APOE4 exacerbates α-synuclein seeding activity and contributes to neurotoxicity in Alzheimer’s disease with Lewy body pathology
Open accessAbstract
Approximately half of Alzheimer’s disease (AD) brains have concomitant Lewy pathology at autopsy, suggesting that α-synuclein (α-SYN) aggregation is a regulated event in the pathogenesis of AD. Genome-wide association studies revealed that the ε4 allele of the apolipoprotein E (APOE4) gene, the strongest genetic risk factor for AD, is also the most replicated genetic risk factor for Lewy body dementia (LBD), signifying an important role of APOE4 in both amyloid-β (Aβ) and α-SYN pathogenesis. How APOE4 modulates α-SYN aggregation in AD is unclear. In this study, we aimed to determine how α-SYN is associated with AD-related pathology and how APOE4 impacts α-SYN seeding and toxicity. We measured α-SYN levels and their association with other established AD-related markers in brain samples from autopsy-confirmed AD patients (N = 469), where 54% had concomitant LB pathology (AD + LB). We found significant correlations between the levels of α-SYN and those of Aβ40, Aβ42, tau and APOE, particularly in insoluble fractions of AD + LB. Using a real-time quaking-induced conversion (RT-QuIC) assay, we measured the seeding activity of soluble α-SYN and found that α-SYN seeding was exacerbated by APOE4 in the AD cohort, as well as a small cohort of autopsy-confirmed LBD brains with minimal Alzheimer type pathology. We further fractionated the soluble AD brain lysates by size exclusion chromatography (SEC) ran on fast protein liquid chromatography (FPLC) and identified the α-SYN species (~ 96 kDa) that showed the strongest seeding activity. Finally, using human induced pluripotent stem cell (iPSC)-derived neurons, we showed that amplified α-SYN aggregates from AD + LB brain of patients with APOE4 were highly toxic to neurons, whereas the same amount of α-SYN monomer was not toxic. Our findings suggest that the presence of LB pathology correlates with AD-related pathologies and that APOE4 exacerbates α-SYN seeding activity and neurotoxicity, providing mechanistic insight into how APOE4 affects α-SYN pathogenesis in AD.
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Biochemical studies indicate that APOE4 increases the seeding potential of α-synuclein.
“Biochemical studies indicate that APOE4 increases the seeding potential of αSyn131,132, and further mouse studies have shown that APOE4 alters the proteolytic processing of αSyn.”
From Multifaceted roles of APOE in Alzheimer disease (2024) · cites this paper as [131]
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“Alzheimer’s disease (AD) is a neurodegenerative disorder defined by the presence of two pathological features: amyloid-β (Aβ) plaques and tau neurofibrillary tangles [12].”
BackgroundSelf-citationα-Synuclein occurs physiologically as a helically folded tetramer that resists aggregation
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- Authors
- Jin, Y., Li, F., Sonoustoun, B., Kondru, N. C., Martens, Y. A., Qiao, W., Heckman, M. G., Ikezu, T. C., Li, Z., Burgess, J. D., Amerna, D., O’Leary, J., DeTure, M. A., Zhao, J., McLean, P. J., Dickson, D. W., Ross, O. A., Bu, G., & Zhao, N.
- Affiliations
- Mayo Clinic (US)
- Mayo Clinic in Florida (US)
- Corresponding author
- Bu, Guojun
- Zhao, Na
- ORCID
- Venue
- Acta Neuropathologica
- Published
- 2022-04-26
- Volume
- 143
- Issue
- 6
- Pages
- 641-662
- ISSN
- 0001-6322 (ISSN-L)
- 1432-0533
- PMC
- PMC9107450
- OpenAlex
- W4224504085
- Cited by
- 69
- References
- 5
- Citations by year
- 2026: 14 · 2025: 17 · 2024: 15 · 2023: 15 · 2022: 8
- FWCI
- 8.50
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Acta Neuropathologica (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Rare & Special e-Zone (The Hong Kong University of Science and Technology) (submittedVersion)
- Funders
- Mayo Alzheimer’s Disease Research Center Developmental Grant
- National Institute of Neurological Disorders and Stroke (U54NS110435)
- National Institute on Aging (U19AG069701)
- Ted Turner and Family
- The Little Family Foundation
- The Mayo Clinic Center of Indiviudualized Medicine and an MSA Coalition award
- Topics
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- APOE ε4, alpha-synuclein, seeding activity, Lewy body pathology, Alzheimer's disease, dementia with Lewy bodies, neurotoxicity, amyloid-beta, tau protein, protein aggregation, RT-QuIC, iPSC-derived neurons, genetic risk factors
- MeSH terms
- Alzheimer Disease, Apolipoproteins E, Humans, Lewy Bodies, tau Proteins, Neurotoxicity Syndromes, Lewy Body Disease, alpha-Synuclein, Apolipoprotein E4, Genome-Wide Association Study, Induced Pluripotent Stem Cells
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