ApoE and Aβ in Alzheimer’s Disease: Accidental Encounters or Partners?

Kanekiyo, Takahisa; Xu, Huaxi; Bu, Guojun

doi:10.1016/j.neuron.2014.01.045

Cited by 626Alzheimer's disease research and treatmentsDementia and Cognitive Impairment ResearchNeuroinflammation and Neurodegeneration Mechanisms

ApoE and Aβ in Alzheimer’s Disease: Accidental Encounters or Partners?

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Kanekiyo, Takahisa, Xu, Huaxi, Bu, Guojun·2014·Neuron

DOI 10.1016/j.neuron.2014.01.045PMC PMC3983361

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Abstract

Among the three human apolipoprotein E (apoE) isoforms, apoE4 increases the risk of Alzheimer's disease (AD). While transporting cholesterol is a primary function, apoE also regulates amyloid-β (Aβ) metabolism, aggregation, and deposition. Although earlier work suggests that different affinities of apoE isoforms to Aβ might account for their effects on Aβ clearance, recent studies indicate that apoE also competes with Aβ for cellular uptake through apoE receptors. Thus, several factors probably determine the variable effects apoE has on Aβ. In this Review, we examine biochemical, structural, and functional studies and propose testable models that address the complex mechanisms underlying apoE-Aβ interaction and how apoE4 may increase AD risk and also serve as a target pathway for therapy.

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As LDLR and heparin play critical roles in Aβ clearance and tau aggregation, the ε7 isoform may influence AD pathology through these pathways.
“As these molecules play critical roles in Aβ clearance and tau aggregation,41,42 the ε7 isoform may influence AD pathology through these pathways.”
From Association of rare APOE missense variants with Alzheimer's disease in the Japanese population (2025) · cites this paper as [41]
In “ApoE in Aβ clearance” (page unavailable), the paper says LDLR mediates brain-to-blood Aβ clearance. In “ApoE and Aβ in endocytic trafficking” (page unavailable), it links heparan sulfate proteoglycans to cellular uptake of tau, but does not say that heparin plays a critical role in tau aggregation. The ε7 proposal follows the citation and is the citing authors’ inference. (LLM, conf=0.86)
Experimental — accuracy not yet measured
ApoE is a crucial factor in development of AD.
“ApoE is also a crucial factor in the development of AD (5, 6, 31, 32).”
From The E3 ubiquitin ligase Idol controls brain LDL receptor expression, ApoE clearance, and Aβ amyloidosis (2015) · cites this paper as [31]
APOE binds to cell surface receptors including LDLR, LRP1, VLDLR, and APOER2.
“APOE binds to cell surface receptors, such as low‐density lipoprotein receptor (LDLR), LDLR‐related protein 1 (LRP1), very low‐density lipoprotein receptor (VLDLR), and apolipoprotein E receptor 2 (APOER2 or LRP8). 2 , 14 , 15”
From Deletion of neuronal Idol ameliorates Alzheimer's disease–related pathologies via APOE receptors (2025) · cites this paper as [15]
APOE regulates Aβ clearance via LDL receptors and microglia are critical for Aβ clearance.
“Since APOE regulates Aβ clearance via LDL receptors and microglia are critical for Aβ clearance, 15 we first focused on the role of IDOL in microglia.”
From Deletion of neuronal Idol ameliorates Alzheimer's disease–related pathologies via APOE receptors (2025) · cites this paper as [15]
Apolipoprotein E4 is the major genetic risk factor for late-onset familial and sporadic Alzheimer's disease.
“Apolipoprotein (apo) E4, an isoform of the APOE gene in humans, is the major genetic risk factor for late-onset familial and sporadic AD [4–8], which account for most AD cases.”
From Apolipoprotein E4, inhibitory network dysfunction, and Alzheimer’s disease (2019) · cites this paper as [7]

