Cited by 157Alzheimer's disease research and treatmentsNeuroscience and Neuropharmacology ResearchNeuroinflammation and Neurodegeneration Mechanisms

ApoE, ApoE Receptors, and the Synapse in Alzheimer's Disease

Open access
Lane-Donovan, Courtney, Herz, Joachim·2017·Trends in Endocrinology & Metabolism

Abstract

As the population ages, neurodegenerative diseases such as Alzheimer's disease (AD) are becoming a significant burden on patients, their families, and health-care systems. Neurodegenerative processes may start up to 15 years before outward signs and symptoms of AD, as evidenced by data from AD patients and mouse models. A major genetic risk factor for late-onset AD is the ɛ4 isoform of apolipoprotein E (ApoE4), which is present in almost 20% of the population. In this review we discuss the contribution of ApoE receptor signaling to the function of each component of the tripartite synapse - the axon terminal, the postsynaptic dendritic spine, and the astrocyte - and examine how these systems fail in the context of ApoE4 and AD.

AI snapshot

Written from the paper’s full text.

TL;DR

This review argues that ApoE receptors (the LDL receptor family) act as central regulators of synaptic function across all three compartments of the tripartite synapse, and that the ApoE4 isoform disrupts these neuromodulatory roles early in Alzheimer's disease. It proposes that ApoE4 drives neuronal dysfunction both by impairing amyloid-beta turnover and by blunting Reelin/ApoE receptor protection of the synapse.

Key findings

  • ApoE4 is a major late-onset AD risk factor: one copy roughly triples risk, two copies confer about a 90% lifetime risk, and allele frequency is 15–20%; ApoE2 appears protective and ApoE3 risk-neutral.
  • Reelin signaling through Apoer2/Lrp8 and Vldlr phosphorylates Dab1, which boosts NMDAR-mediated calcium influx and LTP while inhibiting GSK3β and tau phosphorylation; Reelin application to hippocampal slices prevents Aβ-induced LTP reduction, and intraventricular Reelin improves learning and memory in mice.
  • Aβ oligomers oppose Reelin via calcineurin/STEP-driven NMDAR internalization and via caspase-3/Akt-mediated GSK3β activation, reducing LTP; Reelin-deficient mice overexpressing Aβ are heavily impaired on the Morris Water Maze.
  • ApoE4's structural instability (molten globule tendency, aggregation at 37°C) stalls endosomal recycling of ApoE receptors and co-trapped glutamate receptors, producing a state of "Reelin resistance"; ApoE4 targeted-replacement mice and human ApoE4 carriers show reduced dendritic spine complexity.
  • Presynaptically, Reelin acting through Apoer2/Vldlr raises intracellular calcium and selectively enhances fusion of VAMP7-containing vesicles; ApoE4 TR mice show decreased glutamate, increased glutamine, and late increases in vglut1.
  • Astrocytic Lrp4 mediates agrin-driven ATP release, which is converted to adenosine and suppresses presynaptic glutamate release via A1 receptors; ApoE4 limits astrocytic synaptic pruning and causes the greatest glial activation.

Methods

  • Narrative review; no primary data collection or new experiments.
  • Synthesizes published human, mouse, and in vitro literature on ApoE, LDL receptor family members, Reelin, and AD pathology.
  • Organizes evidence by tripartite synapse compartment (postsynaptic spine, axon terminal, astrocyte) and by signaling pathway (Reelin/Dab1, calcium homeostasis, actin polymerization, endocytic trafficking).

Limitations

  • Stated: the authors list unresolved questions, including whether ApoE4 represents gain or loss of function, whether ApoE isoforms affect presynaptic VAMP7-vesicle mobilization, the mechanism by which ApoE influences astrocytic pruning, how Lrp4 increases astrocytic ATP release, and which molecular targets could ameliorate ApoE4's endocytic recycling effects.
  • Stated: definitive human evidence that Reelin is protective is largely lacking; the role of Lrp1 in ApoE-isoform effects on pruning "remains to be demonstrated"; the impact of altered presynaptic glutamate production in vivo requires follow-up.
  • Evident from the text: as a review it presents no new data, and several mechanistic claims rest on mouse models or slice preparations whose translation to human AD is not established.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.tem.2016.12.001

Cites

100 of 100 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 95 cited sources checked · 0 supported · 0 flagged

  • Interpretationreasoning

    ApoE has a role in neuronal function prior to amyloid deposition.

