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McMaster MW, Shah A, Kangarlu J, Cheikhali R, Frishman WH, Aronow WS. The Impact of the Apolipoprotein E Genotype on Cardiovascular Disease and Cognitive Disorders. Cardiol Rev 2024:00045415-990000000-00250. [PMID: 38661359 DOI: 10.1097/crd.0000000000000703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Apolipoprotein E (ApoE) plays a critical role in cholesterol transport and protection against the development of atherosclerotic cardiovascular disease (ASCVD). Humans have 3 prevalent isoforms of ApoE: apolipoprotein E2 (ApoE2), apolipoprotein E3 (ApoE3), and apolipoprotein E4 (ApoE4). The E4 allele has been associated with higher ASCVD risk. While E4 patients do have higher cholesterol levels, they do not have enough to account for the substantially elevated ASCVD risk relative to E2 and E3 patients. ASCVD risk calculators would underestimate the true effect of E4 if the difference was caused entirely by a difference in cholesterol level. This article reviews the function of ApoE in atherosclerosis, and how each isoform functions differently. We review what is known about the molecular mechanisms through which ApoE prevents endothelial dysfunction and damage, how ApoE stimulates macrophage efflux of cholesterol from atherogenic lesions, and the ways in which ApoE decreases inflammation throughout atherosclerosis. The impact of ApoE on Alzheimer's disease and a discussion of why it is possibly unrelated to ASCVD prevention are included. Clinical applications to hyperlipidemia management and ASCVD prevention in specific patient populations are discussed.
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Affiliation(s)
- Matthew W McMaster
- From the Department of Medicine, Westchester Medical Center, Valhalla, NY
| | - Avisha Shah
- From the Department of Medicine, Westchester Medical Center, Valhalla, NY
- Department of Cardiology, New York Medical College, Valhalla, NY
| | - John Kangarlu
- From the Department of Medicine, Westchester Medical Center, Valhalla, NY
| | - Ryan Cheikhali
- From the Department of Medicine, Westchester Medical Center, Valhalla, NY
| | - William H Frishman
- From the Department of Medicine, Westchester Medical Center, Valhalla, NY
| | - Wilbert S Aronow
- From the Department of Medicine, Westchester Medical Center, Valhalla, NY
- Department of Cardiology, New York Medical College, Valhalla, NY
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Phu TA, Vu NK, Ng M, Gao AS, Stoolman JS, Chandel NS, Raffai RL. ApoE enhances mitochondrial metabolism via microRNA-142a/146a-regulated circuits that suppress hematopoiesis and inflammation in hyperlipidemia. Cell Rep 2023; 42:113206. [PMID: 37824329 DOI: 10.1016/j.celrep.2023.113206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/08/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023] Open
Abstract
Apolipoprotein E (ApoE) is recognized for its pleiotropic properties that suppress inflammation. We report that ApoE serves as a metabolic rheostat that regulates microRNA control of glycolytic and mitochondrial activity in myeloid cells and hematopoietic stem and progenitor cells (HSPCs). ApoE expression in myeloid cells increases microRNA-146a, which reduces nuclear factor κB (NF-κB)-driven GLUT1 expression and glycolytic activity. In contrast, ApoE expression reduces microRNA-142a, which increases carnitine palmitoyltransferase 1a (CPT1A) expression, fatty acid oxidation, and oxidative phosphorylation. Improved mitochondrial metabolism by ApoE expression causes an enrichment of tricarboxylic acid (TCA) cycle metabolites and nicotinamide adenine dinucleotide (NAD+) in macrophages. The study of mice with conditional ApoE expression supports the capacity of ApoE to foster microRNA-controlled immunometabolism. Modulation of microRNA-146a and -142a in the hematopoietic system of hyperlipidemic mice using RNA mimics and antagonists, respectively, improves mitochondrial metabolism, which suppresses inflammation and hematopoiesis. Our findings unveil microRNA regulatory circuits, controlled by ApoE, that exert metabolic control over hematopoiesis and inflammation in hyperlipidemia.
