Apolipoprotein E: high-avidity binding to beta-amyloid and increased frequency of type 4 allele in late-onset familial Alzheimer disease.
Open accessAbstract
Apolipoprotein E is immunochemically localized to the senile plaques, vascular amyloid, and neurofibrillary tangles of Alzheimer disease. In vitro, apolipoprotein E in cerebrospinal fluid binds to synthetic beta A4 peptide (the primary constituent of the senile plaque) with high avidity. Amino acids 12-28 of the beta A4 peptide are required. The gene for apolipoprotein E is located on chromosome 19q13.2, within the region previously associated with linkage of late-onset familial Alzheimer disease. Analysis of apolipoprotein E alleles in Alzheimer disease and controls demonstrated that there was a highly significant association of apolipoprotein E type 4 allele (APOE-epsilon 4) and late-onset familial Alzheimer disease. The allele frequency of the APOE-epsilon 4 in 30 random affected patients, each from a different Alzheimer disease family, was 0.50 +/- 0.06; the allele frequency of APOE-epsilon 4 in 91 age-matched unrelated controls was 0.16 +/- 0.03 (Z = 2.44, P = 0.014). A functional role of the apolipoprotein E-E4 isoform in the pathogenesis of late-onset familial Alzheimer disease is suggested.
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- Findingown data
In 30 randomly chosen affected individuals, one from each of 30 Alzheimer disease families, the APOE-e4 allele frequency was 0.50 ± 0.06.
“The alele frequency of the APOE-e4 in 30 random affected patients, each from a different Azheimer disease family, was 0.50 t 0.06;”
- Also stated in: § MATERIALS AND METHODS · plain
“the frequency of the APOE-e4 allele in the 30 patients (0.50 ± 0.06)”
Quote in the paperSubstantial claim - Also stated in: § MATERIALS AND METHODS · plain
- Findingcitation
The APOE-e4 allele frequency in the study's control group was similar to that in a larger population study.
“The allele frequency of APOE-E4 found in our control population was similar to that found in a larger population study (20).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [20] 20. Menzel, J., Kladetzky, K. G. & Assmann, G. (1983) Arterio- sclerosis 4, 310-315.
Not checked in the free run.
- Findingown data
The APOE-e4 allele frequency difference between the 30 patients and 91 controls was statistically significant (Z=2.44, P=0.014).
“the aUlele frequency of APOE-e4 in 91 age-matched unrelated controls was 0.16 ± 0.03 (Z = 2.44, P = 0.014).”
- Also stated in: § MATERIALS AND METHODS · plain
“differed significantly from the frequency found in the 91 controls (0.16 ± 0.03; Z = 2.44, P = 0.014).”
Quote in the paperSubstantial claim- Rests on an assumption: The 91 unrelated CEPH grandparents used as controls are genetically comparable to the familial Alzheimer disease cases, so the allele frequency difference is not due to population stratification.
- Rests on an assumption: The two early-onset families in the sample do not materially affect the association between APOE-e4 and late-onset familial Alzheimer disease.
- Also stated in: § MATERIALS AND METHODS · plain
- Findingown data
In 91 age-matched unrelated controls, the APOE-e4 allele frequency was 0.16 ± 0.03.
“the aUlele frequency of APOE-e4 in 91 age-matched unrelated controls was 0.16 ± 0.03 (Z = 2.44, P = 0.014).”
- Also stated in: § MATERIALS AND METHODS · plain
“the frequency found in the 91 controls (0.16 ± 0.03; Z = 2.44, P = 0.014).”
Quote in the paperSubstantial claim- Rests on an assumption: The 91 unrelated CEPH grandparents used as controls are genetically comparable to the familial Alzheimer disease cases, so the allele frequency difference is not due to population stratification.
- Also stated in: § MATERIALS AND METHODS · plain
- Findingown data
ApoE in CSF stayed bound to immobilized beta-A4-(1-40), beta-A4-(1-28), and beta-A4-(12-28) after PBS plus 5% SDS washing.
“ApoE in CSF remained bound to immobilized (A4-(1-40), fA4-(1-28), andj'A4-(12-28) after incubation and washing with phosphate-buffer saline plus 5% SDS.”
Quote in the paperSubstantial claim
- Findingown data
The contaminating beta-A4-binding protein was identified as ApoE by microsequencing.
“This contaminant protein was identified by protein microsequenc- ing to be ApoE.”
Quote in the paperSubstantial claim - Findingown data
ApoE immunoreactivity followed the distribution of beta-A4 amyloid, including near glial processes.
“ApoE immunoreactivity (Fig. 4B) closely imitated the distribution of 3A4 amyloid (Fig. 4C), even being observed near glial processes (Fig. 4 B and C, arrowheads).”