    “indicating a role for ApoE in neuronal function prior to amyloid deposition”
    Quote in the paperSubstantial claim
  • Premisecitation

    Some of these ApoE4-related alterations are present much earlier in life.

    “some of these changes are present much earlier in life [16]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] Dean DC 3rd 2014 Brain differences in infants at differential genetic risk for late-onset Alzheimer disease: a cross-sectional imaging study JAMA Neurol 71 1 11 22 24276092 PMC4056558 source

      Not checked in the free run.

  • Premisecitation

    Lrp1 interacts with the N-methyl-D-aspartate receptor (NMDAR), promoting endocytosis of NMDAR from the cell surface.

    “Lrp1 interacts with the N-methyl-D-aspartate receptor (NMDAR), promoting the endocytosis of NMDAR from the cell surface [19].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] Maier W 2013 LRP1 is critical for the surface distribution and internalization of the NR2B NMDA receptor subtype Mol Neurodegener 8 25 23866919 PMC3722104 source

      Not checked in the free run.

  • Premisecitation

    The primary ligand for Apoer2 and Vldlr in the central nervous system is Reelin, not ApoE.

    “The primary ligand for these receptors in the CNS is not ApoE, but rather the glycoprotein Reelin [22].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] Lee GH D’Arcangelo G 2016 New Insights into Reelin-Mediated Signaling Pathways Front Cell Neurosci 10 122 27242434 PMC4860420 source

      Not checked in the free run.

  • Premisecitation

    ApoE4 hinders the clearance of amyloid-beta (Aβ) significantly more than ApoE3 and ApoE2.

    “ApoE4 hindering Aβ clearance significantly over ApoE3 and ApoE2 [14]”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [14] Castellano JM 2011 Human apoE isoforms differentially regulate brain amyloid-beta peptide clearance Sci Transl Med 3 89 89ra57 PMC3192364 21715678 source

      Not checked in the free run.

  • May combine two claims. 26
  • Classified as probably not a substantial claim. 7
  • May combine two claims.

    Premisecitation

    Carrying one copy of ApoE4 triples the risk of developing AD, and carrying two copies confers a 90% lifetime risk.

    “Possession of one copy of ApoE4 triples the risk of developing AD, while individuals with two copies have a 90% lifetime risk of developing the disease.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] Lutz MW 2016 A Genetics-based Biomarker Risk Algorithm for Predicting Risk of Alzheimer’s Disease Alzheimers Dement (N Y) 2 1 30 44 27047990 PMC4817110 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The allele frequency of ApoE4 is 15-20%, with some variation in incidence between populations.

    “The allele frequency of ApoE4 is 15–20%, with some variation in incidence between populations [13].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Liu CC 2013 Apolipoprotein E and Alzheimer disease: risk, mechanisms and therapy Nat Rev Neurol 9 2 106 18 23296339 PMC3726719 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    ApoE2 is protective against AD, while ApoE3 is risk-neutral.

    “Conversely, ApoE2 is considered to be protective against AD, while ApoE3 is considered risk-neutral”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Liu CC 2013 Apolipoprotein E and Alzheimer disease: risk, mechanisms and therapy Nat Rev Neurol 9 2 106 18 23296339 PMC3726719 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Dab1-mediated activation of Src and Fyn leads to tyrosine phosphorylation of the NR2 subunits of NMDARs, which causes increased Ca2+ influx and reduces NMDAR endocytosis.