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Apolipoprotein E4 Domain Interaction Occurs in Living Neuronal Cells as Determined by Fluorescence Resonance Energy Transfer
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Modulation of Aβ Deposition in APP Transgenic Mice by an Apolipoprotein E Null Background
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The Amyloid-β Pathway in Alzheimer’s Disease
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TREM2 Binds to Apolipoproteins, Including APOE and CLU/APOJ, and Thereby Facilitates Uptake of Amyloid-Beta by Microglia
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The Gut Microbiota and Alzheimer’s Disease
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ApoE in Alzheimer’s disease: pathophysiology and therapeutic strategies
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Astrocytes: a central element in neurological diseases
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Apolipoprotein E Is a Ligand for Triggering Receptor Expressed on Myeloid Cells 2 (TREM2)
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Amyloid β Protein and Alzheimer’s Disease: When Computer Simulations Complement Experimental Studies
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Self-Organizing 3D Human Neural Tissue Derived from Induced Pluripotent Stem Cells Recapitulate Alzheimer’s Disease Phenotypes
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Astrocytic and microglial cells as the modulators of neuroinflammation in Alzheimer’s disease
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ApoE2, ApoE3, and ApoE4 Differentially Stimulate APP Transcription and Aβ Secretion
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“Other proteins with a crucial role in Aβ clearance are apolipoprotein E (ApoE) and α2-macroglobulin (α2-M); they interact with transporters including low-density lipoprotein Frontiers in Aging Neuroscience | www.frontiersin.org 1 July 2016 | Volume 8 | Article 160 receptor-related protein 1 (LRP1) receptors, very low-…”
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TREM2, microglia, and neurodegenerative diseases
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Understanding disease progression and improving Alzheimer's disease clinical trials: Recent highlights from the Alzheimer's Disease Neuroimaging Initiative
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Apolipoprotein E, Receptors, and Modulation of Alzheimer’s Disease
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Actions of Brain-Derived Neurotrophin Factor in the Neurogenesis and Neuronal Function, and Its Involvement in the Pathophysiology of Brain Diseases
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APOE and Alzheimer’s Disease: From Lipid Transport to Physiopathology and Therapeutics
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ApoE attenuates unresolvable inflammation by complex formation with activated C1q
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Non-alcoholic fatty liver disease induces signs of Alzheimer’s disease (AD) in wild-type mice and accelerates pathological signs of AD in an AD model
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Astrogliosis: An integral player in the pathogenesis of Alzheimer's disease
Osborn, L. M., Kamphuis, W., Wadman, W. J., & Hol, E. M. (2016) · Progress in Neurobiology · doi:10.1016/j.pneurobio.2016.01.001 · Cited by 312 · see citing works
Role of LRP1 in the pathogenesis of Alzheimer's disease: evidence from clinical and preclinical studies
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Blood-brain barrier-associated pericytes internalize and clear aggregated amyloid-β42 by LRP1-dependent apolipoprotein E isoform-specific mechanism
Ma, Q., Zhao, Z., Sagare, A. P., Wu, Y., Wang, M., Owens, N. C., Verghese, P. B., Herz, J., Holtzman, D. M., & Zlokovic, B. V. (2018) · Molecular Neurodegeneration · doi:10.1186/s13024-018-0286-0 · Cited by 281 · see citing works
Immunotherapeutic Approaches for Alzheimer’s Disease
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Advances in developing novel therapeutic strategies for Alzheimer’s disease
Cao, J., Hou, J., Ping, J., & Cai, D. (2018) · Molecular Neurodegeneration · doi:10.1186/s13024-018-0299-8 · Cited by 283 · see citing works
TREM2-Ligand Interactions in Health and Disease
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The low-density lipoprotein receptor-related protein 1 and amyloid-Î² clearance in Alzheimerâ€™s disease
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APOE in the bullseye of neurodegenerative diseases: impact of the APOE genotype in Alzheimer’s disease pathology and brain diseases
Fernández-Calle, R., Konings, S. C., Frontiñán-Rubio, J., García-Revilla, J., Camprubí-Ferrer, L., Svensson, M., Martinson, I., Boza-Serrano, A., Venero, J. L., Nielsen, H. M., et al. (2022) · Molecular Neurodegeneration · doi:10.1186/s13024-022-00566-4 · Cited by 278 · see citing works
Implications of GABAergic Neurotransmission in Alzheimer’s Disease
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Clearance of cerebral Aβ in Alzheimer’s disease: reassessing the role of microglia and monocytes
Zuroff, L. R., Daley, D. A., Black, K. L., & Koronyo‐Hamaoui, M. (2017) · Cellular and Molecular Life Sciences · doi:10.1007/s00018-017-2463-7 · Cited by 275 · see citing works
Apolipoprotein E and Alzheimer’s disease: Findings, hypotheses, and potential mechanisms
