APOE2 enhances neuroprotection against Alzheimer’s disease through multiple molecular mechanisms
Abstract
The common APOE2 gene variant is neuroprotective against Alzheimer's disease (AD) and reduces risk by nearly 50%. However, the mechanisms by which APOE2 confers neuroprotection are largely unknown. Here we showed that ApoE protein abundance in human postmortem cortex follows an isoform-dependent pattern (E2>E3>E4). We also identified a unique downstream transcriptional profile determined by microarray and characterized by downregulation of long-term potentiation (LTP) related transcripts and upregulation of extracellular matrix (ECM)/integrin-related transcripts in E2 cases and corroborated this finding at the protein level by demonstrating increases in ECM collagens and laminins. In vivo studies of healthy older individuals demonstrated a unique and advantageous biomarker signature in E2 carriers. APOE2 also reduced the risk of mild cognitive impairment to AD conversion by half. Our findings suggest that ApoE2 protein abundance, coupled with its inability to bind to LDLRs, may act to increase amyloid-beta (Ab) clearance. In addition, increased ECM and reduced LTP-related expression results in diminished activity-dependent Ab secretion and/or excitotoxicity, and thus also promotes neuroprotection.
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The APOE2hAβ LTP finding is consistent with observations reported in APOE2-carrying mice but appears paradoxical given APOE2's typical association with neuroprotection in AD.
“This finding is consistent with observations reported in APOE2-carrying mice [82], but appears paradoxical given APOE2’s typical association with neuroprotection in AD [83, 84].”
APOE2 markedly delays the age of onset of Alzheimer's disease, even in the presence of the APOE4 allele.
“and markedly delaying the age of onset, even in the presence of the APOE4 allele.12,13”
From AAVrh.10-Mediated APOE2 Central Nervous System Gene Therapy for APOE4-Associated Alzheimer's Disease (2018) · cites this paper as [12]
APOE2 is a protective allele, reducing Alzheimer's disease risk by approximately 50% (1.8-fold decreased risk).
“In contrast, APOE2 is a protective allele, reducing AD risk by approximately 50% (1.8-fold decreased risk)”
From AAVrh.10-Mediated APOE2 Central Nervous System Gene Therapy for APOE4-Associated Alzheimer's Disease (2018) · cites this paper as [12]
Individuals who are APOE4 homozygotes have a markedly increased risk of developing AD.
“Individuals who are APOE4 homozygotes have a markedly increased risk of developing AD.”
From AAVrh.10-Mediated APOE2 Central Nervous System Gene Therapy for APOE4-Associated Alzheimer's Disease (2018) · cites this paper as [12]
APOE2 homozygotes are protected from late-onset AD.
“APOE2 homozygotes are protected from late-onset AD and, compared to E4 homozygotes, APOE2/E4 heterozygotes have a markedly reduced risk of developing AD.6,12,13”
From AAVrh.10-Mediated APOE2 Central Nervous System Gene Therapy for APOE4-Associated Alzheimer's Disease (2018) · cites this paper as [12]
Compared to E4 homozygotes, APOE2/E4 heterozygotes have a markedly reduced risk of developing AD.
“APOE2 homozygotes are protected from late-onset AD and, compared to E4 homozygotes, APOE2/E4 heterozygotes have a markedly reduced risk of developing AD.6,12,13”
From AAVrh.10-Mediated APOE2 Central Nervous System Gene Therapy for APOE4-Associated Alzheimer's Disease (2018) · cites this paper as [12]
Converting an APOE4 homozygote to an E4/E2 heterozygote would markedly decrease the risk for developing early-onset AD compared with E4 homozygotes.
“From epidemiologic studies, this would markedly decrease the risk for developing early-onset AD compared to E4 homozygotes.”
From AAVrh.10-Mediated APOE2 Central Nervous System Gene Therapy for APOE4-Associated Alzheimer's Disease (2018) · cites this paper as [12]
CypA mRNA is increased in Alzheimer's disease brains.
“CypA mRNA is also increased in AD brains (118).”
From Blood-Brain Barrier: From Physiology to Disease and Back (2019) · cites this paper as [118]
APOE2 expression leads to increased APOE levels in mouse models and human brain, which can influence amyloid pathology.
“It has also been shown that APOE2 expression leads to increased APOE levels in mouse models and human brain (Riddell et al, 2008; Bales et al, 2009; Conejero-Goldberg et al, 2014), which can influence amyloid pathology.”
From APOE from astrocytes restores Alzheimer’s Aβ-pathology and DAM-like responses in APOE deficient microglia (2024) · cites this paper as Conejero-Goldberg et al, 2014
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“This finding is consistent with observations reported in APOE2-carrying mice [82], but appears paradoxical given APOE2’s typical association with neuroprotection in AD [83, 84].”
ResultExploring the combined effects of sleep apnea and APOE-e4 on biomarkers of Alzheimer’s disease
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- Authors
- Conejero-Goldberg, C., Gomar, J. J., Bobes-Bascaran, T., Hyde, T. M., Kleinman, J. E., Herman, M. M., Chen, S., Davies, P., & Goldberg, T. E.
- Affiliations
- Northwell Health (US)
- Lieber Institute for Brain Development (US)
- National Institutes of Health (US)
- Corresponding author
- Goldberg, T E
- Venue
- Molecular Psychiatry
- Published
- 2014-02-04
- Volume
- 19
- Issue
- 11
- Pages
- 1243-1250
- ISSN
- 1359-4184 (ISSN-L)
- 1476-5578
- OpenAlex
- W2076631828
- Cited by
- 199
- References
- 55
- Citations by year
- 2026: 6 · 2025: 16 · 2024: 16 · 2023: 10 · 2022: 15 · 2021: 25 · 2020: 50 · 2019: 12 · 2018: 14 · 2017: 19 · 2016: 8 · 2015: 7 · 2014: 1
- FWCI
- 7.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Molecular Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Alzheimer's Drug Discovery Foundation
- F. Hoffmann-La Roche
- Northern California Institute for Research and Education
- National Institutes of Health (5u01ag024904-10)
- National Institute on Aging (U01-AG-024904, P30AG010129, K01AG030514)
- National Institute of Biomedical Imaging and Bioengineering
- 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
- APOE2, Alzheimer's disease, neuroprotection, APOE isoforms, long-term potentiation, extracellular matrix, integrins, laminin, collagen, amyloid-beta clearance, mild cognitive impairment, biomarker signatures, excitotoxicity
- MeSH terms
- Adult, Aged, Alzheimer Disease, Cerebral Cortex, Collagen, Extracellular Matrix, Female, Humans, Laminin, Male, Middle Aged, Risk, RNA, Messenger, Biomarkers, Integrins, Long-Term Potentiation, Disease Progression, Protein Isoforms, Apolipoprotein E2, Cognitive Dysfunction
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