    “Dab1-mediated activation of Src and Fyn leads to the tyrosine phosphorylation of the NR2 subunits of NMDARs, which causes increased Ca2+ influx when the receptors are activated and also reduces NMDAR endocytosis [27, 28]”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [27] Chen Y 2005 Reelin modulates NMDA receptor activity in cortical neurons J Neurosci 25 36 8209 16 16148228 PMC6725528 source

      Not checked in the free run.

    • cites [28] Snyder EM 2005 Regulation of NMDA receptor trafficking by amyloid-beta Nat Neurosci 8 8 1051 8 16025111 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    STEP dephosphorylates and deactivates Fyn, enhancing the overall effect of STEP on NMDAR endocytosis.

    “STEP additionally dephosphorylates and deactivates Fyn, enhancing the overall effect of STEP on NMDAR endocytosis [36].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] Nguyen TH 2002 Striatal enriched phosphatase 61 dephosphorylates Fyn at phosphotyrosine 420 J Biol Chem 277 27 24274 9 11983687 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    ApoE receptors activated by Reelin are essential in maintaining signal strength over the noise of rising Ca2+ levels induced by AD-promoting mechanisms, thereby protecting the synapse during early AD until Aβ and tau accumulate to levels that cause synaptic loss.

    “the ApoE receptors activated by Reelin are essential in maintaining the signal strength over the noise of rising Ca2+ levels induced by AD-promoting mechanisms. This mechanism affords protection to the synapse by maintaining synaptic strength during the early stages of AD until Aβ and τ accumulate to such levels that the system breaks down and synaptic loss ensues.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    Dab1 activates phosphoinositol-3 (PI3) kinase and subsequently Akt, which phosphorylates glycogen synthase kinase 3β (GSK3β) at its inhibitory Ser-9 phosphorylation site, reducing phosphorylation of numerous targets including tau.

    “Dab1 activates phosphoinositol-3 (PI3) kinase and subsequently Akt, which phosphorylates glycogen synthase kinase 3β (GSK3β) at its inhibitory Ser-9 phosphorylation site. This reduces the phosphorylation of numerous targets of GSK3β, the most relevant of which in the context of AD is the microtubule-associated protein τ [25].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [25] Herz J Chen Y 2006 Reelin, lipoprotein receptors and synaptic plasticity Nat Rev Neurosci 7 11 850 9 17053810 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    GSK3β activation reduces synaptic long-term potentiation (LTP) and provides a potential biochemical mechanism by which Aβ can induce tau hyperphosphorylation.

    “GSK3β activation reduces synaptic long-term potentiation (LTP) and provides a potential biochemical mechanism by which Aβ can induce τ hyperphosphorylation [39].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [39] Zhu LQ 2007 Activation of glycogen synthase kinase-3 inhibits long-term potentiation with synapse-associated impairments J Neurosci 27 45 12211 20 17989287 PMC6673262 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Higher resting Ca2+ levels tip the balance of synaptic plasticity towards long-term depression (LTD), leading to memory trace erasure and loss of synapses.

    “The main effect of higher resting levels of Ca2+ appears to be to tip the balance of synaptic plasticity towards LTD. The net result of this would be memory trace erasure and loss of synapses.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    Aβ oligomers reduce activity of LIMK, which leads to dephosphorylated active cofilin, depolymerization of actin filaments, and the generation of actin rods.

    “Aβ oligomers reduce activity of LIMK, which in turns leads to dephosphorylated, active cofilin, depolymerization of actin filaments and the generation of actin rods [66].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [66] Zhao L 2006 Role of p21-activated kinase pathway defects in the cognitive deficits of Alzheimer disease Nat Neurosci 9 2 234 42 16415866 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Actin polymerization and dendritic spine growth exhibit a net increase in the presence of Reelin, and mice that overexpress Reelin have higher spine density and increased spine complexity.

    “actin polymerization and dendritic spine growth exhibit a net increase in the presence of Reelin, and mice that overexpress Reelin have higher spine density and increased spine complexity [64, 65].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [64] Chai X 2009 Reelin stabilizes the actin cytoskeleton of neuronal processes by inducing n-cofilin phosphorylation at serine3 J Neurosci 29 1 288 99 19129405 PMC6664910 source

      Not checked in the free run.

