Cited by 264Cholesterol and Lipid MetabolismLipid metabolism and disordersLipoproteins and Cardiovascular Health

The DOI matches its Crossref record; 31 of the 33 references it cites were found in a registry or an index; none of the 27 sources its claims cite is checked for support yet.

Type III hyperlipoproteinemia and spontaneous atherosclerosis in mice resulting from gene replacement of mouse Apoe with human Apoe*2.

Open access
Sullivan, P M, Mezdour, H, Quarfordt, S H, Maeda, N·1998·Journal of Clinical Investigation

Abstract

To study isoform-specific effects of apolipoprotein E (apoE) in vivo, we generated mice with a human APOE*2 allele in place of the mouse Apoe gene via targeted gene replacement in embryonic stem cells. Mice expressing human apoE2 (2/2) have virtually all the characteristics of type III hyperlipoproteinemia. Their plasma cholesterol and triglyceride levels are both twice to three times those in (normolipidemic) mice that are expressing human apoE3 (3/3) made in an identical manner. The 2/2 mice are markedly defective in clearing beta-migrating VLDL particles, and spontaneously develop atherosclerotic plaques, even on a regular diet. An atherogenic diet, high in fat and cholesterol, exacerbates development of atherosclerosis and xanthomas in the 2/2 mice. Thus, comparisons between the 2/2 and 3/3 mice unequivocally demonstrate that a single amino acid difference (Arg158 Cys) in the apoE protein is sufficient to cause type III HLP and spontaneous atherosclerosis in mice.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

Targeted replacement of the mouse Apoe gene with human APOE*2 produced mice with virtually all features of type III hyperlipoproteinemia and spontaneous atherosclerosis, whereas mice carrying human APOE*3 made identically were normolipidemic. The paper concludes that a single amino acid difference (Arg158→Cys) in apoE is sufficient to cause type III HLP and spontaneous atherosclerosis in mice.

Key findings

  • APOE*2 homozygous (2/2) mice had plasma total cholesterol and triglycerides two to three times higher than APOE*3 homozygous (3/3) mice on normal chow; e.g., females: TC 238 ± 48 vs. 75 ± 15 mg/dl and TG 184 ± 46 vs. 48 ± 13 mg/dl (P < 0.0001). HDL cholesterol did not differ, and 2/3 heterozygotes had normal lipid levels.
  • 2/2 mice showed β-VLDL accumulation: broad β-migration on agarose gels, VLDL cholesterol-to-triglyceride ratio 0.76 vs. 0.03 in 3/3 mice, and ~65% of total cholesterol in VLDL-IDL fractions vs. >85% in HDL for 3/3 mice. Plasma apoE2 was 16-fold higher than apoE3 in 3/3 mice.
  • Clearance of radiolabeled apoE-deficient remnant particles was severely delayed in 2/2 mice: fractional catabolic rate 0.007/min vs. 0.02/min in 3/3 mice, with ~50% of label remaining at 2 h in 2/2 and apoE−/− mice.
  • 2/2 mice spontaneously developed atherosclerosis on regular chow: all seven 10-month-old females evaluated had plaques near the aortic root, average size 9.4 × 10^4 (as reported; text labels area units m²), vs. smaller plaques in 4 of 11 3/3 females, average 1 × 10^3. An atherogenic diet enhanced plaque size in 2/2 females to 5.3 × 10^5, eight times larger than 3/3 females (6.4 × 10^4), and caused xanthomas.

Methods

  • Gene replacement in mouse embryonic stem cells replaced the mouse Apoe gene with human APOE*2, using the same strategy previously used for APOE*3; mice were 129/C57BL/6 F2 hybrids, with 2/3 heterozygotes from F3 matings.
  • Mice were fed regular chow, an atherogenic diet (15.8% fat, 1.25% cholesterol, 0.5% sodium cholate), or a western-style diet (21% fat, 0.2% cholesterol). Plasma lipids, lipoproteins, apoE, and apoB were analyzed by enzymatic assays, agarose gel electrophoresis, FPLC, SDS-PAGE, and ELISA.
  • Remnant clearance was measured after injection of 14C-labeled β-VLDL from apoE−/− mice into 2/2, 3/3, and apoE−/− mice; atherosclerosis was assessed histologically in proximal aorta/aortic sinus sections. Statistical comparisons used two-tailed unpaired Student t tests or Mann-Whitney U tests.

