APOE alters glucose flux through central carbon pathways in astrocytes
Open accessAbstract
The Apolipoprotein E (APOE) gene is a major genetic risk factor associated with Alzheimer's disease (AD). APOE encodes for three main isoforms in humans (E2, E3, and E4). Homozygous E4 individuals have more than a 10-fold higher risk for developing late-onset AD, while E2 carriers are protected. A hallmark of AD is a reduction in cerebral glucose metabolism, alluding to a strong metabolic component in disease onset and progression. Interestingly, E4 individuals display a similar regional pattern of cerebral glucose hypometabolism decades prior to disease onset. Mapping this metabolic landscape may help elucidate the underlying biological mechanism of APOE-associated risk for AD. Efficient metabolic coupling of neurons and glia is necessary for proper neuronal function, and disruption in glial energy distribution has been proposed to contribute to neuronal cell death and AD pathology. One important function of astrocytes – canonically the primary source of apolipoprotein E in the brain – is to provide metabolic substrates (lactate, lipids, amino acids and neurotransmitters) to neurons. Here we investigate the effects of APOE on astrocyte glucose metabolism in vitro utilizing scintillation proximity assays, stable isotope tracer metabolomics, and gene expression analyses. Glucose uptake is impaired in E4 astrocytes relative to E2 or E3 with specific alterations in central carbon metabolism. Using stable isotope labeled glucose [U-13C] allowed analyses of astrocyte-specific deep metabolic networks affected by APOE, and provided insight to the effects downstream of glucose uptake. Enrichment of 13C in early steps of glycolysis was lowest in E4 astrocytes (highest in E2), while synthesis of lactate from glucose was highest in E4 astrocytes (lowest in E2). We observed an increase in glucose flux through the pentose phosphate pathway (PPP), with downstream increases in gluconeogenesis, lipid, and de novo nucleotide biosynthesis in E4 astrocytes. There was also a marked increase in 13C enrichment in the TCA cycle of E4 astrocytes – whose substrates were also incorporated into biosynthetic pathways at a higher rate. Pyruvate carboxylase (PC) and pyruvate dehydrogenase (PDH) are the two main enzymes controlling pyruvate entry to the TCA cycle. PC gene expression is increased in E4 astrocytes and the activity relative to PDH was also increased, compared to E2 or E3. Decreased enrichment in the TCA cycle of E2 and E3 astrocytes is suggestive of increased oxidation and non-glucose derived anaplerosis, which could be fueling mitochondrial ATP production. Conversely, E4 astrocytes appear to increase carbon flux into the TCA cycle to fuel cataplerosis. Together, these data demonstrate clear APOE isoform-specific effects on glucose utilization in astrocytes, including E4-associated increases in lactate synthesis, PPP flux, and de novo biosynthesis pathways.
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APOE4 astrocytes and microglia have increased glycolytic activity when compared with the same cells expressing APOE3.
“APOE4 astrocytes and microglia have increased glycolytic activity when compared with the same cells expressing APOE3 (refs. 175,176).”
From Multifaceted roles of APOE in Alzheimer disease (2024) · cites this paper as [175]
The Results section (page unavailable) reports higher glucose flux into late glycolysis—pyruvate and lactate—in E4 astrocytes than in E3 astrocytes. It does not study microglia, and its Discussion reports reduced glucose uptake and potentially reduced flux through early glycolysis in E4 astrocytes, so it does not support a general increase in glycolytic activity in both cell types. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThese findings of decreased mitochondrial function and a switch to glycolysis are consistent with previous studies.
“These findings of decreased mitochondrial function and a switch to glycolysis is consistent with previous studies 33,35 .”