    • cites [65] Bosch C 2016 Reelin Regulates the Maturation of Dendritic Spines, Synaptogenesis and Glial Ensheathment of Newborn Granule Cells Cereb Cortex PMC5066826 27624722 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    ApoE has two structural domains: an N-terminal domain responsible for interaction with ApoE receptors, and a C-terminal domain responsible for lipoprotein binding.

    “ApoE has two structural domains, an N-terminal domain, which is responsible for interaction with ApoE receptors, and a C-terminal domain, which is responsible for lipoprotein binding [68].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [68] Zhong N Weisgraber KH 2009 Understanding the association of apolipoprotein E4 with Alzheimer disease: clues from its structure J Biol Chem 284 10 6027 31 18948255 PMC2649104 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    When ApoE4 is present, the final recycling step of ApoE receptors is delayed and the process is stalled in the endosome, presumably due to the propensity of ApoE4 to form molten globules at the lower pH of the endosome.

    “when ApoE4 is present, the final recycling step is delayed and the process is stalled in the endosome, presumably due to the propensity of ApoE4 to form molten globules at the lower pH of the endosome [69, 71].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [69] Morrow JA 2002 Apolipoprotein E4 forms a molten globule. A potential basis for its association with disease J Biol Chem 277 52 50380 5 12393895 source

      Not checked in the free run.

    • cites [71] Heeren J 2004 Impaired recycling of apolipoprotein E4 is associated with intracellular cholesterol accumulation J Biol Chem 279 53 55483 92 15485881 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The presence of an arginine at position 112 promotes the formation of a salt bridge between Arg-61 and Glu-255, leading to a domain interaction between the N- and C-terminals. As a result, ApoE4 has a greater tendency to form molten globules over the other ApoE isoforms, as well as a greater propensity to aggregate at 37°C.

    “The presence of an arginine at position 112 promotes the formation of a salt bridge between Arg-61 and Glu-255, leading to a “domain interaction” between the N- and C-terminals. As a result, ApoE4 has a greater tendency to form molten globules over the other ApoE isoforms, as well as a greater propensity to aggregate at 37°C [69, 70].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [69] Morrow JA 2002 Apolipoprotein E4 forms a molten globule. A potential basis for its association with disease J Biol Chem 277 52 50380 5 12393895 source

      Not checked in the free run.

    • cites [70] Hatters DM 2006 Amino-terminal domain stability mediates apolipoprotein E aggregation into neurotoxic fibrils J Mol Biol 361 5 932 44 16890957 source

      Not checked in the free run.

  • May combine two claims.

    Premisenone given

    ApoE binds the receptors at a different site from Reelin, and thus does not directly affect receptor signaling by hindering Reelin engagement; however, the ApoE isoforms do affect receptor trafficking.

    “ApoE binds the receptors at a different site from Reelin, and thus does not directly affect receptor signaling by hindering Reelin engagement; however, the ApoE isoforms do affect receptor trafficking.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationcitation

    These findings suggest a reduced ability of presynaptic ApoE4 neurons to convert glutamine to glutamate and a compensatory increase in vesicular glutamate loading.

    “suggesting a reduced ability of presynaptic ApoE4 neurons to convert glutamine to glutamate and a compensatory increase in vesicular glutamate loading [75].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [75] Dumanis SB 2013 APOE genotype affects the pre-synaptic compartment of glutamatergic nerve terminals J Neurochem 124 1 4 14 22862561 PMC3509249 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    ApoE4 targeted replacement mice have a reduction in dendritic spine complexity, a finding that is mirrored in human ApoE4 carriers.

    “ApoE4 targeted replacement mice have a reduction in dendritic spine complexity, a finding that is mirrored in human ApoE4 carriers [67].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [67] Ji Y 2003 Apolipoprotein E isoform-specific regulation of dendritic spine morphology in apolipoprotein E transgenic mice and Alzheimer’s disease patients Neuroscience 122 2 305 15 14614898 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    With age, Reelin levels are reduced in the brain, and in AD, Reelin levels are particularly reduced in the entorhinal cortex.