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Affiliation(s)
- Tuan Anh Phu
- Department of Veterans Affairs, Surgical Service (112G), San Francisco VA Medical Center, San Francisco, CA 94121, USA; Northern California Institute for Research and Education, San Francisco, CA 94121, USA
| | - Ngan K Vu
- Department of Veterans Affairs, Surgical Service (112G), San Francisco VA Medical Center, San Francisco, CA 94121, USA; Northern California Institute for Research and Education, San Francisco, CA 94121, USA
| | - Martin Ng
- Department of Veterans Affairs, Surgical Service (112G), San Francisco VA Medical Center, San Francisco, CA 94121, USA; Northern California Institute for Research and Education, San Francisco, CA 94121, USA
| | - Alex S Gao
- Department of Veterans Affairs, Surgical Service (112G), San Francisco VA Medical Center, San Francisco, CA 94121, USA; Northern California Institute for Research and Education, San Francisco, CA 94121, USA
| | - Joshua S Stoolman
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Navdeep S Chandel
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; Department of Biochemistry & Molecular Genetics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Robert L Raffai
- Department of Veterans Affairs, Surgical Service (112G), San Francisco VA Medical Center, San Francisco, CA 94121, USA; Northern California Institute for Research and Education, San Francisco, CA 94121, USA; Department of Surgery, Division of Endovascular and Vascular Surgery, University of California, San Francisco, San Francisco, CA 94143, USA.
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Phu TA, Ng M, Vu NK, Gao AS, Raffai RL. ApoE expression in macrophages communicates immunometabolic signaling that controls hyperlipidemia-driven hematopoiesis & inflammation via extracellular vesicles. J Extracell Vesicles 2023; 12:e12345. [PMID: 37593979 PMCID: PMC10436255 DOI: 10.1002/jev2.12345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 08/19/2023] Open
Abstract
While apolipoprotein E (apoE) expression by myeloid cells is recognized to control inflammation, whether such benefits can be communicated via extracellular vesicles is not known. Through the study of extracellular vesicles produced by macrophages derived from the bone marrow of Wildtype (WT-BMDM-EV) and ApoE deficient (EKO-BMDM-EV) mice, we uncovered a critical role for apoE expression in regulating their cell signaling properties. WT-BMDM-EV communicated anti-inflammatory properties to recipient myeloid cells by increasing cellular levels of apoE and miR-146a-5p, that reduced NF-κB signalling. They also downregulated cellular levels of miR-142a-3p, resulting in increased levels of its target carnitine palmitoyl transferase 1A (CPT1A) which improved fatty acid oxidation (FAO) and oxidative phosphorylation (OxPHOS) in recipient cells. Such favorable metabolic polarization enhanced cell-surface MerTK levels and the phagocytic uptake of apoptotic cells. In contrast, EKO-BMDM-EV exerted opposite effects by reducing cellular levels of apoE and miR-146a-5p, which increased NF-κB-driven GLUT1-mediated glucose uptake, aerobic glycolysis, and oxidative stress. Furthermore, EKO-BMDM-EV increased cellular miR-142a-3p levels, which reduced CPT1A levels and impaired FAO and OxPHOS in recipient myeloid cells. When cultured with naïve CD4+ T lymphocytes, EKO-BMDM-EV drove their activation and proliferation, and fostered their transition to a Th1 phenotype. While infusions of WT-BMDM-EV into hyperlipidemic mice resolved inflammation, infusions of EKO-BMDM-EV increased hematopoiesis and drove inflammatory responses in myeloid cells and T lymphocytes. ApoE-dependent immunometabolic signaling by macrophage extracellular vesicles was dependent on transcriptional axes controlled by miR-146a-5p and miR-142a-3p that could be reproduced by infusing miR-146a mimics & miR-142a antagonists into hyperlipidemic apoE-deficient mice. Together, our findings unveil a novel property for apoE expression in macrophages that modulates the immunometabolic regulatory properties of their secreted extracellular vesicles.
