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ApoE and Aβ in Alzheimer’s Disease: Accidental Encounters or Partners?
Open accessAbstract
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 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]
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“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]
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“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]
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“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]
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“Importantly, brain Aβ pathology is inarguably associated with APOE4 status (7).”
From APOE4-mediated amyloid-β pathology depends on its neuronal receptor LRP1 (2019) · cites this paper as [7]
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“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]
In the citing paper
“Overall, it has been demonstrated, both in vivo and in vitro, that apoE plays major roles in AD pathogenesis in both an Aβ-dependent and independent manner, and different cellular sources of apoE4 may contribute in distinct ways to AD pathogenesis [4–8, 12–14, 21, 22].”
From Apolipoprotein E4, inhibitory network dysfunction, and Alzheimer’s disease (2019) · cites this paper as [7]
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Metadata
- Authors
- Kanekiyo, T., Xu, H., & Bu, G.
- Affiliations
- Mayo Clinic (US)
- Xiamen University (CN)
- Corresponding author
- Bu, Guojun
- Venue
- Neuron
- Publisher
- Elsevier BV
- Published
- 2014-02
- Volume
- 81
- Issue
- 4
- Pages
- 740-754
- ISSN
- 0896-6273 (ISSN-L)
- 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
- 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
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › 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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