Quote in the paperNot a substantial claim - Findingown data
The 12-28 hydropathic mimic peptide bound ApoE after PBS plus 5% SDS washing.
“This peptide also bound ApoE after washing with phosphate- buffered saline plus 5% SDS (Fig. 2).”
Quote in the paperSubstantial claim - Findingown data
ApoE did not bind to the even-hydropathy peptide.
“ApoE did not bind to this immobilized peptide (Fig. 2 Lower).”
Quote in the paperSubstantial claim - Findingown data
ApoE from cerebrospinal fluid binds with high avidity to synthetic beta-A4 peptide in vitro.
“In vitro, apolipoprotein E in cerebrospinal fluid binds to synthetic 13A4 peptide (the primary constituent of the senile plaque) with high avidity.”
- Also stated in: § MATERIALS AND METHODS · boosted
“Using this technique, we have demonstrated high-avidity binding of ApoE in CSF to ,BA4 peptide.”
Quote in the paperSubstantial claim - Also stated in: § MATERIALS AND METHODS · boosted
- Findingown data
The APOE-e4 allele occurs more frequently in late-onset familial Alzheimer disease patients than in age-matched unrelated controls.
“Analysis of apolipoprotein E alleles in Alzhei- mer disease and controls demonstrated that there was a highiy significant assocition of apolipoprotein E type 4 alele (APOE- e4) and late-onset familil Alzheimer disea.”
- Also stated in: § MATERIALS AND METHODS · plain
“Association studies ofAPOE alleles using DNA samples from one randomly selected familial Alzheimer disease patient from each of 30 families and from 91 age-matched unrelated controls showed that the frequency of the APOE-e4 allele in the 30 patients (0.50 ± 0.06) differed significantly from the frequency found in the 91 controls (0.16 ± 0.03; Z = 2.44, P = 0.014).”
- Also stated in: § MATERIALS AND METHODS · plain
“The association of the APOE-e4 allele with familial Alzheimer disease was significantly increased compared to the population controls and is consistent with prior analyses.”
Quote in the paperSubstantial claim- Rests on an assumption: The 91 unrelated CEPH grandparents used as controls are genetically comparable to the familial Alzheimer disease cases, so the allele frequency difference is not due to population stratification.
- Rests on an assumption: The two early-onset families in the sample do not materially affect the association between APOE-e4 and late-onset familial Alzheimer disease.
- Also stated in: § MATERIALS AND METHODS · plain
- Findingown data
The 12-28 amino acid segment of beta-A4 peptide is necessary for ApoE binding.
“Amino acids 12-28 of the flA4 peptide are required.”
- Also stated in: § MATERIALS AND METHODS · plain
“ApoE in CSF remained bound to immobilized (A4-(1-40), fA4-(1-28), andj'A4-(12-28) after incubation and washing with phosphate-buffer saline plus 5% SDS.”
Quote in the paperSubstantial claim - Also stated in: § MATERIALS AND METHODS · plain
- Interpretationown data
The combined peptide binding, immunochemistry, and allele association results suggest a more integrated role for ApoE in beta-A4 metabolism and targeting in Alzheimer disease.
“Our combined peptide binding data, immunochemistry, and allele association analyses suggest a more integrated role of ApoE in (3A4 metabolism and targeting in Alzheimer disease.”
Quote in the paperSubstantial claim- Rests on an assumption: In vitro binding of ApoE to synthetic beta-A4 peptides reflects a biologically relevant interaction that occurs in vivo.
- Interpretationown data
ApoE binding to beta-A4, the hydropathic mimic peptide, and prion protein plaque may depend on hydrophobic domains in those peptides.
“Binding of ApoE to PA4, to the hydropathic mimic peptide, and to the prion protein plaque may require the hydrophobic domains of each of these peptides.”
Quote in the paperSubstantial claim - Interpretationown data
The ApoE-E4 isoform may have a functional role in the pathogenesis of late-onset familial Alzheimer disease.
“A functional role of the apolipoprotein E-E4 isoform in the pathogenesis of late-onset familial Alzheimer dise is suggested.”
Quote in the paperSubstantial claim- Rests on an assumption: In vitro binding of ApoE to synthetic beta-A4 peptides reflects a biologically relevant interaction that occurs in vivo.
- Rests on an assumption: Localization of ApoE to Alzheimer disease lesions indicates a functional pathogenetic role rather than a secondary or incidental association.
- Interpretationreasoning
The presence of ApoE in the defining pathological lesions of Alzheimer disease suggests a functional pathogenetic role for ApoE.