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Affiliation(s)
- Tuan Anh Phu
- Department of Veterans AffairsSurgical Service (112G)San Francisco VA Medical CenterSan FranciscoCaliforniaUSA
- Northern California Institute for Research and EducationSan FranciscoCaliforniaUSA
| | - Martin Ng
- Department of Veterans AffairsSurgical Service (112G)San Francisco VA Medical CenterSan FranciscoCaliforniaUSA
- Northern California Institute for Research and EducationSan FranciscoCaliforniaUSA
| | - Ngan K. Vu
- Department of Veterans AffairsSurgical Service (112G)San Francisco VA Medical CenterSan FranciscoCaliforniaUSA
- Northern California Institute for Research and EducationSan FranciscoCaliforniaUSA
| | - Alex S. Gao
- Department of Veterans AffairsSurgical Service (112G)San Francisco VA Medical CenterSan FranciscoCaliforniaUSA
- Northern California Institute for Research and EducationSan FranciscoCaliforniaUSA
| | - Robert L. Raffai
- Department of Veterans AffairsSurgical Service (112G)San Francisco VA Medical CenterSan FranciscoCaliforniaUSA
- Northern California Institute for Research and EducationSan FranciscoCaliforniaUSA
- Department of SurgeryDivision of Endovascular and Vascular SurgeryUniversity of CaliforniaSan FranciscoCaliforniaUSA
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Vipin A, Kumar D, Soo SA, Zailan FZ, Leow YJ, Koh CL, Ng ASL, Ng KP, Kandiah N. APOE4 carrier status determines association between white matter disease and grey matter atrophy in early-stage dementia. Alzheimers Res Ther 2023; 15:103. [PMID: 37270543 DOI: 10.1186/s13195-023-01251-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 05/29/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND White matter hyperintensities, a neuroimaging marker of small-vessel cerebrovascular disease and apolipoprotein ε4 (APOE4) allele, are important dementia risk factors. However, APOE4 as a key effect modifier in the relationship between white matter hyperintensities and grey matter volume needs further exploration. METHODS One hundred ninety-two early-stage dementia (including mild cognitive impairment and mild dementia) and 259 cognitively unimpaired participants from a neurocognitive research cohort with neuroimaging data, APOE genotyping, and neuropsychological assessments were studied. We investigated independent and interactive effects of white matter hyperintensities and APOE4 on whole-brain voxel-wise grey matter volume using voxel-based morphometry (uncorrected p < 0.001; minimum cluster size = 100 voxels). We further assessed interactive effects between APOE4 and white matter hyperintensities on global cognition, memory, and executive function in early-stage dementia and cognitively unimpaired participants. RESULTS Independent of APOE4 status, higher white matter hyperintensity load was associated with greater grey matter atrophy across frontal, parietal, temporal, and occipital lobes in cognitively unimpaired and early-stage dementia subjects. However, interaction analyses and independent sample analyses revealed that APOE4 non-carriers demonstrated greater white matter hyperintensity-associated grey matter atrophy compared to APOE4 carriers in both cognitively unimpaired and early-stage dementia groups. Additional confirmatory analyses among APOE4 non-carriers demonstrated that white matter hyperintensities resulted in widespread grey matter loss. Analyses of cognitive function demonstrated that higher white matter hyperintensity load was associated with worse global (Mini-Mental State Examination, Montreal Cognitive Assessment) and executive function (Color Trails 2) in APOE4 non-carriers compared to APOE4 carriers in early-stage dementia but not cognitively unimpaired participants. CONCLUSIONS The association between white matter hyperintensities and grey matter loss is more pronounced in APOE4 non-carriers than APOE4 carriers in the cognitively unimpaired and early-stage dementia stages. Furthermore, white matter hyperintensity presence results in poorer executive function in APOE4 non-carriers compared to APOE4 carriers. This finding may have significant impact on the design of clinical trials with disease modifying therapies.
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Grants
- MOE AcRF Tier 3 Award MOE2017-T3-1-002 Ministry of Education - Singapore
- MOE AcRF Tier 3 Award MOE2017-T3-1-002 Ministry of Education - Singapore
- MOE AcRF Tier 3 Award MOE2017-T3-1-002 Ministry of Education - Singapore
- MOE AcRF Tier 3 Award MOE2017-T3-1-002 Ministry of Education - Singapore
- MOE AcRF Tier 3 Award MOE2017-T3-1-002 Ministry of Education - Singapore
- MOE AcRF Tier 3 Award MOE2017-T3-1-002 Ministry of Education - Singapore
- NMRC/CIRG/1415/2015, NMRC/CSA/063/2014, MOH-CSAINV18nov-0007, NMRC/CIRG/14MAY025 National Medical Research Council
- NMRC/CIRG/1415/2015, NMRC/CSA/063/2014, MOH-CSAINV18nov-0007, NMRC/CIRG/14MAY025 National Medical Research Council
- NMRC/CIRG/1415/2015, NMRC/CSA/063/2014, MOH-CSAINV18nov-0007, NMRC/CIRG/14MAY025 National Medical Research Council
- NMRC/CIRG/1415/2015, NMRC/CSA/063/2014, MOH-CSAINV18nov-0007, NMRC/CIRG/14MAY025 National Medical Research Council
