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Miao G, Zhuo D, Han X, Yao W, Liu C, Liu H, Cao H, Sun Y, Chen Z, Feng T. From degenerative disease to malignant tumors: Insight to the function of ApoE. Biomed Pharmacother 2023; 158:114127. [PMID: 36516696 DOI: 10.1016/j.biopha.2022.114127] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/03/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
Apolipoprotein E (ApoE) is a multifunctional protein involved in lipid transport and lipoprotein metabolism, mediating lipid distribution/redistribution in tissues and cells. It can also regulate inflammation and immune function, maintain cytoskeleton stability, and improve neural tissue Function. Due to genetic polymorphisms of ApoE (ε2, ε3, and ε4), its three common structural isoforms (ApoE2, ApoE3, ApoE4) are also associated with the risk of many diseases, especially degenerative diseases, such as vascular degenerative diseases including atherosclerosis (AS), coronary heart disease (CHD), and neurodegenerative disease like Alzheimer's disease (AD). The frequency of the ε4 allele and APOE variants were significantly higher than that of the ε2 and ε3 alleles in the patients with CHD or AD. In recent years, ApoE has frequently appeared in tumor research and become a tumor biomarker gradually. It has been found that ApoE is highly expressed in most solid tumor tissues, such as glioblastoma, gastric cancer, pancreatic ductal cell carcinoma, etc. Studies illustrated that ApoE could regulate the polarization changes of macrophages, participate in the construction of tumor immune microenvironment, regulate tumor inflammation and immune response and play a role in tumor progression, invasion, and metastasis. Of course, many functions of ApoE and its relationship with diseases are still under research. By reviewing the structure and function of ApoE from degeneration diseases to tumor neoplasms, we hope to better understand such a biomarker and further explore the value of ApoE in later studies.
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Affiliation(s)
- Ganggang Miao
- Department of General Surgery, The People's Hospital of Danyang, Affiliated Danyang Hospital of Nantong University, Danyang, Jiangsu, China; Department of General Surgery, The Affiliated Nanjing Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Danping Zhuo
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xue Han
- Department of Clinical Laboratory, the Affiliated Hospital of Qingdao University, Qingdao, Shangdong, China
| | - Wentao Yao
- Department of Urology, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, Jiangsu, China
| | - Chuan Liu
- Hepatobiliary/Liver Transplantation Center, The First Affiliated Hospital of Nanjing Medical University, Key Laboratory of Living Donor Transplantation, Chinese Academy of Medical Sciences, Nanjing, China
| | - Hanyuan Liu
- Department of General Surgery, The Affiliated Nanjing Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hongyong Cao
- Department of General Surgery, The Affiliated Nanjing Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Yangbai Sun
- Department of Musculoskeletal Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Zhiqiang Chen
- Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China.
| | - Tingting Feng
- Jiangsu Key Laboratory of Infection and Immunity, Institute of Biology and Medical Sciences, Soochow University, Suzhou, China.
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2
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Limonova AS, Ershova AI, Meshkov AN, Kiseleva AV, Divashuk MG, Kutsenko VA, Drapkina OM. Case Report: Hypertriglyceridemia and Premature Atherosclerosis in a Patient With Apolipoprotein E Gene ε 2ε 1 Genotype. Front Cardiovasc Med 2021; 7:585779. [PMID: 33537346 PMCID: PMC7847930 DOI: 10.3389/fcvm.2020.585779] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 12/01/2020] [Indexed: 12/23/2022] Open
Abstract
We present a case of a 40-year-old male with premature atherosclerosis, with evidence of both eruptive and tendinous xanthomas, which could imply an increase in both low-density lipoprotein (LDL) and triglyceride (TG) levels. However, his LDL was 2.08 mmol/l, TG -11.8 mmol/l on rosuvastatin 20 mg. Genetic evaluation was performed using a custom panel consisting of 25 genes and 280 variants responsible for lipid metabolism. A rare ε2ε1 genotype of apolipoprotein E was detected. The combination of clinical manifestations and genetic factors in this patient leads to the diagnosis of familial dysbetalipoproteinemia. Implementation of genetic testing into routine clinical practice could not only improve disease diagnostics and management, but also help prevent their development.
