deficiency and potentially other hyperlipidemias may be a risk factor in the pathogenicity of Lyme disease Interactions editInteractive pathway map edit Click on genes proteins and metabolites below to link to respective articles 1 File nbsp nbsp alt Statin Pathway edit Statin Pathway edit The interactive pathway map can be edited at WikiPathways Statin Pathway WP430 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WW Zhou J Shirer WR Coppola G Karydas A et al June 2012 Gender modulates the APOE e4 effect in healthy older adults convergent evidence from functional brain connectivity and spinal fluid tau levels The Journal of Neuroscience 32 24 8254 8262 doi 10 1523 JNEUROSCI 0305 12 2012 PMC 3394933 PMID 22699906 Tsuang D Leverenz JB Lopez OL Hamilton RL Bennett DA Schneider JA et al February 2013 APOE e4 increases risk for dementia in pure synucleinopathies JAMA Neurology 70 2 223 228 doi 10 1001 jamaneurol 2013 600 PMC 3580799 PMID 23407718 Saeed U Desmarais P Masellis M 2021 08 03 The APOE e4 variant and hippocampal atrophy in Alzheimer s disease and Lewy body dementia a systematic review of magnetic resonance imaging studies and therapeutic relevance Expert Review of Neurotherapeutics 21 8 851 870 doi 10 1080 14737175 2021 1956904 ISSN 1473 7175 PMID 34311631 S2CID 236451232 McNeill E Channon KM Greaves DR March 2010 Inflammatory cell recruitment in cardiovascular disease murine models and potential clinical applications Clinical Science 118 11 641 655 doi 10 1042 CS20090488 PMID 20210786 Kassa FA Van Den Ham K Rainone A Fournier S Boilard E Olivier M September 2016 Absence of apolipoprotein E protects mice from cerebral malaria Scientific Reports 6 33615 Bibcode 2016NatSR 633615K doi 10 1038 srep33615 PMC 5028887 PMID 27647324 Wozniak MA Riley EM Itzhaki RF March 2004 Apolipoprotein E polymorphisms and risk of malaria Journal of Medical Genetics 41 3 145 146 doi 10 1136 jmg 2003 014613 PMC 1735716 PMID 14985370 Further reading editAshford JW 2004 APOE genotype effects on Alzheimer s disease onset and epidemiology Journal of Molecular Neuroscience 23 3 157 165 doi 10 1385 JMN 23 3 157 PMID 15181244 S2CID 14864342 Beffert U Danik M Krzywkowski P Ramassamy C Berrada F Poirier J July 1998 The neurobiology of apolipoproteins and their receptors in the CNS and Alzheimer s disease Brain Research Brain Research Reviews 27 2 119 142 doi 10 1016 S0165 0173 98 00008 3 PMID 9622609 S2CID 28731779 Bennet AM Di Angelantonio E Ye Z Wensley F Dahlin A Ahlbom A et al September 2007 Association of apolipoprotein E genotypes with lipid levels and coronary risk JAMA 298 11 1300 1311 doi 10 1001 jama 298 11 1300 PMID 17878422 Bocksch L Stephens T Lucas A Singh B December 2001 Apolipoprotein E possible therapeutic target for atherosclerosis Current Drug Targets Cardiovascular amp Hematological Disorders 1 2 93 106 doi 10 2174 1568006013337944 PMID 12769659 de Knijff P van den Maagdenberg AM Frants RR Havekes LM 1995 Genetic heterogeneity of apolipoprotein E and its influence on plasma lipid and lipoprotein levels Human Mutation 4 3 178 194 doi 10 1002 humu 1380040303 PMID 7833947 S2CID 41959843 Gunzburg MJ Perugini MA Howlett GJ December 2007 Structural basis for the recognition and cross linking of amyloid fibrils by human apolipoprotein E The Journal of Biological Chemistry 282 49 35831 35841 doi 10 1074 jbc M706425200 PMID 17916554 Huang Y Weisgraber KH Mucke L Mahley RW 2004 Apolipoprotein E diversity of cellular origins structural and biophysical properties and effects in Alzheimer s disease Journal of Molecular Neuroscience 23 3 189 204 doi 10 1385 JMN 23 3 189 PMID 15181247 S2CID 40135107 Itzhaki RF Dobson CB Shipley SJ Wozniak MA June 2004 The role of viruses and of APOE in dementia Annals of the New York Academy of Sciences 1019 1 15 18 Bibcode 2004NYASA1019 15I doi 10 1196 