Cited by 202Immune Response and InflammationInflammasome and immune disordersSepsis Diagnosis and Treatment

APOε4 is associated with enhanced in vivo innate immune responses in human subjects

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Gale, Stephen C., Gao, Li, Mikacenic, Carmen, Coyle, Susette M., Rafaels, Nicholas, Murray Dudenkov, Tanda, Madenspacher, Jennifer H., Draper, David W. +11 more·2014·Journal of Allergy and Clinical Immunology

Abstract

Background The genetic determinants of the human innate immune response are poorly understood. Apolipoprotein (Apo) E, a lipid-trafficking protein that affects inflammation, has well-described wild-type (ε3) and disease-associated (ε2 and ε4) alleles, but its connection to human innate immunity is undefined.Objective We sought to define the relationship of APOε4 to the human innate immune response.Methods We evaluated APOε4 in several functional models of the human innate immune response, including intravenous LPS challenge in human subjects, and assessed APOε4 association to organ injury in patients with severe sepsis, a disease driven by dysregulated innate immunity.Results Whole blood from healthy APOε3/APOε4 volunteers induced higher cytokine levels on ex vivo stimulation with Toll-like receptor (TLR) 2, TLR4, or TLR5 ligands than blood from APOε3/APOε3 patients, whereas TLR7/8 responses were similar. This was associated with increased lipid rafts in APOε3/APOε4 monocytes. By contrast, APOε3/APOε3 and APOε3/APOε4 serum neutralized LPS equivalently and supported similar LPS responses in Apoe-deficient macrophages, arguing against a differential role for secretory APOE4 protein. After intravenous LPS, APOε3/APOε4 patients had higher hyperthermia and plasma TNF-α levels and earlier plasma IL-6 than APOε3/APOε3 patients. APOE4-targeted replacement mice displayed enhanced hypothermia, plasma cytokines, and hepatic injury and altered splenic lymphocyte apoptosis after systemic LPS compared with APOE3 counterparts. In a cohort of 828 patients with severe sepsis, APOε4 was associated with increased coagulation system failure among European American patients.Conclusions APOε4 is a determinant of the human innate immune response to multiple TLR ligands and associates with altered patterns of organ injury in human sepsis.

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Crossref · 10.1016/j.jaci.2014.01.032

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  • Prior work shows that E4 impairs microglial metabolism/immune reactivity and can exaggerate cytokine reactivity to LPS.

    “Prior work shows that E4 impairs microglial metabolism/immune reactivity and can exaggerate cytokine reactivity to LPS”

    From Older adult APOE4 mice exhibit modest immunometabolic adaptation following microglial APOE2 replacement (2027) · cites this paper as Gale et al., 2014

    The Results section reports higher TNFα after LPS challenge in human APOε4 carriers and APOE4-targeted mice, supporting exaggerated cytokine reactivity to LPS. The paper’s reported experiments concern blood responses and systemic inflammation; our copy does not establish that E4 impairs microglial metabolism or microglial immune reactivity. Page numbers are unavailable in the indexed copy. (LLM, conf=0.88)

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  • APOE genotype influences the inflammatory response, with E4 expression linked to significantly higher cytokine levels in both humans and mice compared to E3 or E2.

    “In addition to metabolic dysregulation, APOE genotype also influences the inflammatory response, with E4 expression linked to significantly higher cytokine levels in both humans and mice compared to E3 or E2”

    From Older adult APOE4 mice exhibit modest immunometabolic adaptation following microglial APOE2 replacement (2027) · cites this paper as Gale et al., 2014

    The Results report higher cytokine responses in APOε3/APOε4 humans than APOε3/APOε3 humans after specified immune challenges, and higher plasma TNFα and G-CSF in LPS-challenged APOE4 mice than APOE3 mice. The study does not establish higher cytokine levels relative to APOE2 in either species; it also reports that some cytokine responses were similar between the E4 and E3 groups. (LLM, conf=0.90)

    Experimental — accuracy not yet measured
  • Comparable findings have been reported following intraperitoneal LPS injection.

    “and comparable findings have been reported following intraperitoneal LPS injection”
  • The APOE4 variant both sensitises to endotoxin and predisposes to Alzheimer's disease.

    “the APOE4 variant both sensitises to endotoxin and predisposes to Alzheimer’s disease.”

    From The endotoxin hypothesis of neurodegeneration (2019) · cites this paper as [83]

  • Humans with the APOE4 variant are more sensitive to injected LPS than those with APOE3, and mice with endogenous ApoE replaced with APOE4 are more sensitive to LPS than those replaced with APOE3.

    “Humans with the APOE4 variant are more sensitive to injected LPS than those with APOE3, and similarly, mice with endogenous ApoE replaced with APOE4 are more sensitive to LPS than those replaced with APOE3 [83].”

    From The endotoxin hypothesis of neurodegeneration (2019) · cites this paper as [83]

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Authors
Gale, S. C., Gao, L., Mikacenic, C., Coyle, S. M., Rafaels, N., Murray Dudenkov, T., Madenspacher, J. H., Draper, D. W., Ge, W., Aloor, J. J., Azzam, K. M., Lai, L., Blackshear, P. J., Calvano, S. E., Barnes, K. C., Lowry, S. F., Corbett, S., Wurfel, M. M., & Fessler, M. B.
Affiliations
  • Johns Hopkins University (US)
  • University of Washington (US)
  • National Institutes of Health (US)
Corresponding author
Fessler, Michael B.
Venue
Journal of Allergy and Clinical Immunology
Publisher
Elsevier BV
Published
2014-07
Volume
134
Issue
1
Pages
127-134.e9
ISSN
0091-6749 (ISSN-L)
OpenAlex
W2110616131
Cited by
202
References
56
Citations by year
2026: 24 · 2025: 20 · 2024: 12 · 2023: 20 · 2022: 19 · 2021: 29 · 2020: 19 · 2019: 16 · 2018: 12 · 2017: 9 · 2016: 10 · 2015: 12
FWCI
4.72
Type
journal article
Language
en
Open access
Locations
  • Journal of Allergy and Clinical Immunology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (5p50hl073994-05, 5r01gm034695-26)
  • National Heart, Lung, and Blood Institute (P50 HL-073994, HL73994, R01HL089807)
  • National Institute of General Medical Sciences (R01 GM-34695, R01 GM-034695)
  • National Institute of Environmental Health Sciences (Z01ES102005, ZIAES102005)
Topics
  • Life Sciences › Immunology and Microbiology › Immunology › Immune Response and Inflammation
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Inflammasome and immune disorders
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
Keywords
apolipoprotein E, APOE ε4, innate immunity, Toll-like receptors, lipopolysaccharide response, sepsis, organ damage, lipid rafts, monocytes, TNF-α, interleukin-6, coagulopathy, lymphocyte apoptosis, hyperthermia
MeSH terms
Adult, Animals, Cells, Cultured, Humans, Immunity, Innate, Ligands, Lipopolysaccharides, Mice, Transgenic, Monocytes, Tumor Necrosis Factor-alpha, Interleukin-6, Gene Expression, Sepsis, Toll-Like Receptor 2, Toll-Like Receptor 4, Toll-Like Receptor 5, Mice, Apolipoprotein E3, Apolipoprotein E4

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