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Affiliation(s)
- Alena S Limonova
- Laboratory of Clinomics, National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Alexandra I Ershova
- Laboratory of Clinomics, National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Alexey N Meshkov
- Laboratory of Molecular Genetics, National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Anna V Kiseleva
- Laboratory of Molecular Genetics, National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Mikhail G Divashuk
- Laboratory of Molecular Genetics, National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia.,Kurchatov Genomics Center-All-Russia Research Institute of Agricultural Biotechnology, Moscow, Russia
| | - Vladimir A Kutsenko
- Biostatistics Laboratory, National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia.,Department of Theory of Probability, Department of Mechanics and Mathematics, Lomonosov Moscow State University, Moscow, Russia
| | - Oxana M Drapkina
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
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3
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Le R, Abbas M, McIntyre AD, Hegele RA. Severe Combined Dyslipidemia With a Complex Genetic Basis. J Investig Med High Impact Case Rep 2020; 7:2324709619877050. [PMID: 31538826 PMCID: PMC6755624 DOI: 10.1177/2324709619877050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background. Familial dysbetalipoproteinemia (also known as type 3 hyperlipoproteinemia) is typically associated with homozygosity for the apolipoprotein E2 isoform, but also sometimes with dominant rare missense variants in the APOE gene. Patients present with roughly equimolar elevations of cholesterol and triglyceride (TG) due to pathologic accumulation of remnant lipoprotein particles. Clinical features include tuberoeruptive xanthomas, palmar xanthomas, and premature vascular disease. Case. A 48-year-old male presented with severe combined dyslipidemia: total cholesterol and TG were 11.5 and 21.4 mmol/L, respectively. He had dyslipidemia since his early 20s, with tuberous xanthomas on his elbows and knees. His body mass index was 42 kg/m2. He also had treated hypertension, mild renal impairment, and a history of gout. He had no history of cardiovascular disease, peripheral arterial disease, or pancreatitis. Multiple medications had been advised including rosuvastatin, ezetimibe, fenofibrate, and alirocumab, but his lipid levels were never adequately controlled. Genetic Analysis. Targeted next-generation sequencing identified (1) the APOE E2/E2 homozygous genotype classically described with familial dysbetalipoproteinemia; (2) in addition, one APOE E2 allele contained the rare heterozygous missense variant p.G145D, previously termed apo E-Bethesda; (3) a rare heterozygous APOC2 nonsense variant p.Q92X; and (4) a high polygenic risk score for TG levels (16 out of 28 TG-raising alleles) at the 82nd percentile for age and sex. Conclusion. The multiple genetic "hits" on top of the classical APOE E2/E2 genotype likely explain the more severe dyslipidemia and refractory clinical phenotype.
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Affiliation(s)
- Ryan Le
- Western University, London, Ontario, Canada
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4
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Prada D, Colicino E, Power MC, Weisskopf MG, Zhong J, Hou L, Spiro A, Vokonas P, Brenan K, Herrera LA, Schwartz J, Wright R, Hu H, Baccarelli AA. APOE ε4 allele modifies the association of lead exposure with age-related cognitive decline in older individuals. ENVIRONMENTAL RESEARCH 2016; 151:101-105. [PMID: 27474937 PMCID: PMC5071136 DOI: 10.1016/j.envres.2016.07.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 07/01/2016] [Accepted: 07/22/2016] [Indexed: 05/16/2023]
Abstract
BACKGROUND Continuing chronic and sporadic high-level of lead exposure in some regions in the U.S. has directed public attention to the effects of lead on human health. Long-term lead exposure has been associated with faster cognitive decline in older individuals; however, genetic susceptibility to lead-related cognitive decline during aging has been poorly studied. METHODS We determined the interaction of APOE-epsilon variants and environmental lead exposure in relation to age-related cognitive decline. We measured tibia bone lead by K-shell-x-ray fluorescence, APOE-epsilon variants by multiplex PCR and global cognitive z-scores in 489 men from the VA-Normative Aging Study. To determine global cognitive z-scores we incorporated multiple cognitive assessments, including word list memory task, digit span backwards, verbal fluency test, sum of drawings, and pattern comparison task, which were assessed at multiple visits. We used linear mixed-effect models with random intercepts for individual and for cognitive test. RESULTS An interquartile range (IQR:14.23μg/g) increase in tibia lead concentration was associated with a 0.06 (95% confidence interval [95%CI]: -0.11 to -0.01) lower global cognition z-score. In the presence of both ε4 alleles, one IQR increase in tibia lead was associated with 0.57 (95%CI: -0.97 to -0.16; p-value for interaction: 0.03) lower total cognition z-score. A borderline association was observed in presence of one ε4 allele (Estimate-effect per 1-IQR increase: -0.11, 95%CI: -0.22, 0.01) as well as lack of association in individuals without APOE ε4 allele. CONCLUSIONS Our findings suggest that individuals carrying both ε4 alleles are more susceptible to lead impact on global cognitive decline during aging.