    “With age, Reelin levels are reduced in the brain and in AD, Reelin levels are particularly reduced in the entorhinal cortex [44].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [44] Chin J 2007 Reelin depletion in the entorhinal cortex of human amyloid precursor protein transgenic mice and humans with Alzheimer’s disease J Neurosci 27 11 2727 33 17360894 PMC6672562 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Astrocyte-derived ApoE is important for cholesterol transport through ApoE-containing 'HDL-like' particles, which play an important role in synaptic development and maintenance.

    “Astrocyte-derived ApoE is important for cholesterol transport through ApoE-containing “HDL-like” particles, which play an important role in synaptic development and maintenance [1, 4, 5].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [1] Lane-Donovan C 2014 More than cholesterol transporters: lipoprotein receptors in CNS function and neurodegeneration Neuron 83 4 771 87 25144875 PMC4240629 source

      Not checked in the free run.

    • cites [4] Pfrieger FW 2010 Role of glial cells in the formation and maintenance of synapses Brain Res Rev 63 1–2 39 46 19931561 source

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    • cites [5] Mahley RW 2016 Central Nervous System Lipoproteins: ApoE and Regulation of Cholesterol Metabolism Arterioscler Thromb Vasc Biol 36 7 1305 15 27174096 PMC4942259 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Reelin signaling activates PI3kinase, which initiates a pathway that induces phosphorylation of LIM kinase-1 (LIMK-1), which in turn phosphorylates cofilin at an inhibitory site, blocking the actin-depolymerizing activity of cofilin.

    “Reelin signaling activates PI3kinase, as described above [61]. In turn, PI3kinase initiates a signaling pathway that induces phosphorylation of LIM kinase-1 (LIMK-1), which in turn phosphorylates cofilin at an inhibitory site, blocking the actin-depolymerizing activity of cofilin [62, 63].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [61] Bock HH 2003 Phosphatidylinositol 3-kinase interacts with the adaptor protein Dab1 in response to Reelin signaling and is required for normal cortical lamination J Biol Chem 278 40 38772 9 12882964 source

      Not checked in the free run.

    • cites [62] Caroni P 2014 Synapse rearrangements upon learning: from divergent-sparse connectivity to dedicated sub-circuits Trends Neurosci 37 10 604 14 25257207 source

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    • cites [63] Mizuno K 2013 Signaling mechanisms and functional roles of cofilin phosphorylation and dephosphorylation Cell Signal 25 2 457 69 23153585 source

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  • May combine two claims.

    Premisecitation

    Aβ oligomers bind to α7 nicotinic acetylcholine receptors (α7 nAChRs) and to metabotropic glutamate receptors, in particular mGluR5.

    “Aβ binds to α7 nicotinic acetylcholine receptors (α7 nAChRs) and to metabotropic glutamate receptors, in particular mGluR5 [31–33].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [31] Dineley KT 2001 Beta-amyloid activates the mitogen-activated protein kinase cascade via hippocampal alpha7 nicotinic acetylcholine receptors: In vitro and in vivo mechanisms related to Alzheimer’s disease J Neurosci 21 12 4125 33 11404397 PMC6762764 source

      Not checked in the free run.

    • cites [32] Renner M 2010 Deleterious effects of amyloid beta oligomers acting as an extracellular scaffold for mGluR5 Neuron 66 5 739 54 20547131 PMC3111138 source

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    • cites [33] Lauren J 2009 Cellular prion protein mediates impairment of synaptic plasticity by amyloid-beta oligomers Nature 457 7233 1128 32 19242475 PMC2748841 source

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  • May combine two claims.

    Premisecitation

    ApoE exists in three isoforms that differ at residues 112 and 158: ApoE2 has cysteine at both positions, ApoE3 has cysteine at position 112 and arginine at position 158, and ApoE4 has arginines at both positions.