“The ldcalization of ApoE to the defining pathological lesions of Alzheimer disease suggests a functional pathogenetic role for ApoE.”
Quote in the paperSubstantial claim- Rests on an assumption: Localization of ApoE to Alzheimer disease lesions indicates a functional pathogenetic role rather than a secondary or incidental association.
- Interpretationreasoning
ApoE binding to beta-A4 or other hydrophobic peptides may be a required step in targeting those peptides for their final intra- or extracellular metabolism.
“Binding of ApoE to .3A4peptide, or to other hydrophobic peptides, may be a requisite step in targeting these peptides for their final intra-or extracellular metabolism.”
Quote in the paperSubstantial claim- Rests on an assumption: In vitro binding of ApoE to synthetic beta-A4 peptides reflects a biologically relevant interaction that occurs in vivo.
- Interpretationreasoning
The APOE-e4 association with familial Alzheimer disease implies that allele-specific functions may contribute to the molecular mechanism of disease expression.
“The finding that the APOE-e4 allele is associated with familial Alzheimer disease patients has two major implications.First, there may be allele-specific functions that con- tribute to the molecular mechanism ofthe disease expression.”
Quote in the paperSubstantial claim - Premisecitation
The APOE locus falls in a chromosome 19 region previously linked to late-onset familial Alzheimer disease.
“The gene for apolipo- protein E is located on chromosome 19q13.2,within the region previously associated with linkage of late-onset familial Alz- heimer diseas.”
- Also stated in: § MATERIALS AND METHODS · hedged
“With nonparametric linkage analysis methods (15), genetic markers from chromosome 19q13.1-q13.3had previously suggested linkage to late-onset familial Alzheimer disease.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [15] 15. Pericak-Vance, M. A., Bebout, J. L., Gaskell, P. C., Jr., Ya- maoka, L. H., Hung, W. Y., Alberts, M. J., Walker, A. P., Bartlett, R. J., Haynes, C. A., Welsh, K. A., Earl, N. L., Heyman, A., Clark, C. M. & Roses, A. D. (1991) Am. J. Hum. Genet. 48, 1034-1050.
Not checked in the free run.
- Also stated in: § MATERIALS AND METHODS · hedged
- Interpretationreasoning
ApoE may be a shared factor in the pathogenesis or cellular response of several dementing diseases.
“ApoE may be a common denominator in either the pathogenesis or the cellular response of several dementing dis-Table 1.”
Quote in the paperSubstantial claim
- May combine two claims. 12
- Classified as probably not a substantial claim. 19
May combine two claims.
Findingown dataApoE protein is present in senile plaques, vascular amyloid, and neurofibrillary tangles in Alzheimer disease brain tissue.
“Apolipoprotein E is immunochemically local- ized to the senile plaques, vascular amyloid, and neuroflbrillary tangles of Alzheimer diwase.”
- Also stated in: § MATERIALS AND METHODS · plain
“Antiserum to ApoE stained amyloid plaques in tissues from Alzheimer disease patients and an aged lemur (Fig. 4 B and E).”
- Also stated in: § MATERIALS AND METHODS · plain
“ApoE is found in senile plaques, in neurofibrillary tangles, and-at the sites of congophilic angiopathy of Alzhei- mer disease”
Quote in the paperSubstantial claim- Also stated in: § MATERIALS AND METHODS · plain
May combine two claims.
Findingown dataAnti-ApoE antiserum stained amyloid plaques in Alzheimer disease patient tissue and in an aged lemur.
“Antiserum to ApoE stained amyloid plaques in tissues from Alzheimer disease patients and an aged lemur (Fig. 4 B and E).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataAntithrombin did not bind beta-A4 peptide, but a contaminating protein did.
“Using the in vitro assay described here, we found that antithrombin, a related protein, did not bind the fA4 peptide but a contaminant protein did.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataGuanidine hydrochloride failed to elute ApoE from beta-A4-(12-28) peptide but eluted nearly all ApoE from the even-hydropathy control peptide.
“Guanidine hydrochloride did not elute ApoE from the 3A4-(12-28) peptide but did elute virtually all the ApoE bound to the even-hydropathy control peptide (Fig. 1 Lower, lanes 4).”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationApoE has three major isoforms identified by amino acid sequencing: E3, E4, and E2.
“There are three major isoforms of ApoE identified by amino acid sequencing, designated ApoE-E3, ApoE-E4, and ApoE-E2.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [1] 1. Mahley, R. W. (1988) Science 240, 622-628.
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationAPOE mRNA is increased severalfold in Alzheimer disease brain and in scrapie-infected animal brain.