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Affiliation(s)
- Diddier Prada
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA 02115, USA; Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología - Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City 14080, Mexico
| | - Elena Colicino
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA 02115, USA
| | - Melinda C Power
- Department of Epidemiology and Biostatistics, George Washington University Milken Institute of Public Health, 950 New Hampshire Avenue NW, Washington, DC 20052, USA
| | - Marc G Weisskopf
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA 02115, USA
| | - Jia Zhong
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA 02115, USA
| | - Lifang Hou
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 420 East Superior St, Chicago, IL 60611, USA
| | - Avron Spiro
- Veterans Affairs Boston Healthcare System, 150 South Huntington Ave, Boston, MA 02130, USA; Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA; Department of Psychiatry, Boston University School of Medicine, 72 East Concord Street, Boston, MA 02118, USA
| | - Pantel Vokonas
- Veterans Affairs Boston Healthcare System, 150 South Huntington Ave, Boston, MA 02130, USA; Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
| | - Kasey Brenan
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA 02115, USA
| | - Luis A Herrera
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología - Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City 14080, Mexico
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA 02115, USA
| | | | | | - Andrea A Baccarelli
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA 02115, USA.
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5
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Corbo RM, Prévost M, Raussens V, Gambina G, Moretto G, Scacchi R. Structural and phylogenetic approaches to assess the significance of human Apolipoprotein E variation. Mol Genet Metab 2006; 89:261-9. [PMID: 16621646 DOI: 10.1016/j.ymgme.2006.02.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2006] [Accepted: 02/27/2006] [Indexed: 11/26/2022]
Abstract
Apolipoprotein E (APOE) is an important gene whose common polymorphism, and precisely the e *4 allele, has been reportedly associated with some disorders, including Alzheimer's disease (AD) and coronary artery disease. In the course of previous surveys on AD patients and healthy individuals some rare variants were detected by means of Isoelectric focusing and denaturing high-performance liquid chromatography techniques. After a mutation in a gene is identified, the problem arises to understand its effective significance. Structure modelling and phylogenetic analysis methods are widely used to establish the possible deleterious effect of mutations. In this study their usefulness in the analysis of APOE variants was evaluated. The two combined methods provided helpful indications for distinguishing between mutations possibly involved in AD susceptibility and not deleterious mutations.
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Affiliation(s)
- Rosa Maria Corbo
- Department of Genetics and Molecular Biology, University La Sapienza, Rome, Italy
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6
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Murrell JR, Price BM, Baiyewu O, Gureje O, Deeg M, Hendrie H, Ogunniyi A, Hall K. The fourth apolipoprotein E haplotype found in the Yoruba of Ibadan. Am J Med Genet B Neuropsychiatr Genet 2006; 141B:426-7. [PMID: 16583434 PMCID: PMC4550481 DOI: 10.1002/ajmg.b.30295] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Jill R. Murrell
- Department of Pathology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Brandon M. Price
- Department of Pathology, Indiana University School of Medicine, Indianapolis, Indiana
| | | | - Oye Gureje
- Department of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Mark Deeg
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Hugh Hendrie
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana
| | | | - Kathleen Hall
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana
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7
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Mann WA, Meyer N, Berg D, Greten H, Beisiegel U. Lipoprotein lipase compensates for the defective function of apo E variants in vitro by interacting with proteoglycans and lipoprotein receptors. Atherosclerosis 1999; 145:61-9. [PMID: 10428296 DOI: 10.1016/s0021-9150(99)00015-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Lipoprotein lipase (LPL) and apolipoprotein E (apo E) independently enhance binding and uptake of lipoproteins to cells. A coordinate effect of LPL and apo E has been previously described in human hepatozytes where simultaneous addition of both proteins resulted in an additive increase of chylomicron binding and uptake. The role of lipoprotein receptors and proteoglycans in this coordinate effect was now analysed using various cell types and heparinase treatment. To investigate a pathophysiological relevance, the effect of LPL and normal apo E-3 was compared to LPL and four apo E variants, associated with type III hyperlipoproteinemia (HLP). Apo E-3 and LPL increased the binding and uptake of chylomicrons and beta-very low density lipoproteins (VLDL) in an additive way in all cell types analysed, except proteoglycan deficient Chinese hamster ovary (CHO)-cells. Heparinase treatment almost completely abolished the effect of apo E and LPL. Addition of LPL to the apo E variants resulted in significant compensation of their defective function in mediating beta-VLDL binding to low density lipoprotein (LDL)-receptor defective fibroblasts. These findings indicate that the coordinate effect of apo E and LPL is mediated by proteoglycans and lipoprotein receptors, independent of the LDL receptor. LPL may compensate for the defective function of apo E variants by enhancing lipoprotein binding to these receptors. Defects in this mechanism may explain how mutations in the LPL molecule contribute to the manifestation of type III HLP in addition to the presence of a defective apo E.