- NMRC/CIRG/1415/2015, NMRC/CSA/063/2014, MOH-CSAINV18nov-0007, NMRC/CIRG/14MAY025 National Medical Research Council
- NMRC/CIRG/1415/2015, NMRC/CSA/063/2014, MOH-CSAINV18nov-0007, NMRC/CIRG/14MAY025 National Medical Research Council
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
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Affiliation(s)
- Ashwati Vipin
- Dementia Research Centre - Lee Kong Chian School of Medicine, Nanyang Technology University, 11 Mandalay Road, Singapore, 308232, Singapore
- National Neuroscience Institute, Singapore, Singapore
| | - Dilip Kumar
- Dementia Research Centre - Lee Kong Chian School of Medicine, Nanyang Technology University, 11 Mandalay Road, Singapore, 308232, Singapore
- National Neuroscience Institute, Singapore, Singapore
| | - See Ann Soo
- Dementia Research Centre - Lee Kong Chian School of Medicine, Nanyang Technology University, 11 Mandalay Road, Singapore, 308232, Singapore
- National Neuroscience Institute, Singapore, Singapore
| | - Fatin Zahra Zailan
- Dementia Research Centre - Lee Kong Chian School of Medicine, Nanyang Technology University, 11 Mandalay Road, Singapore, 308232, Singapore
- National Neuroscience Institute, Singapore, Singapore
| | - Yi Jin Leow
- Dementia Research Centre - Lee Kong Chian School of Medicine, Nanyang Technology University, 11 Mandalay Road, Singapore, 308232, Singapore
- National Neuroscience Institute, Singapore, Singapore
| | - Chen Ling Koh
- National Neuroscience Institute, Singapore, Singapore
| | - Adeline Su Lyn Ng
- National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Kok Pin Ng
- Dementia Research Centre - Lee Kong Chian School of Medicine, Nanyang Technology University, 11 Mandalay Road, Singapore, 308232, Singapore
- National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Nagaendran Kandiah
- Dementia Research Centre - Lee Kong Chian School of Medicine, Nanyang Technology University, 11 Mandalay Road, Singapore, 308232, Singapore.
- National Neuroscience Institute, Singapore, Singapore.
- Duke-NUS Medical School, Singapore, Singapore.
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Sung JH, Ou Y, Barger SW. Amyloid β-Peptide Effects on Glucose Regulation Are Dependent on Apolipoprotein E Genotype. eNeuro 2023; 10:ENEURO.0376-22.2023. [PMID: 37163733 PMCID: PMC10135078 DOI: 10.1523/eneuro.0376-22.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 01/26/2023] [Accepted: 02/14/2023] [Indexed: 05/12/2023] Open
Abstract
The apolipoprotein E gene (APOE) confers the greatest genetic risk factor for Alzheimer's disease (AD), wherein the ε4 allele confers an elevated risk compared with the ε3 allele. Biological mechanisms that differ across these alleles have been explored in mouse models wherein the murine Apoe gene has undergone targeted replacement with sequences encoding human ApoE3 or ApoE4 (ApoE-TR mice). Such models have indicated that the two variants of ApoE produce differential effects on energy metabolism, including metabolic syndrome. However, glucose regulation has not been compared in ApoE-TR mice with and without amyloid β-peptide (Aβ) accumulation. We crossed ApoE3-TR and ApoE4-TR mice with a transgenic line that accumulates human Aβ1-42 In male ApoE3-TR mice, introduction of Aβ caused aberrations in glucose tolerance and in membrane translocation of astrocytic glucose transporter 1 (GLUT1). Phosphorylation of Tau at AD-relevant sites was correlated with glucose intolerance. These effects appeared independent of insulin dysregulation and were not observed in females. In ApoE4-TR mice, the addition of Aβ had no significant effects because of a trend toward perturbation of the baseline values.
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Affiliation(s)
- Jin Hee Sung
- Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72205
| | - Yang Ou
- Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72205
| | - Steven W Barger
- Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72205
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, AR 72205
- Geriatric Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, Little Rock, AR 72205
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Martín-Montes A, Recuero M, Sastre I, Vilella E, Rosich-Estragó M, Atienza M, Cantero JL, Frank-García A, Bullido MJ. Cholesterol dysregulation in peripheral blood mononuclear cells of Alzheimer's disease. J Neuroimmunol 2022; 373:577996. [PMID: 36334319 DOI: 10.1016/j.jneuroim.2022.577996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/14/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
Cholesterol and the immune system are involved in Alzheimer's Disease (AD). To investigate the relations among them, we compared the cholesterol content in peripheral blood mononuclear cells (PBMC) of cognitively healthy controls and patients with mild cognitive impairment (MCI) and AD in two independent samples. Free cholesterol content of PBMC was lower in MCI and AD patients, and was modulated by APOE genotype. A decrease of CD8+ and an increase of CD16+ was also found in AD patients. These results suggest that cholesterol levels in PBMCs may represent an early signature of the disease and support the involvement of immune system in AD.