“APOE mRNA is increased severalfold in the brain of patients with Alzheimer disease and in the brain of animals with scrapie (10), a transmissible disease in animals that is similar to Creutzfeld-Jakob disease in humans and also exhibits prion protein plaques (9).”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [10] 10. Diedrich, J. F., Minnigan, H., Carp, R. I., Whitaker, J. N., Race, R., Frey, W., II, & Haase, A. T. (1991) J. Virol. 65, 4759-4768.
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- cites [9] 9. Prusiner, S. B., Hsiao, K. K., Bredesen, D. E. & DeArmond, S. J. (1989) in Handbook of Clinical Neurology, ed.
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationApoE is also bound in amyloid plaques of Creutzfeld-Jakob disease.
“ApoE is also bound in the amyloid plaques of another dementing degenerative disease, Creutzfeld-Jakob disease (8).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [8] 8. Namba, Y., Tomonaga, M., Kawasaki, H., Otomo, E. & Ikeda, K. (1991) Brain Res. 541, 163-166.
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Probably not a substantial claim: may not pass S2 (checkable).
InterpretationcitationGiven that beta-A4 amyloid is a normal extracellular product in many cell types, specific ApoE-beta-A4 interactions could define additional mechanisms of Alzheimer disease pathogenesis.
“With the recent appreciation that 3A4 amyloid is a normal extracellular product in many cell types (26), the discovery of specific interactions between ApoE and ,SA4 could define additional mechanisms of Alz- heimer disease pathogenesis.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [26] 26. Haass, C., Schlossmacher, M. G., Hung, A. Y., Vigo-Pelfey, C., Mellon, A., Ostaszewski, B. L., Lieberburg, I., Koo, E. H., Schenk, D., Teplow, D. B. & Selkoe, D. J. (1992) Science 359, 322-325.
Not checked in the free run.
- Rests on an assumption: In vitro binding of ApoE to synthetic beta-A4 peptides reflects a biologically relevant interaction that occurs in vivo.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationApoE-E4 has arginine at residue 112, while E3 has cysteine.
“ApoE-E4 contains an arginine at residue 112, whereas E3 has a cysteine.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [1] 1. Mahley, R. W. (1988) Science 240, 622-628.
Not checked in the free run.
May combine two claims.
Study design and conductown dataAPOE-e4 allele frequency was similar across all 83 tested Alzheimer disease patients in the 30 families, supporting that the 30-patient random sample represented the families' e4 frequency.
“APOE-e4 frequency was similar for all 83 tested Alzheimer disease patients in the 30 families, indicating that the random sample used in the association analysis accurately represented the e4 allele frequency in the families (Table 1).”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based).
InterpretationreasoningThe APOE-e4 association with familial Alzheimer disease implies that another intragenic polymorphism on an APOE-e4 background could confer susceptibility to Alzheimer disease.
“Second, there could also be another intragenic polymorphism on an APOE-e4 background that confers susceptibility to Alzheimer disease.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
PremisecitationThe APOE gene maps to chromosome 19q13.2.
“The gene for apolipo- protein E is located on chromosome 19q13.2,within the region previously associated with linkage of late-onset familial Alz- heimer diseas.”
- Also stated in: § MATERIALS AND METHODS · plain
“APOE is on the proximal long arm of chromosome 19, at 19q13.2 (1).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [1] 1. Mahley, R. W. (1988) Science 240, 622-628.
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- Also stated in: § MATERIALS AND METHODS · plain
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationCreutzfeld-Jakob disease amyloid deposits contain prion protein, not the beta-A4 peptide found in Alzheimer disease.
“The amyloid deposits in Creutzfeld-Jakob disease contain the prion protein, not the 3A4 peptide in Alzheimer disease (9).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [9] 9. Prusiner, S. B., Hsiao, K. K., Bredesen, D. E. & DeArmond, S. J. (1989) in Handbook of Clinical Neurology, ed.
Not checked in the free run.
Classified as probably not a substantial claim. May combine two claims.
InterpretationreasoningA function involving binding, transport, and targeting of beta-A4 or other peptides may link the diagnostic lesions and genetic susceptibility, suggesting a functional role for ApoE isoforms in Alzheimer disease pathogenesis.
“A function involving the binding, transport, and targeting of 83A4 (or other peptides) may link the diagnostic lesions and genetic susceptibility, suggesting a functional role for ApoE isoforms in the mechanism of Alzheimer disease pathogenesis.”
Quote in the paperSubstantial claim- Rests on an assumption: In vitro binding of ApoE to synthetic beta-A4 peptides reflects a biologically relevant interaction that occurs in vivo.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
InterpretationcitationIntraneuronal ApoE staining may represent neurofibrillary tangles or early neuronal degeneration.