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Affiliation(s)
- W A Mann
- Medical Clinic, University Hospital Eppendorf, Hamburg, Germany.
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8
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Groß W, März W. Application of electrophoretic techniques to the diagnosis of disorders of lipoprotein metabolism. Examples at the levels of lipoproteins and apolipoproteins. Anal Chim Acta 1999. [DOI: 10.1016/s0003-2670(98)00497-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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9
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Mann WA, Meyer N, Weber W, Meyer S, Greten H, Beisiegel U. Apolipoprotein E isoforms and rare mutations: parallel reduction in binding to cells and to heparin reflects severity of associated type III hyperlipoproteinemia. J Lipid Res 1995. [DOI: 10.1016/s0022-2275(20)39885-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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10
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Iron A, Richard P, de Zulueta MP, Thomas G, Thomas M. Genotyping of a patient homozygous for a rare apolipoprotein E1 [Gly127-->Asp; Arg158-->Cys] (Weisgraber allele). J Inherit Metab Dis 1995; 18:723-6. [PMID: 8750611 DOI: 10.1007/bf02436763] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We examined the apolipoprotein E polymorphism of an obese patient presenting non-insulin-dependent diabetes, hypertension and moderate lipid disturbances. The apolipoprotein E genotyping carried out from leukocyte DNA using PCR amplification and restriction enzyme digestion demonstrated homozygosity for the rare apoE1[Gly127-->Asp; Arg158--> Cys] (Weisgraber allele). The nucleotide change results in a glycine to aspartic acid substitution at amino acid 127 in the apolipoprotein E2.
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Affiliation(s)
- A Iron
- Departement de Biochimie Medicale et Biologie Moleculaire, Universite de Bordeaux 2, Bordeaux, France
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11
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Maekawa B, Cole TG, Seip RL, Bylund D. Apolipoprotein E genotyping methods for the clinical laboratory. J Clin Lab Anal 1995; 9:63-9. [PMID: 7722775 DOI: 10.1002/jcla.1860090112] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
To select the best method for detecting apolipoprotein E (apo E) genotypes determined by the three common alleles epsilon 2, epsilon 3 and epsilon 4, we compared the radiolabeled allele-specific oligonucleotide (ASO) probe assay and the nonisotopic restriction isotyping assay. Leukocytic DNA was extracted from the blood of 93 patients after which the region containing two mutation points coding amino acid residues 112 and 158 was amplified by using the polymerase chain reaction (PCR). Amplified DNA fragments were spotted on nylon membranes, then hybridized for the ASO probe assay. The amplified DNA fragments were also digested with restriction endonuclease Hhal, followed by polyacrylamide gel electrophoresis for the restriction isotyping assay. The apo E genotypes determined by both methods for every specimen studied were in complete agreement. Although the radiolabeled ASO probe method was 10 times more sensitive than restriction isotyping on polyacrylamide gel, the two were comparable in accuracy. Additionally, because it is simpler to perform, is less time consuming, and is less expensive, we conclude that the restriction isotyping assay is the more suitable of these two methods for use in a clinical laboratory.