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Tai, L. M., Thomas, R., Marottoli, F. M., Koster, K. P., Kanekiyo, T., Morris, A. W. J., & Bu, G. (2016) · Acta Neuropathologica · doi:10.1007/s00401-016-1547-z · Cited by 231 · see citing works
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Alzheimer’s Risk Factors Age, APOE Genotype, and Sex Drive Distinct Molecular Pathways
Zhao, N., Ren, Y., Yamazaki, Y., Qiao, W., Li, F., Felton, L. M., Mahmoudiandehkordi, S., Kueider-Paisley, A., Sonoustoun, B., Arnold, M., et al. (2020) · Neuron · doi:10.1016/j.neuron.2020.02.034 · Cited by 225 · see citing works
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TREM2, microglia, and Alzheimer’s disease.
Qin, Q., Teng, Z., Liu, C., Li, Q., Yin, Y., & Tang, Y. (2021) · Mechanisms of Ageing and Development · doi:10.1016/j.mad.2021.111438 · Cited by 219 · see citing works
Questions concerning the role of amyloid-β in the definition, aetiology and diagnosis of Alzheimer’s disease
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APOE and Alzheimer’s Disease: Evidence Mounts that Targeting APOE4 may Combat Alzheimer’s Pathogenesis
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Amyloid clearance defect in ApoE4 astrocytes is reversed by epigenetic correction of endosomal pH
Prasad, H., & Rao, R. (2018) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1801612115 · Cited by 200 · see citing works
Apolipoprotein E4, inhibitory network dysfunction, and Alzheimer’s disease
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ApoE Lipidation as a therapeutic target in Alzheimer’s disease
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Evidence for benefit of statins to modify cognitive decline and risk in Alzheimer’s disease
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Neuronal heparan sulfates promote amyloid pathology by modulating brain amyloid-β clearance and aggregation in Alzheimer’s disease
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Neuronal ROS-Induced Glial Lipid Droplet Formation is Altered by Loss of Alzheimer's Disease-Associated Genes
Moulton, M. J., Barish, S., Ralhan, I., Chang, J., Goodman, L. D., Harland, J. G., Marcogliese, P. C., Johansson, J. O., Ioannou, M. S., & Bellen, H. J. (2021) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2112095118 · Cited by 180 · see citing works
Therapeutic approaches targeting Apolipoprotein E function in Alzheimer’s disease
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ApoE, ApoE Receptors, and the Synapse in Alzheimer's Disease
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Apolipoprotein E as a Therapeutic Target in Alzheimer’s Disease: A Review of Basic Research and Clinical Evidence
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More than cholesterol transporters: lipoprotein receptors in CNS function and neurodegeneration
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Interaction of Alzheimer’s β-Amyloid Peptides with Cholesterol: Mechanistic Insights into Amyloid Pore Formation
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Opposing effects of viral mediated brain expression of apolipoprotein E2 (apoE2) and apoE4 on apoE lipidation and Aβ metabolism in apoE4-targeted replacement mice
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Apoe4 and Alzheimer’s Disease Pathogenesis—Mitochondrial Deregulation and Targeted Therapeutic Strategies
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Cellular cholesterol homeostasis and Alzheimer’s disease
Chang, T.-Y., Yamauchi, Y., Hasan, M. T., & Chang, C. (2017) · Journal of Lipid Research · doi:10.1194/jlr.r075630 · Cited by 155 · see citing works
APOE4-mediated amyloid-β pathology depends on its neuronal receptor LRP1
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Authors: Kanekiyo, T., Xu, H., & Bu, G.
Affiliations: Mayo Clinic (US)
Xiamen University (CN)
Corresponding author: Bu, Guojun
ORCID: Kanekiyo, Takahisa
Xu, Huaxi
Bu, Guojun
Venue: Neuron
Publisher: Elsevier BV
Published: 2014-02
Volume: 81
Issue: 4
Pages: 740-754
ISSN: 0896-6273 (ISSN-L)
DOI: 10.1016/j.neuron.2014.01.045
PMC: PMC3983361
OpenAlex: W2051765035
Cited by: 608
References: 166
Citations by year: 2026: 33 · 2025: 64 · 2024: 59 · 2023: 48 · 2022: 38 · 2021: 63 · 2020: 55 · 2019: 48 · 2018: 42 · 2017: 48 · 2016: 42 · 2015: 43 · 2014: 24
FWCI: 6.13
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 383 d)
Locations: Neuron (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Rare & Special e-Zone (The Hong Kong University of Science and Technology) (submittedVersion)
Funders: Mayo Clinic
National Institutes of Health
National Institute on Aging (P01AG030128, R01AG044420, R01AG027924, R01AG021173, R01AG031784, RF1AG046205, R01AG046205, R01AG035355)
National Institute of Neurological Disorders and Stroke (R01NS046673, P01NS074969)
Topics: Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
Keywords: apolipoprotein E, APOE ε4, amyloid-beta, Alzheimer's disease, amyloid-beta clearance, apoE receptors, APOE isoforms, amyloid-beta aggregation, cholesterol transport, disease risk, therapeutic target
MeSH terms: Alzheimer Disease, Animals, Apolipoproteins E, Brain, Humans, Neurons, Risk Factors, Amyloid beta-Peptides

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ApoE and Aβ in Alzheimer’s Disease: Accidental Encounters or Partners?

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