The Role of APOE4 in Disrupting the Homeostatic Functions of Astrocytes and Microglia in Aging and Alzheimer’s Disease
Open accessAbstract
APOE4 is the greatest genetic risk factor for late-onset Alzheimer's disease (AD), increasing the risk of developing the disease by 3-fold in the 14% of the population that are carriers. Despite 25 years of research, the exact mechanisms underlying how APOE4 contributes to AD pathogenesis remain incompletely defined. APOE in the brain is primarily expressed by astrocytes and microglia, cell types that are now widely appreciated to play key roles in the pathogenesis of AD; thus, a picture is emerging wherein APOE4 disrupts normal glial cell biology, intersecting with changes that occur during normal aging to ultimately cause neurodegeneration and cognitive dysfunction. This review article will summarize how APOE4 alters specific pathways in astrocytes and microglia in the context of AD and the aging brain. APOE itself, as a secreted lipoprotein without enzymatic activity, may prove challenging to directly target therapeutically in the classical sense. Therefore, a deeper understanding of the underlying pathways responsible for APOE4 toxicity is needed so that more tractable pathways and drug targets can be identified to reduce APOE4-mediated disease risk.
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ApoE is the most abundant apolipoprotein in the brain, where it is primarily expressed by astrocytes and reactive microglia, regulating cholesterol metabolism.
“ApoE is the most abundant apolipoprotein in the brain, where it is primarily expressed by astrocytes and reactive microglia7, regulating cholesterol metabolism8,9.”
From Decreased lipidated ApoE‐receptor interactions confer protection against pathogenicity of ApoE and its lipid cargoes in lysosomes (2025) · cites this paper as [7]
The Overview of APOE Isoforms (page unavailable) says APOE is predominantly expressed by astrocytes and microglia, and the section on the microglial phenotype in AD reports increased APOE expression in disease-associated microglia. The copy does not establish that APOE is the brain’s most abundant apolipoprotein. The cholesterol-metabolism clause has separate citations (8 and 9) and is not attributed to this source. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe Cys112 residue in APOE2 reduces its receptor binding capacity, congruent with increased plasma lipoproteins, leading to hyperlipidemia III.
“The Cys112 residue in APOE2 reduces its receptor binding capacity, congruent with the increased levels of lipoproteins in plasma, leading to hyperlipidemia III (Fernandez et al., 2019).”
From APOE2, E3, and E4 differentially modulate cellular homeostasis, cholesterol metabolism, and inflammatory response in isogenic iPSC-derived astrocytes (2022) · cites this paper as Fernandez et al., 2019
In “Overview of APOE Isoforms,” the paper links impaired APOE2 receptor binding to delayed lipoprotein clearance and hyperlipoproteinemia III, characterized by accumulated plasma lipoproteins. But its Figure 1 description attributes deficient receptor binding to Cys158, not Cys112; it says Cys112 is present in both APOE2 and APOE3. (LLM, conf=0.90)
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- Authors
- Fernandez, C. G., Hamby, M. E., McReynolds, M. L., & Ray, W. J.
- Affiliations
- The University of Texas MD Anderson Cancer Center (US)
- Corresponding author
- Fernandez, Celia G.
- Venue
- Frontiers in Aging Neuroscience
- Publisher
- Frontiers Media SA
- Published
- 2019-02-11
- Volume
- 11
- Pages
- 14-14
- ISSN
- 1663-4365 (ISSN-L)
- PMC
- PMC6378415
- OpenAlex
- W2911484089
- Cited by
- 277
- References
- 194
- Citations by year
- 2026: 25 · 2025: 32 · 2024: 31 · 2023: 54 · 2022: 50 · 2021: 36 · 2020: 43 · 2019: 6
- FWCI
- 3.97
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Aging Neuroscience (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Robert A. and Renee E. Belfer Family Foundation
- Topics
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- APOE ε4, Alzheimer's disease, astrocytes, microglia, brain aging, neurodegeneration, cognitive impairment, therapeutic target, genetic risk factors
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