Effects of a Frequent Apolipoprotein E Isoform, ApoE4 Freiburg (Leu28→Pro), on Lipoproteins and the Prevalence of Coronary Artery Disease in Whites
Abstract
Abstract —Different isoforms of apoE modulate the concentrations of plasma lipoproteins and the risk for atherosclerosis. A novel apoE isoform, apoE4 Freiburg , was detected in plasma by isoelectric focusing because its isoelectric point is slightly more acidic than that of apoE4. ApoE4 Freiburg results from a base exchange in the APOE4 gene that causes the replacement of a leucine by a proline at position 28. Analysis of the allelic frequencies in whites in southwestern Germany revealed that this isoform is frequent among control subjects (10:4264 alleles) and is even more frequent in patients with coronary artery disease (21:2874 alleles; P =0.004; adjusted odds ratio, 3.09; 95% confidence interval, 1.20 to 7.97). ApoE4 Freiburg affects serum lipoproteins by lowering cholesterol, apoB, and apoA-I compared with apoE4 ( P <0.05). Our 4 apoE4 Freiburg homozygotes suffered from various phenotypes of hyperlipoproteinemia (types IIa, IIb, IV, and V). In vitro binding studies excluded a binding defect of apoE4 Freiburg , and in vivo studies excluded an abnormal accumulation of chylomicron remnants. ApoE4 Freiburg and apoE4 accumulated to a similar extent in triglyceride-rich lipoproteins. HDLs, however, contained about 40% less apoE4 Freiburg than apoE4. In conclusion, our data indicate that apoE4 Freiburg exerts its possible atherogenic properties by affecting the metabolism of triglyceride-rich lipoproteins and HDL.
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Three carriers of p.Leu46Pro had the ε4ε4 genotype, forming the Apoε4-Freiberg genotype.
“In addition, three carriers of p.Leu46Pro had the ε4ε4 (homozygous for the common p.Cys130Arg variant), forming the Apoε4-Freiberg [37] (Table A2).”
From Spectrum and Prevalence of Rare APOE Variants and Their Association with Familial Dysbetalipoproteinemia (2024) · cites this paper as [37]
APOE4 Freiburg/Pittsburgh (Leu28Pro, Cys112Arg) heterozygotes tended to have higher triglyceride levels.
“APOE4 Freiburg/Pittsburgh (Leu28Pro, Cys112Arg) heterozygotes tended to have higher triglyceride levels.”
From Impact of Apolipoprotein E Variants: A Review of Naturally Occurring Variants and Clinical Features (2025) · cites this paper as [108]
APOE4 Freiburg/Pittsburgh (Leu28Pro, Cys112Arg) was found in the same year in a screening focused on hyperlipidemia and in a screening for AD.
“APOE4 Freiburg/Pittsburgh (Leu28Pro, Cys112Arg) was found in the same year in a screening focused on hyperlipidemia and in a screening for AD108, 109).”
From Impact of Apolipoprotein E Variants: A Review of Naturally Occurring Variants and Clinical Features (2025) · cites this paper as [108]
Four APOE4 Freiburg/Pittsburgh (Leu28Pro, Cys112Arg) homozygotes were reported to have various types of hyperlipoproteinemia (types IIa, IIb, IV, V), including two hypertriglyceridemic patients with coronary artery disease.
“Four APOE4 Freiburg/Pittsburgh (Leu28Pro, Cys112Arg) homozygotes were reported to have various types of hyperlipoproteinemia (types IIa, IIb, IV, V), including two hypertriglyceridemic patients with coronary artery disease108).”
From Impact of Apolipoprotein E Variants: A Review of Naturally Occurring Variants and Clinical Features (2025) · cites this paper as [108]
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- Authors
- Orth, M., Weng, W., Funke, H., Steinmetz, A., Assmann, G., Nauck, M., Dierkes, J., Ambrosch, A., Weisgraber, K. H., Mahley, R. W., Wieland, H., & Luley, C.
- Affiliations
- University of Freiburg (DE)
- Venue
- Arteriosclerosis, Thrombosis, and Vascular Biology
- Published
- 1999-05
- Volume
- 19
- Issue
- 5
- Pages
- 1306-1315
- ISSN
- 1079-5642 (ISSN-L)
- 1524-4636
- OpenAlex
- W2026860413
- Semantic Scholar
- 1457504114e3d9ae0d10b0a4d30b3ce99ad68544
- Cited by
- 42
- References
- 61
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 2 · 2022: 5 · 2020: 3 · 2018: 1 · 2017: 1 · 2016: 1 · 2015: 1 · 2013: 2 · 2012: 1
- FWCI
- 2.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Arteriosclerosis Thrombosis and Vascular Biology (publishedVersion)
- PubMed (publishedVersion)
- FreiDok plus (Universitätsbibliothek Freiburg) (submittedVersion)
- Funders
- Deutsche Forschungsgemeinschaft (79 1-1)
- National Institutes of Health
- National Heart, Lung, and Blood Institute (HL-41633, P01HL041633)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
- Keywords
- apolipoprotein E isoforms, coronary artery disease, hyperlipoproteinemia, triglyceride-rich lipoproteins, HDL cholesterol, apolipoprotein B, apolipoprotein A-I, serum cholesterol, atherosclerosis risk, genetic polymorphism, white
- MeSH terms
- Adult, Aged, Alleles, Apolipoproteins, Apolipoproteins E, Blood Protein Electrophoresis, Chylomicrons, Coronary Disease, Eating, Female, Gene Frequency, Genotype, Germany, Humans, Hyperlipoproteinemias, Isoelectric Focusing, Lipids, Lipoproteins, Lipoproteins, HDL, Male, Middle Aged, Myocardial Infarction, Phenotype, Receptors, LDL, Polymorphism, Restriction Fragment Length, Risk Factors, Triglycerides, Comorbidity, Prevalence, Odds Ratio, Amino Acid Substitution, Protein Isoforms, White People, Apolipoprotein E4
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