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Affiliation(s)
- A Martín-Montes
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz, IdiPAZ (Hospital Universitario La Paz - Universidad Autónoma de Madrid), Madrid, Spain; CIBERNED, Center for Networked Biomedical Research on Neurodegenerative Diseases, Carlos III Institute of Health, Madrid, Spain.
| | - M Recuero
- Centro de Biologia Molecular "Severo Ochoa" (C.S.I.C.-U.A.M.), Universidad Autonoma de Madrid, Madrid, Spain; CIBERNED, Center for Networked Biomedical Research on Neurodegenerative Diseases, Carlos III Institute of Health, Madrid, Spain
| | - I Sastre
- Centro de Biologia Molecular "Severo Ochoa" (C.S.I.C.-U.A.M.), Universidad Autonoma de Madrid, Madrid, Spain; CIBERNED, Center for Networked Biomedical Research on Neurodegenerative Diseases, Carlos III Institute of Health, Madrid, Spain
| | - E Vilella
- Hospital Universitari Institut Pere Mata, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili-CERCA, Reus, Spain; Universitat Rovira i Virgili, Reus, Spain; Centro de investigación biomédica en red en salud mental, CIBERSAM-Instituto de Salud Carlos III, Madrid, Spain
| | - M Rosich-Estragó
- Hospital Universitari Institut Pere Mata, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili-CERCA, Reus, Spain; Universitat Rovira i Virgili, Reus, Spain; Centro de investigación biomédica en red en salud mental, CIBERSAM-Instituto de Salud Carlos III, Madrid, Spain
| | - M Atienza
- CIBERNED, Center for Networked Biomedical Research on Neurodegenerative Diseases, Carlos III Institute of Health, Madrid, Spain; Laboratory of Functional Neuroscience, Pablo de Olavide University, Seville, Spain
| | - J L Cantero
- CIBERNED, Center for Networked Biomedical Research on Neurodegenerative Diseases, Carlos III Institute of Health, Madrid, Spain; Laboratory of Functional Neuroscience, Pablo de Olavide University, Seville, Spain
| | - A Frank-García
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz, IdiPAZ (Hospital Universitario La Paz - Universidad Autónoma de Madrid), Madrid, Spain; CIBERNED, Center for Networked Biomedical Research on Neurodegenerative Diseases, Carlos III Institute of Health, Madrid, Spain
| | - M J Bullido
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz, IdiPAZ (Hospital Universitario La Paz - Universidad Autónoma de Madrid), Madrid, Spain; Centro de Biologia Molecular "Severo Ochoa" (C.S.I.C.-U.A.M.), Universidad Autonoma de Madrid, Madrid, Spain; CIBERNED, Center for Networked Biomedical Research on Neurodegenerative Diseases, Carlos III Institute of Health, Madrid, Spain.
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Apolipoprotein E in Cardiometabolic and Neurological Health and Diseases. Int J Mol Sci 2022; 23:ijms23179892. [PMID: 36077289 PMCID: PMC9456500 DOI: 10.3390/ijms23179892] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/25/2022] [Accepted: 08/28/2022] [Indexed: 11/17/2022] Open
Abstract
A preponderance of evidence obtained from genetically modified mice and human population studies reveals the association of apolipoprotein E (apoE) deficiency and polymorphisms with pathogenesis of numerous chronic diseases, including atherosclerosis, obesity/diabetes, and Alzheimer’s disease. The human APOE gene is polymorphic with three major alleles, ε2, ε3 and ε4, encoding apoE2, apoE3, and apoE4, respectively. The APOE gene is expressed in many cell types, including hepatocytes, adipocytes, immune cells of the myeloid lineage, vascular smooth muscle cells, and in the brain. ApoE is present in subclasses of plasma lipoproteins, and it mediates the clearance of atherogenic lipoproteins from plasma circulation via its interaction with LDL receptor family proteins and heparan sulfate proteoglycans. Extracellular apoE also interacts with cell surface receptors and confers signaling events for cell regulation, while apoE expressed endogenously in various cell types regulates cell functions via autocrine and paracrine mechanisms. This review article focuses on lipoprotein transport-dependent and -independent mechanisms by which apoE deficiency or polymorphisms contribute to cardiovascular disease, metabolic disease, and neurological disorders.