    “ApoE exists in the human population in three isoforms, which differ at only two residues, 112 and 158. ApoE2 has a cysteine at both positions, ApoE3 has a cysteine at position 112 and an arginine at position 158, and ApoE4 has arginines at both positions [68].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [68] Zhong N Weisgraber KH 2009 Understanding the association of apolipoprotein E4 with Alzheimer disease: clues from its structure J Biol Chem 284 10 6027 31 18948255 PMC2649104 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    ApoE4 induces a state of 'Reelin resistance' that likely affects more than synaptic plasticity, including Ca2+ homeostasis, spine remodeling, and pre-synaptic and astrocytic roles.

    “In this way, ApoE4 induces a state of “Reelin resistance” that likely affects more than synaptic plasticity (e.g., Ca2+ homeostasis, spine remodeling, and the pre-synaptic and astrocytic roles described below).”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Lrp4 functions in neuromuscular junction development and in maintaining the adult neuromuscular junction.

    “for its role in neuromuscular junction (NMJ) development and in the maintenance of the adult NMJ”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [87] Selcen D 2015 Impaired Synaptic Development, Maintenance, and Neuromuscular Transmission in LRP4-Related Myasthenia JAMA Neurol 72 8 889 96 26052878 PMC4532561 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Glial activation indicates pro-inflammatory changes commonly seen in Alzheimer's disease brains.

    “glial activation is an indication of pro-inflammatory changes that is commonly found in AD brains”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [98] Heppner FL 2015 Immune attack: the role of inflammation in Alzheimer disease Nat Rev Neurosci 16 6 358 72 25991443 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Anti-Lrp4 and anti-MuSK antibodies contribute to myasthenia gravis.

    “the role of anti-Lrp4 and anti-MuSK antibodies in myasthenia gravis [87]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [87] Selcen D 2015 Impaired Synaptic Development, Maintenance, and Neuromuscular Transmission in LRP4-Related Myasthenia JAMA Neurol 72 8 889 96 26052878 PMC4532561 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    At the neuromuscular junction, Lrp4, APP, and MuSK form a complex that prepatterns the muscle.

    “at the NMJ, Lrp4, APP and muscle-specific kinase (MuSK) form a complex to prepattern the muscle [88–90]”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [88] Choi HY 2013 APP interacts with LRP4 and agrin to coordinate the development of the neuromuscular junction in mice Elife 2 e00220 23986861 PMC3748711 source

      Not checked in the free run.

    • cites [89] Kim N 2008 Lrp4 is a receptor for Agrin and forms a complex with MuSK Cell 135 2 334 42 18848351 PMC2933840 source

      Not checked in the free run.

    • cites [90] Zhang B 2008 LRP4 serves as a coreceptor of agrin Neuron 60 2 285 97 18957220 PMC2743173 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Lrp1 is highly expressed in astrocytes, where it is responsible for phagocytosis of degraded myelin.

    “Lrp1 is highly expressed in astrocytes, where it is responsible for phagocytosis of degraded myelin [78, 79].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [78] Cahoy JD 2008 A transcriptome database for astrocytes, neurons, and oligodendrocytes: a new resource for understanding brain development and function J Neurosci 28 1 264 78 18171944 PMC6671143 source

      Not checked in the free run.

    • cites [79] Gaultier A 2009 Low-density lipoprotein receptor-related protein 1 is an essential receptor for myelin phagocytosis J Cell Sci 122 Pt 8 1155 62 19299462 PMC2714439 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Lrp4 is the gene mutated in Cenani-Lenz syndrome.

    “Lrp4 is more commonly known as the gene defective in Cenani-Lenz syndrome [83–86]”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [83] Karner CM 2010 Lrp4 regulates initiation of ureteric budding and is crucial for kidney formation--a mouse model for Cenani-Lenz syndrome PLoS One 5 4 e10418 20454682 PMC2861670 source

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    • cites [84] Johnson EB 2005 Abnormal development of the apical ectodermal ridge and polysyndactyly in Megf7-deficient mice Hum Mol Genet 14 22 3523 38 16207730 source

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    • cites [85] Johnson EB 2006 Defective splicing of Megf7/Lrp4, a regulator of distal limb development, in autosomal recessive mulefoot disease Genomics 88 5 600 9 16963222 source

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    • cites [86] Li Y 2010 LRP4 mutations alter Wnt/beta-catenin signaling and cause limb and kidney malformations in Cenani-Lenz syndrome Am J Hum Genet 86 5 696 706 20381006 PMC2869043 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    ApoE4 promotes neuronal dysfunction by impairing Aβ turnover and accelerating amyloid deposition.