“In addition, intraneuronal staining was observed, which may represent staining of neurofibrillary tangles (8) or early degeneration of neurons (Fig. 4 D-F).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [8] 8. Namba, Y., Tomonaga, M., Kawasaki, H., Otomo, E. & Ikeda, K. (1991) Brain Res. 541, 163-166.
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationPCR-based restriction isotyping of APOE alleles has been developed for population studies.
“PCR-based restriction isotyping ofAPOE alleles has been developed for use in population'studies (13, 14).”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [13] 13. Wenham, P. R., Price, W. H. & Blundell, G. (1991) Lancet 337, 1158-1159.
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- cites [14] 14. Hixson, J. E. & Vernier, D. T. (1990)J. LipidRes. 31, 545-548.
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Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationBrain contains large amounts of APOE mRNA, second only to liver.
“Brain contains large quantities ofAPOE mRNA, second only to the liver (5).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [5] 5. Elshourbagy, N. A., Liao, W. S., Mahley, R. W. & Taylor, J. M. (1985) Proc. Natl. Acad. Sci. USA 82, 203-207.
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Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationSeveral proteins, including ApoE, APP, alpha1-antichymotrypsin, complement factors, and immunoglobulins, are associated with beta-A4.
“Several additional proteins are asso- ciated with 13A4, including ApoE, APP, a1-antichymotrypsin, complement factors, and immunoglobulins (12).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [12] 12. Beyreuther, K. & Masters, C. L. (1991) Brain Pathol. 1, 241-251.
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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationApoE-E2 has cysteine at residue 158, while E3 has arginine.
“ApoE-E2 contains a cysteine at residue 158, whereas E3 has an arginine.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [1] 1. Mahley, R. W. (1988) Science 240, 622-628.
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Probably not a substantial claim: may not pass S3 (load-bearing).
Interpretationown dataThe association of APOE-e4 with familial Alzheimer disease is consistent with prior analyses.
“The association of the APOE-e4 allele with familial Alzheimer disease was significantly increased compared to the population controls and is consistent with prior analyses.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationAfter optic nerve crush in the central nervous system, ApoE binds to degenerating optic tracts and to retino-recipient layers of the lateral geniculate nucleus and superior colliculus.
“After crush injury to the central nervous system optic nerve, ApoE is bound to the degenerating optic tracts and to the retino-recipient layers of the lateral geniculate nucleus and the superior colliculus (7).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [7] 7. Snipes, G. J., McGuire, C. B., Norden, J. J. & Freeman, J. A. (1986) Proc. Nat!. Acad. Sci. USA 83, 1130-1134.
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Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationApoE is produced and secreted in the central nervous system by astrocytes.
“ApoE is pro- duced and secreted in the central nervous systram by astro- cytes (2-4).”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [2] 2. Ignatius, M. J., Gebicke-Harter, P. J., Skene, J. H. P., Schill- ing, J. W., Weisgraber, K. H., Mahley, R. W. & Shooter, E. M. (1986) Proc. Natl. Acad. Sci. USA 83, 1125-1129.
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- cites [3] 3. Boyles, J., Pitas, R. E., Wilson, E., Mahley, R. W. & Taylor, J. M. (1985) J. Clin. Invest. 76, 1501-1513.
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- cites [4] 4. Pitas, R. E., Boyles, J. K., Lee, S. H., Foss, D. & Mahley, R. W. (1987) Biochim. Biophys. Acta 917, 148-161.
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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationIn the peripheral nervous system, ApoE synthesis increases 250- to 350-fold within 3 weeks after sciatic nerve crush, and ApoE makes up 5% of total soluble extracellular protein.
“In the peripheral nervous system, the synthesis of ApoE increases 250-to 350-fold within 3 weeks of sciatic nerve crush, and ApoE constitutes 5% of the total soluble extracellular protein (2, 6).”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [2] 2. Ignatius, M. J., Gebicke-Harter, P. J., Skene, J. H. P., Schill- ing, J. W., Weisgraber, K. H., Mahley, R. W. & Shooter, E. M. (1986) Proc. Natl. Acad. Sci. USA 83, 1125-1129.
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- cites [6] 6. Boyles, J. K., Zoellner, C. D., Anderson, L. J., Kosik, L. M., Pitas, R. E., Weisgraber, K. H., Hui, D. Y., Mahley, R. W., Gebicke-Haerter, P. J., Ignatius, M. J. & Shooter, E. M. (1989) J. Clin. Invest. 83, 1015-1031.
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThese proteins and beta-A4 amyloid peptide are found around cerebral vessels in Alzheimer disease, producing congophilic angiopathy.