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Zanella I, Zacchi E, Fornari C, Fumarola B, Antoni MD, Zizioli D, Quiros-Roldan E. An exploratory pilot study on the involvement of APOE, HFE, C9ORF72 variants and comorbidities in neurocognitive and physical performance in a group of HIV-infected people. Metab Brain Dis 2022; 37:1569-1583. [PMID: 35353274 PMCID: PMC8964929 DOI: 10.1007/s11011-022-00975-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/24/2022] [Indexed: 11/18/2022]
Abstract
Cognitive decline of aging is modulated by chronic inflammation and comorbidities. In people with HIV-infection (PWH) it may also be affected by HIV-induced inflammation, lifestyle and long-term effects of antiretroviral therapies (ART). The role of genetics in the susceptibility to HIV-associated neurocognitive disorders (HAND) is not fully understood. Here we explored the possible relations among variants in 3 genes involved in inflammation and neurodegenerative disorders (APOE: ε2/ε3/ε4; HFE: H63D; C9ORF72: hexanucleotide expansions ≥ 9 repeats), cognitive/functional impairment (MiniMental State Examination MMSE, Clock Drawing Test CDT, Short Physical Performance Battery SPPB), comorbidities and HIV-related variables in a cohort of > 50 years old PWH (n = 60) with at least 10 years efficient ART. Patients with diabetes or hypertension showed significantly lower MMSE (p = .031) or SPPB (p = .010) scores, respectively, while no relations between HIV-related variables and cognitive/functional scores were observed. Patients with at least one APOEε3 allele had higher CDT scores (p = .019), APOEε2/ε4 patients showing the lowest scores in all tests. Patients with HFE-H63D variant showed more frequently hypertriglyceridemia (p = .023) and those harboring C9ORF72 expansions > 9 repeats had higher CD4+-cell counts (p = .032) and CD4% (p = .041). Multiple linear regression analysis computed to verify possible associations among cognitive/functional scores and all variables further suggested positive association between higher CDT scores and the presence of at least one APOEε3 allele (2,2; 95% CI [0,03 0,8]; p = .037), independent of other variables, although the model did not reach the statistical significance (p = .14). These data suggest that in PWH on efficient ART cognitive abilities and physical performances may be partly associated with comorbidities and genetic background. However, further analyses are needed to establish whether they could be also dependent and influenced by comorbidities and genetic background.
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Affiliation(s)
- Isabella Zanella
- Department of Molecular and Translational Medicine, University of Brescia, 25123, Brescia, Italy.
- Clinical Chemistry Laboratory, Cytogenetics and Molecular Genetics Section, Diagnostic Department, ASST Spedali Civili Di Brescia, 25123, Brescia, Italy.
| | - Eliana Zacchi
- Department of Clinical and Experimental Sciences, University of Brescia, 25123, Brescia, Italy
- Division of Infectious and Tropical Diseases, ASST Spedali Civili Di Brescia, 25123, Brescia, Italy
| | - Chiara Fornari
- Department of Clinical and Experimental Sciences, University of Brescia, 25123, Brescia, Italy
- Division of Infectious and Tropical Diseases, ASST Spedali Civili Di Brescia, 25123, Brescia, Italy
| | - Benedetta Fumarola
- Department of Clinical and Experimental Sciences, University of Brescia, 25123, Brescia, Italy
- Division of Infectious and Tropical Diseases, ASST Spedali Civili Di Brescia, 25123, Brescia, Italy
| | - Melania Degli Antoni
- Department of Clinical and Experimental Sciences, University of Brescia, 25123, Brescia, Italy
- Division of Infectious and Tropical Diseases, ASST Spedali Civili Di Brescia, 25123, Brescia, Italy
| | - Daniela Zizioli
- Department of Molecular and Translational Medicine, University of Brescia, 25123, Brescia, Italy
| | - Eugenia Quiros-Roldan
- Department of Clinical and Experimental Sciences, University of Brescia, 25123, Brescia, Italy
- Division of Infectious and Tropical Diseases, ASST Spedali Civili Di Brescia, 25123, Brescia, Italy
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