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Affiliation(s)
- B Maekawa
- Tsukuba Research Laboratory, Hitachi Chemical Co., Ltd., Ibaraki, Japan
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12
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de Knijff P, van den Maagdenberg AM, Frants RR, Havekes LM. Genetic heterogeneity of apolipoprotein E and its influence on plasma lipid and lipoprotein levels. Hum Mutat 1994; 4:178-94. [PMID: 7833947 DOI: 10.1002/humu.1380040303] [Citation(s) in RCA: 91] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Apolipoprotein E (apoE) is one of the major protein constituents of chylomicron and very-low-density lipoprotein (VLDL) remnants and plays a central role as a ligand in the receptor-mediated uptake of these particles by the liver. Including the most common variant, apoE3, 30 apoE variants have been characterized. At present, 14 apoE variants have been found to be associated with familial dysbetalipoproteinemia, a genetic lipid disorder characterized by elevated plasma cholesterol and triglyceride levels and an increased risk for atherosclerosis. Seven apoE variants were found to be associated with other forms of hyperlipoproteinemia. This report presents an overview of all currently known apoE variants and their effects on lipoprotein metabolism.
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Affiliation(s)
- P de Knijff
- TNO Institute of Prevention and Health Research, Gaubius Laboratory, Leiden, The Netherlands
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13
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Hackler R, Schäfer JR, Motzny S, Brand S, Kleine TO, Kaffarnik H, Steinmetz A. Rapid determination of apolipoprotein E phenotypes from whole plasma by automated isoelectric focusing using PhastSystem and immunofixation. J Lipid Res 1994. [DOI: 10.1016/s0022-2275(20)40122-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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14
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Affiliation(s)
- K H Weisgraber
- Gladstone Institute of Cardiovascular Disease, San Francisco, California 94141-9100
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15
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Wenham PR, McDowell IF, Hodges VM, McEneny J, O'Kane MJ, Davies RJ, Nicholls DP, Trimble ER, Blundell G. Rare apolipoprotein E variant identified in a patient with type III hyperlipidaemia. Atherosclerosis 1993; 99:261-71. [PMID: 8503953 DOI: 10.1016/0021-9150(93)90028-s] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We report a rare apolipoprotein E variant in an Irish female with Type III hyperlipidaemia who has the phenotype E2E1 as determined by isoelectric focusing. Sequence analysis of the apolipoprotein E gene from the proband and from four other family members, using DNA amplified by the polymerase chain reaction, demonstrated the presence of a point mutation in the common epsilon 2 allele with a G-->A transition at nucleotide 3791. This was confirmed by digestion with the restriction endonuclease TaqI, which cuts at a new site within the apolipoprotein E gene, created by the base change. This mutation results in a substitution of aspartic acid for glycine at position 127 of the mature protein. We believe this to be the first description of this apolipoprotein E variant in a family from the British Isles. The mutation appears to be 'recessive' with respect to the expression of Type III hyperlipidaemia, although it may be somewhat more potent in this regard than the parent epsilon 2 allele. The Type III hyperlipidaemia is responsive to treatment with diet and gemfibrozil.
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Affiliation(s)
- P R Wenham
- Department of Clinical Biochemistry, Western General Hospital, Edinburgh, UK
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16
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Zannis VI, Kardassis D, Zanni EE. Genetic mutations affecting human lipoproteins, their receptors, and their enzymes. ADVANCES IN HUMAN GENETICS 1993; 21:145-319. [PMID: 8391199 DOI: 10.1007/978-1-4615-3010-7_3] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- V I Zannis
- Department of Medicine, Housman Medical Research Center, Boston University Medical Center, Massachusetts 02118
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17
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Moriyama K, Sasaki J, Matsunaga A, Arakawa F, Takada Y, Araki K, Kaneko S, Arakawa K. Apolipoprotein E1 Lys-146----Glu with type III hyperlipoproteinemia. ACTA ACUST UNITED AC 1992; 1128:58-64. [PMID: 1356443 DOI: 10.1016/0005-2760(92)90257-v] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
During the screening of samples obtained from 5 individuals with type III hyperlipidemia, we identified a variant of apolipoprotein (apo) E which exhibited a discrepancy in apo E phenotype showing the E3/E1 isoform on isoelectric focusing (IEF) analysis and E3/E3 on gene analysis. Sequence analysis of the DNA of the proband that was amplified by PCR and subcloned, revealed a single substitution of one lysine (AAG) for one glutamic acid (GAG) at position 146, thereby adding two negatively charged units to apo E3. This defect had been described only for apo E1 to date (Mann et al. (1989) Clin. Res. 37, 520A (abstract)). In this case, PCR-mediated site-directed mutagenesis was used to identify the structural alterations forming the abnormal E1 genotype in the proband's family. Purified apo E1 Lys-146----Glu showed less than 10% of binding activity to apo B, E receptor on human skin fibroblasts compared with apo E3. This substitution demonstrates that Lys-146 is essential for the binding of apo E to the receptor.