“These pro- teins, as well as the ,BA4 amyloid peptide, are also found surrounding cerebral vessels in Alzheimer disease, producing the”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [12] 12. Beyreuther, K. & Masters, C. L. (1991) Brain Pathol. 1, 241-251.
Not checked in the free run.
The paper relies on this without support.
In vitro binding of ApoE to synthetic beta-A4 peptides reflects a biologically relevant interaction that occurs in vivo.
“Using this technique, we have demonstrated high-avidity binding of ApoE in CSF to ,BA4 peptide.”
The paper relies on this without support.
The 91 unrelated CEPH grandparents used as controls are genetically comparable to the familial Alzheimer disease cases, so the allele frequency difference is not due to population stratification.
“Controls used in the study were 91 unrelated grandparents from the Centre d'Etude du Polymorphisme Humain (16).”
The paper relies on this without support.
The two early-onset families in the sample do not materially affect the association between APOE-e4 and late-onset familial Alzheimer disease.
“In 28 of the families the disease was of the late-onset type (mean age of onset >60 years of age), and in 2 of the families, early onset (mean age of onset < 60 years of age).”
The paper relies on this without support.
Localization of ApoE to Alzheimer disease lesions indicates a functional pathogenetic role rather than a secondary or incidental association.
“The ldcalization of ApoE to the defining pathological lesions of Alzheimer disease suggests a functional pathogenetic role for ApoE.”
The paper relies on this without support.
The synthetic beta-A4 peptide fragments used in the binding assay reproduce the relevant structural features of native beta-A4 in senile plaques.
“Preparation of Immobilized Peptides.fA4 peptides (Bachem) and other peptides were covalently immobilized on Immobilon AV affmity membrane (Millipore).”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Common APOE variants affect Alzheimer's disease risk: APOE4 carries high risk, APOE3 is viewed as neutral, and APOE2 is relatively protective.
“Common variants of the apolipoprotein E gene (APOE) influence the risk of Alzheimer’s disease: APOE4 is linked to high risk, APOE3 is considered to confer a neutral risk, and APOE2 is associated with relative protection.2–5”
From <i>APOE3</i> Christchurch Heterozygosity and Autosomal Dominant Alzheimer’s Disease (2024) · cites this paper as [2]
The allele-association passage reports that APOE-e4 was significantly more frequent in patients from families with Alzheimer’s disease than in controls, supporting its link to elevated risk in that setting. Table 1 also lists lower E2 frequency in patients than controls, but the paper does not establish that E2 is protective or characterize E3 as neutral. Its findings concern primarily late-onset familial Alzheimer’s disease, not Alzheimer’s disease generally. (LLM, conf=0.88)
Experimental — accuracy not yet measuredAPOE4 is the strongest genetic risk factor for Alzheimer's disease.
“APOE4 is the strongest genetic risk factor for Alzheimer’s disease (AD)1–3.”
From APOE4 impairs myelination via cholesterol dysregulation in oligodendrocytes (2022) · cites this paper as [3]
The paper reports a significant association between APOE-e4 and late-onset familial Alzheimer’s disease: its allele frequency was 0.50 in affected patients versus 0.16 in controls. It does not compare APOE4 with other genetic risk factors to establish that it is the strongest, or establish the claim for Alzheimer’s disease generally. (LLM, conf=0.87)
Experimental — accuracy not yet measuredAPOE ε4 is the strongest genetic risk factor for the most common form of late-onset Alzheimer's disease.
“Apolipoprotein E ε4 (APOE ε4) is the strongest genetic risk factor for Alzheimer’s disease (AD).”
From Haploinsufficiency of Human APOE Reduces Amyloid Deposition in a Mouse Model of Amyloid-β Amyloidosis (2011) · cites this paper as Strittmatter et al., 1993
The allele-association passage (Materials and Methods; page not supplied) reports significantly higher APOE ε4 frequency in patients from late-onset familial Alzheimer’s disease families than in controls. The paper does not establish that ε4 is the strongest genetic risk factor relative to other factors, and it says a separate report will address sporadic Alzheimer’s disease. It therefore supports an association in the studied families, not the broader claim as stated. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe APOE4 allele is a major genetic risk factor for late-onset Alzheimer's disease.
“The APOE4 allele is the strongest genetic risk factor for late-onset Alzheimer's disease (AD).”
From APOE4 impairs the microglial response in Alzheimer’s disease by inducing TGFβ-mediated checkpoints (2023) · cites this paper as [8]
The allele-association passage (labeled Materials and Methods; page not provided) reports a significantly higher APOE-e4 frequency in familial Alzheimer disease patients than in controls, supporting its importance as a genetic risk factor. The paper does not compare APOE-e4 with other genetic risk factors to establish the citing sentence’s claim that it is the strongest, and its findings concern predominantly late-onset familial disease rather than all late-onset Alzheimer’s disease. (LLM, conf=0.86)
Experimental — accuracy not yet measuredAPOE4 was previously shown to accelerate AD progression in humans and in mouse models.