annals 1297 003 PMID 15246985 S2CID 28979273 Kolbe D da Silva NA Dose J Torres GG Caliebe A Krause Kyora B Nebel A May 2023 Current allele distribution of the human longevity gene APOE in Europe can mainly be explained by ancient admixture Aging Cell 22 5 Wiley e13819 doi 10 1111 acel 13819 PMC 10186601 PMID 36951219 Kolovou GD Anagnostopoulou KK August 2007 Apolipoprotein E polymorphism age and coronary heart disease Ageing Research Reviews 6 2 94 108 doi 10 1016 j arr 2006 11 001 PMID 17224309 S2CID 35607578 Lambert JC Amouyel P August 2007 Genetic heterogeneity of Alzheimer s disease complexity and advances Psychoneuroendocrinology 32 Suppl 1 S62 S70 doi 10 1016 j psyneuen 2007 05 015 PMID 17659844 S2CID 8114580 Liu CC Liu CC Kanekiyo T Xu H Bu G February 2013 Apolipoprotein E and Alzheimer disease risk mechanisms and therapy Nature Reviews Neurology 9 2 106 118 doi 10 1038 nrneurol 2012 263 PMC 3726719 PMID 23296339 Mahley RW Ji ZS January 1999 Remnant lipoprotein metabolism key pathways involving cell surface heparan sulfate proteoglycans and apolipoprotein E Journal of Lipid Research 40 1 1 16 doi 10 1016 S0022 2275 20 33334 4 PMID 9869645 Mahley RW Rall SC 2002 Apolipoprotein E far more than a lipid transport protein Annual Review of Genomics and Human Genetics 1 1 507 537 doi 10 1146 annurev genom 1 1 507 PMID 11701639 Mahley RW April 1988 Apolipoprotein E cholesterol transport protein with expanding role in cell biology Science 240 4852 622 630 Bibcode 1988Sci 240 622M doi 10 1126 science 3283935 PMID 3283935 Masterman T Hillert J June 2004 The telltale scan APOE epsilon4 in multiple sclerosis The Lancet Neurology 3 6 331 doi 10 1016 S1474 4422 04 00763 X PMID 15157846 S2CID 54404547 Moriyama K Sasaki J Matsunaga A Arakawa F Takada Y Araki K et al September 1992 Apolipoprotein E1 Lys 146 Glu with type III hyperlipoproteinemia Biochimica et Biophysica Acta 1128 1 58 64 doi 10 1016 0005 2760 92 90257 V PMID 1356443 Parasuraman R Greenwood PM Sunderland T April 2002 The apolipoprotein E gene attention and brain function Neuropsychology 16 2 254 274 doi 10 1037 0894 4105 16 2 254 PMC 1350934 PMID 11949718 Raber J 2007 Role of apolipoprotein E in anxiety Neural Plasticity 2007 91236 doi 10 1155 2007 91236 PMC 1940061 PMID 17710250 Roses AD Einstein G Gilbert J Goedert M Han SH Huang D et al January 1996 Morphological biochemical and genetic support for an apolipoprotein E effect on microtubular metabolism Annals of the New York Academy of Sciences 777 1 146 157 Bibcode 1996NYASA 777 146R doi 10 1111 j 1749 6632 1996 tb34413 x PMID 8624078 S2CID 9145181 Strittmatter WJ Roses AD May 1995 Apolipoprotein E and Alzheimer disease Proceedings of the National Academy of Sciences of the United States of America 92 11 4725 4727 Bibcode 1995PNAS 92 4725S doi 10 1073 pnas 92 11 4725 PMC 41779 PMID 7761390 Utermann G Pruin N Steinmetz A January 1979 Polymorphism of apolipoprotein E III Effect of a single polymorphic gene locus on plasma lipid levels in man Clinical Genetics 15 1 63 72 doi 10 1111 j 1399 0004 1979 tb02028 x PMID 759055 S2CID 34127430 Ye J August 2007 Reliance of host cholesterol metabolic pathways for the life cycle of hepatitis C virus PLOS Pathogens 3 8 e108 doi 10 1371 journal ppat 0030108 PMC 1959368 PMID 17784784 External links editApolipoproteins E at the U S National Library of Medicine Medical Subject Headings MeSH apoe4 info website for APOE epsilon 4 carriers Human APOE genome location and APOE gene details page in the UCSC Genome Browser Overview of all the structural information available in the PDB for UniProt P02649 Apolipoprotein E at the PDBe KB Retrieved from https en wikipedia org w index php title Apolipoprotein E amp oldid 1216720589 Polymorphisms, wikipedia, wiki, book, books, library,

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