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Affiliation(s)
- K Moriyama
- Department of Internal Medicine, School of Medicine, Fukuoka University, Japan
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18
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Feussner G, Funke H, Weng W, Assmann G, Lackner KJ, Ziegler R. Severe type III hyperlipoproteinemia associated with unusual apolipoprotein E1 phenotype and epsilon 1/'null' genotype. Eur J Clin Invest 1992; 22:599-608. [PMID: 1360898 DOI: 10.1111/j.1365-2362.1992.tb01511.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A 60-year-old white male (KH) was diagnosed to suffer from severe type III hyperlipoproteinemia (HLP) and premature cardiovascular disease. Biochemical analysis revealed an unusual apolipoprotein (apo) E phenotype and genotype. All clinical characteristics of type III HLP were present in the patient. His very low density lipoprotein (VLDL) cholesterol to plasma triglyceride (TG) ratio was elevated at 0.97 without therapy which is unusually high (normal ratio about 0.18). By contrast his plasma apo E level was only moderately elevated (6.8 mg dl-1). The patient's apo E migrated in the apo E1 position on isoelectric focusing gels. Chemical modification with cysteamine and treatment with neuraminidase confirmed the presence of two cysteine residues in the patient's apo E and a normal sialylation pattern. Pedigree analysis suggested that the patient was a compound heterozygote with one apo epsilon 1 allele and another allele whose product did not appear in the plasma compartment ('null' allele). Direct sequencing of polymerase chain reaction (PCR) amplified segments of the apo E gene as well as restriction fragment length polymorphism (RFLP) analysis with the endonuclease Taq I identified an adenosine for guanosine (G-->A) exchange in the second base of codon 127 that is predictive for an Asp for Gly substitution in the encoded apo E amino acid sequence. This mutation is the structural basis for the apo E1 isoform identified upon isoelectric focusing. Five other family members are also carriers of the mutant apo epsilon 1 allele. Two of those were hyperlipidemic and exhibited biochemical characteristics of type III HLP. A second mutation, a deletion of a G in codon 31, is predictive for a reading frameshift that encodes for a premature stop in codon 60. Our inability to identify the product of a second apo E allele in the plasma of the patient and two other members of the KH family corresponds with the heterozygous presence of this mutation in the affected individuals. Both relatives (like the index case) had an increased VLDL cholesterol to plasma TG ratio, which indicates the presence of cholesterol-enriched VLDL particles. We propose that the single base deletion in the apo E gene which is the cause of a non-functional 'null' allele in addition to a probably dominant apo E1 (Gly127-->Asp, Arg158-->Cys) variant of late or incomplete penetrance are the primary genetic defects in this kindred leading to severe dysbetalipoproteinemia.
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Affiliation(s)
- G Feussner
- Medizinische Universitätsklinik Heidelberg, Germany
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Abstract
Apolipoprotein E plays a central role in lipoprotein metabolism by serving as a ligand for the binding of lipoproteins to lipoprotein receptors. Both common and rare variants of apoE have been described. The common variants apoE2 and apoE4 have a significant impact on interindividual variation of lipid and lipoprotein levels in normal subjects. The common variant apoE2 and more than half a dozen rare variants are defective in binding to the low-density lipoprotein (LDL) receptor, and all are causally associated with the lipid disorder type III hyperlipoproteinaemia (HLP). The mode of inheritance of the disorder can be either dominant or recessive, depending on the particular mutation(s) in apoE, although the mechanisms involved are not fully understood. The common variant apoE4 and other rare variants have been reported to be associated with a variety of other lipoprotein disorders, but a causal link has not been established.
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Affiliation(s)
- S C Rall
- Gladstone Institute of Cardiovascular Disease, University of California, San Francisco
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