“The APOE4 allele is a major genetic risk factor for late-onset AD and was previously shown to accelerate AD progression in humans and in mouse models 6-11 .”
From APOE4 impairs the microglial response in Alzheimer’s disease by inducing TGFβ-mediated checkpoints (2023) · cites this paper as [8]
The allele-association passage reports a significantly higher APOE-e4 frequency in people with familial Alzheimer disease than in controls, supporting the genetic-risk portion of the citing sentence. It does not show that APOE4 accelerates disease progression in humans or mouse models; searches for progression and mouse models found no such result. (LLM, conf=0.86)
Experimental — accuracy not yet measured
APOE4 is the largest monogenetic risk factor for Alzheimer's disease, while APOE2 is protective.
“Importantly, the APOE4 variant is the largest monogenetic risk factor for Alzheimer’s disease, while APOE2 is protective1,2.”
From Common germline variants of the human APOE gene modulate melanoma progression and survival (2020) · cites this paper as [1]
The allele-association analysis (section labeled MATERIALS AND METHODS; page not provided) finds APOE-e4 significantly more frequent in patients with late-onset familial Alzheimer disease than in controls. Table 1 shows a lower E2 frequency in those patients, but the paper does not establish that E2 is protective or compare E4 with other genetic risk factors to support calling it the largest monogenetic risk factor for Alzheimer’s disease generally. (LLM, conf=0.87)
Experimental — accuracy not yet measuredAPOE ε4 allele is the highest genetic risk factor for LOAD.
“Among these genes, apolipoprotein E ( APOE ; especially the APOE ε 4 allele) is the highest genetic risk factor for LOAD [23,24].”
From Is there a role for B cells in Alzheimer's disease? (2026) · cites this paper as [24]
The allele-association passage (section labeled Materials and Methods; page unavailable) reports that APOE ε4 was significantly more frequent in patients with late-onset familial Alzheimer disease than in controls. It does not compare APOE ε4 with other genetic risk factors or establish that it is the highest risk factor for LOAD generally; the paper says sporadic disease will be addressed in another report. (LLM, conf=0.88)
Experimental — accuracy not yet measuredAPOE4 exacerbates AD-related pathologies, including amyloid-beta plaques, Tau tangles, neurodegeneration and neuroinflammation.
“It exacerbates AD-related pathologies, including amyloid-beta (Aβ) plaques, Tau tangles, neurodegeneration and neuroinflammation4–16.”
From The APOE-R136S mutation protects against APOE4-driven tau pathology, neurodegeneration, and neuroinflammation (2023) · cites this paper as [12]
The Abstract reports that ApoE binds amyloid-beta and is present in senile plaques and neurofibrillary tangles; it also reports an association between APOE-e4 and late-onset familial Alzheimer disease. The passage labeled MATERIALS AND METHODS suggests a possible role for ApoE-E4 but does not establish that this isoform exacerbates those lesions. The cited passages do not support exacerbation of neurodegeneration or neuroinflammation. Page numbers are unavailable in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredApoE ɛ2 and ɛ3 bind to Aβ; this binding is lost in the apoE ɛ4 variant.
“ApoE ɛ2 and ɛ3 bind to Aβ; however, this is lost in the apoE ɛ4 variant [11, 12].”
From Discovery of a Missense Mutation (Q222K) of the <i>APOE</i> Gene from the Australian Imaging, Biomarker and Lifestyle Study (2023) · cites this paper as [12]
The binding results (indexed under Materials and Methods; page unavailable) show that ApoE in cerebrospinal fluid binds Aβ peptide, but they do not establish binding separately for ε2 and ε3. A later passage says differences in binding among ApoE isoforms are a possibility; it does not show that binding is lost in ε4. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe APOE4 variant is the major genetic risk factor for Alzheimer's disease at the population level.
“The APOE4 variant of apolipoprotein E was identified 30 years ago as the major genetic risk factor for Alzheimer’s Disease (AD) at the population level (Bennett et al, 2009; Corder et al, 1993; Strittmatter et al, 1993)”
From APOE from astrocytes restores Alzheimer’s Aβ-pathology and DAM-like responses in APOE deficient microglia (2024) · cites this paper as Strittmatter et al, 1993
The Abstract (p. 1977) reports a significant association between APOE-e4 and late-onset familial Alzheimer disease. It does not establish that APOE4 is the major genetic risk factor for Alzheimer’s disease at the population level; the reported comparison is between affected members of families and age-matched controls. (LLM, conf=0.88)
Experimental — accuracy not yet measuredAPOE4 significantly alters signaling pathways associated with cholesterol homeostasis and transport.