From APOE4-drives brain bioenergetic shifts independent of Alzheimer’s disease pathology (2026) · cites this paper as [33]
The Discussion reports increased glucose flux into oxygen-independent glycolysis in E4 astrocytes, and the Conclusions report increased glucose flux into lactate. Those passages support the glycolysis part, but they do not establish decreased mitochondrial function; the paper instead describes a different pattern of TCA-cycle activity in E4 astrocytes. No page numbers are available in our copy. (LLM, conf=0.83)
Experimental — accuracy not yet measuredThe increased labeling of glutamic acid and aspartic acid is consistent with a past study in primary astrocytes.
“We found that both APOE4 iAstrocytes and iNeurons had increased labeling of glutamic acid and aspartic acid which is consistent with a past study in primary astrocytes 33 .”
From APOE4-drives brain bioenergetic shifts independent of Alzheimer’s disease pathology (2026) · cites this paper as [33]
The Results section ('APOE alters TCA cycle activity'; page unavailable) reports greater labeling of aspartate (m+4) and glutamate (m+4 and m+5) in E4 astrocytes. However, the Methods ('Tissue culture and in vitro [U-13C] glucose metabolite labeling'; page unavailable) identifies the cells as immortalized astrocytes derived from mice, not primary astrocytes. (LLM, conf=0.90)
Experimental — accuracy not yet measuredCompared to apoE2 or apoE3 isoforms, astrocytes expressing the apoE4 isoform exhibited increased lactate synthesis, pentose phosphate pathway flux, and gluconeogenesis in vitro.
“Compared to the apoE2 or apoE3 isoforms, astrocytes expressing the apoE4 isoform exhibited increased lactate synthesis, pentose phosphate pathway flux, and gluconeogenesis [127].”
From Mitochondrial Oxidative and Nitrosative Stress and Alzheimer Disease (2020) · cites this paper as [127]
ApoE4-expressing astrocytes affect glucose utilization, including increases in lactate synthesis, PPP flux, and de novo biosynthesis pathways.
“and affect glucose utilization, including increases in lactate synthesis, PPP flux, and de novo biosynthesis pathways [54].”
From APOE4 genotype exacerbates the depression-like behavior of mice during aging through ATP decline (2021) · cites this paper as [54]
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References 96 · Cited by 105
- Authors
- Williams, H. C., Farmer, B. C., Piron, M. A., Walsh, A. E., Bruntz, R. C., Gentry, M. S., Sun, R. C., & Johnson, L. A.
- Affiliations
- University of Kentucky (US)
- Corresponding author
- Johnson, Lance A.
- ORCID
- Venue
- Neurobiology of Disease
- Publisher
- Elsevier BV
- Published
- 2020-03
- Volume
- 136
- Pages
- 104742
- ISSN
- 0969-9961 (ISSN-L)
- PMC
- PMC7044721
- OpenAlex
- W2999315469
- Cited by
- 105
- References
- 96
- Citations by year
- 2026: 11 · 2025: 19 · 2024: 15 · 2023: 12 · 2022: 21 · 2021: 17 · 2020: 9 · 2019: 1
- FWCI
- 8.87
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Neurobiology of Disease (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institutes of Health (R01NS070899-09S2 - MSG)
- National Institute on Aging (COBRE P20 GM103527, 1T32AG057461-01, P20 GM121327, F30AG06342201A1, 1R01AG060056-01)
- Barry Community Foundation (COBRE P20 GM121327)
- American Cancer Society
- St. Baldrick's Foundation
- Markey Cancer Center, University of Kentucky
- University of Kentucky
- Royal College of Surgeons of England
- Topics
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neuropharmacology Research
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Keywords
- apolipoprotein E, apolipoprotein E isoforms, astrocytes, glucose metabolism, Alzheimer's disease, cerebral glucose hypometabolism, central carbon metabolism, glycolysis, pentose phosphate pathway, gluconeogenesis, TCA cycle, pyruvate carboxylase, pyruvate dehydrogenase, lactate, astrocyte-neuron metabolic coupling
- MeSH terms
- Animals, Astrocytes, Carbon Isotopes, Cell Line, Transformed, Chromatography, Ion Exchange, Glucose, Humans, Mice, Apolipoprotein E4
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