Limitations

  • The paper has no explicit limitations section. It states that one of four 2/2 mice did not respond to clofibrate and the reason is unknown, possibly related to its F2 genetic background.
  • The authors state that mechanisms for different triglyceride and HDL responses to the western vs. atherogenic diets are unknown, though they attribute the differences most likely to diets rather than sex.
  • Evident from the text: the model may overstate human relevance because mice synthesize ~70% of liver-derived VLDL as apoB48 particles and depend more on apoE for VLDL remnant clearance than humans, so the apoE2 vs. apoE3 difference has a larger impact in mice than in most humans.

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

Integrity signals

Registry

Crossref · 10.1172/jci2673

Cites

31 of 31 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

0 of 27 cited sources checked · 0 supported · 0 flagged

Show all 44 claims

  • The quote only partly states this claim. 3
  • It may state two separate claims as one. 27
  • Probably not a substantial claim. 10
37 of 37
  • The paper relies on this without support.

    The primary molecular cause of type III HLP is a dysfunctional form of apolipoprotein E.

    “The primary molecular cause of the disease is the presence of a dysfunctional form of apolipoprotein (apo) E, a critical ligand needed for plasma lipoprotein clearance.”
  • The paper relies on this without support.

    The majority of type III HLP individuals are homozygous for the apoE2 isoform.

    “The majority of type III HLP individuals are homozygous for the apoE2 isoform, although in rare instances dominant apoE mutations are associated with the disease.”
  • The paper relies on this without support.

    ApoE2 differs from apoE3 by a single amino acid substitution, cysteine at position 158 in place of arginine.

    “ApoE2 differs from the most common isoform, apoE3, by only a single amino acid substitution, cysteine at position 158 in place of arginine.”
  • The paper relies on this without support.

    Type III HLP is characterized by accumulation of chylomicron and VLDL remnants (beta-VLDL), resulting in elevated plasma TC and TG.

    “Type III hyperlipoproteinemia (HLP) 1 is characterized by accumulation of chylomicron and VLDL remnants, collectively termed ␤ -VLDL, which results in elevated plasma levels of total cholesterol (TC) and triglycerides (TG).”
4 of 4

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?

Citations

Cites

Flagged first, then by citations

Show all 33 references

2 of the 33 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Metadata

Authors
Sullivan, P. M., Mezdour, H., Quarfordt, S. H., & Maeda, N.
Affiliations
  • University of North Carolina at Chapel Hill (US)
  • Duke University (US)
Venue
Journal of Clinical Investigation
Published
1998-07-01
Volume
102
Issue
1
Pages
130-135
ISSN
0021-9738 (ISSN-L)
OpenAlex
W2009182898
Cited by
264
References
33
Citations by year
2026: 4 · 2025: 8 · 2024: 10 · 2023: 19 · 2022: 15 · 2021: 9 · 2020: 10 · 2019: 7 · 2018: 3 · 2017: 6 · 2016: 6 · 2015: 9 · 2014: 16 · 2013: 11 · 2012: 14
FWCI
2.72
Type
journal article
Language
en
Open access
Locations
  • Journal of Clinical Investigation (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
  • UNC Libraries
Funders
  • National Institutes of Health
  • National Heart, Lung, and Blood Institute (HL 42630)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Cholesterol and Lipid Metabolism
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
Keywords
type III hyperlipoproteinemia, apolipoprotein E isoforms, spontaneous atherosclerosis, xanthoma, VLDL clearance, serum cholesterol, plasma triglycerides, atherogenic diet
MeSH terms
Animals, Apolipoproteins E, Arteriosclerosis, Cholesterol, Clofibrate, Dietary Fats, Female, Humans, Hyperlipoproteinemia Type III, Lipoproteins, VLDL, Male, Triglycerides, Gene Targeting, Mice

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.

A language model drew the claims from the paper on 2026-10-11, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).

A second model labelled each claim on 2026-10-11 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review