“Consistent with APOE’s biological function2–6, APOE4 significantly altered signaling pathways associated with cholesterol homeostasis and transport.”
From APOE4 impairs myelination via cholesterol dysregulation in oligodendrocytes (2022) · cites this paper as [3]
APOE exists as three polymorphic alleles (APOE2, APOE3, APOE4) which encode three protein isoforms (apoE2, apoE3, and apoE4) distinguished by single amino acid substitutions at positions 112 and 158.
“APOE exists as three polymorphic alleles (APOE2, APOE3, APOE4) which encode three protein isoforms (apoE2, apoE3, and apoE4) distinguished by single amino acid substitutions at positions 112 and 158”
From Older adult APOE4 mice exhibit modest immunometabolic adaptation following microglial APOE2 replacement (2027) · cites this paper as Strittmatter et al., 1993
APOE is the strongest genetic risk factor for LOAD.
“APOE is the strongest genetic risk factor for LOAD”
From Alzheimer Disease: An Update on Pathobiology and Treatment Strategies (2019) · cites this paper as Strittmatter et al., 1993
Variants of the apolipoprotein E allele account for most cases of late-onset Alzheimer's disease.
“Variants of the apolipoprotein E allele appear to account for most cases of late-onset Alzheimer's disease”
From Preclinical Evidence of Alzheimer's Disease in Persons Homozygous for the ε4 Allele for Apolipoprotein E (1996) · cites this paper as [1]
The e4 allele is associated with an increased risk of Alzheimer's disease.
“the e4 allele has been associated with an increased risk of Alzheimer's disease, 1-7”
From Preclinical Evidence of Alzheimer's Disease in Persons Homozygous for the ε4 Allele for Apolipoprotein E (1996) · cites this paper as [1]
Inheritance of the e4 allele of APOE is the only well-established genetic risk factor for sporadic AD.
“Inheritance of the e4 allele of APOE is the only well-established genetic risk factor for sporadic AD (147).”
From Unraveling a Multifactorial Late-Onset Disease: From Genetic Susceptibility to Disease Mechanisms for Age-Related Macular Degeneration (2009) · cites this paper as [147]
Expression of the ApoE4 allele is a major risk factor for sporadic AD.
“expression of the ApoE4 allele, a major risk factor for sporadic AD (Corder et al., 1993; Schmechel et al., 1993; Strittmatter et al., 1993), may be involved.”
From The Aβ oligomer hypothesis for synapse failure and memory loss in Alzheimer’s disease (2011) · cites this paper as Strittmatter et al., 1993
Statistics recomputed
Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.
- Consistentz = 2.44reported p = .014 · recomputed p = .015
“(Z = 2.44, p = .014”
- Consistentz = 2.44reported p = .014 · recomputed p = .015
“Z = 2.44, p = .014”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Self-check results appear here once an independent check has confirmed them.
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- Authors
- Strittmatter, W. J., Saunders, A. M., Schmechel, D., Pericak-Vance, M., Enghild, J., Salvesen, G. S., & Roses, A. D.
- Affiliations
- Duke University (US)
- Department of Medicine (Neurology), Joseph and Kathleen Bryan Alzheimer's Disease Research Center, Duke University Medical Center, Durham, NC 27710.
- Venue
- Proceedings of the National Academy of Sciences
- Publisher
- National Academy of Sciences
- Published
- 1993-03
- Volume
- 90
- Issue
- 5
- Pages
- 1977-1981
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- PMC
- PMC46003
- OpenAlex
- W2021181758
- Cited by
- 4,268
- References
- 26
- Citations by year
- 2026: 67 · 2025: 107 · 2024: 97 · 2023: 108 · 2022: 99 · 2021: 106 · 2020: 116 · 2019: 111 · 2018: 117 · 2017: 104 · 2016: 121 · 2015: 140 · 2014: 123 · 2013: 112 · 2012: 134
- FWCI
- 125.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Proceedings of the National Academy of Sciences (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r35ag007922-07)
- National Institute on Aging (5P50 AG-O5128, P50AG005128, 5R35 AG-O7922)
- 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, amyloid plaques, amyloid binding, allele frequency, genetic association, Alzheimer disease pathogenesis
- MeSH terms
- Alleles, Alzheimer Disease, Amino Acid Sequence, Animals, Apolipoproteins E, Brain, Gene Frequency, Humans, Lemur, Molecular Sequence Data, Peptides, Protein Binding, Solubility, Amyloid beta-Peptides
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