    “by two distinct mechanisms: impairing the turnover of Aβ, thereby accelerating amyloid deposition”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Mechanisms of ApoE and Lrp4 function observed in mouse models apply to human Alzheimer's disease.
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Agrin released from motor neurons signals through APP, MuSK, and Lrp4 to recruit nicotinic acetylcholine receptors.

    “Agrin is released from the motor neuron and signals through APP, MuSK and Lrp4 to recruit nicotinic acetylcholine receptors (AChRs).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [88] Choi HY 2013 APP interacts with LRP4 and agrin to coordinate the development of the neuromuscular junction in mice Elife 2 e00220 23986861 PMC3748711 source

      Not checked in the free run.

    • cites [89] Kim N 2008 Lrp4 is a receptor for Agrin and forms a complex with MuSK Cell 135 2 334 42 18848351 PMC2933840 source

      Not checked in the free run.

    • cites [90] Zhang B 2008 LRP4 serves as a coreceptor of agrin Neuron 60 2 285 97 18957220 PMC2743173 source

      Not checked in the free run.

31 of 31
  • The paper relies on this without support.

    Mechanisms of ApoE/ApoE receptor signaling and ApoE4 effects observed in mouse models and cell studies are relevant to human Alzheimer's disease.

    “ApoE4 targeted replacement mice have a reduction in dendritic spine complexity, a finding that is mirrored in human ApoE4 carriers [67].”
  • The paper relies on this without support.

    The tripartite synapse framework captures the relevant sites of ApoE/ApoE receptor action in Alzheimer's disease.

    “We divide our discussion based on the three components of the tripartite synapse – the post-synaptic spine, the axon terminal, and the astrocyte – and delineate the newly discovered roles of ApoE receptor signaling at each of these compartments (Figure 1).”
  • The paper relies on this without support.

    Mechanisms of ApoE and Lrp4 function observed in mouse models apply to human Alzheimer's disease.

    “ApoE4 promotes neuronal dysfunction at the earliest stages of the pathology, leading up to the clinical manifestation of AD”
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Authors
Lane-Donovan, C., & Herz, J.
Affiliations
University of Freiburg (DE)
Corresponding author
Herz, Joachim
Venue
Trends in Endocrinology & Metabolism
Publisher
Elsevier BV
Published
2017-04
Volume
28
Issue
4
Pages
273-284
ISSN
1043-2760 (ISSN-L)
OpenAlex
W2568317134
Cited by
157
References
103
Citations by year
2026: 13 · 2025: 20 · 2024: 17 · 2023: 18 · 2022: 18 · 2021: 25 · 2020: 13 · 2019: 14 · 2018: 12 · 2017: 7
FWCI
1.54
Type
journal article
Language
en
Open access
Locations
  • Trends in Endocrinology and Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute on Aging (RF1AG053391, F30AG047799)
  • National Heart, Lung, and Blood Institute (R37HL063762)
  • National Institute of Neurological Disorders and Stroke (R01NS093382)
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
Alzheimer's disease, apolipoprotein E, APOE ε4, apoE receptors, tripartite synapse, synapses, axon terminals, dendritic spines, astrocytes, neurodegeneration, late-onset Alzheimer's disease, genetic risk factors
MeSH terms
Reelin Protein, Alzheimer Disease, Animals, Apolipoproteins E, Disease Models, Animal, Female, Humans, Male, Synapses, Low Density Lipoprotein Receptor-Related Protein-1

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-01.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-01.

Statistics and arithmetic are recomputed, not judged.

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