The role of apolipoprotein E in Alzheimer's disease.

The role of apolipoprotein E in Alzheimer's disease.
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DOI:
10.1016/j.neuron.2009.06.026
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发表时间:
2009-08-13
期刊:
影响因子:
16.2
通讯作者:
Holtzman, David M.
Holtzman, David M.
中科院分区:
医学1区
文献类型:
--
作者:
Kim, Jungsu;Basak, Jacob M.;Holtzman, David M.

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载脂蛋白E(APOE)的ε4等位基因是阿尔茨海默病(AD)的主要遗传风险因素。尽管已有大量研究试图阐明这种风险增加的潜在机制,但载脂蛋白E4影响AD发病和进展的方式尚未得到证实。然而,现有证据表明,载脂蛋白E异构体对Aβ聚集和清除的不同作用在AD发病机制中起主要作用。其他潜在机制,如载脂蛋白E异构体对神经毒性和tau蛋白磷酸化的不同调节以及它在突触可塑性和神经炎症中的作用,尚未被排除。研究结果之间的不一致使得很难确定APOE ε4等位基因是代表毒性功能的获得、神经保护功能的丧失,还是两者兼而有之。基于载脂蛋白E的治疗策略旨在减少载脂蛋白E4的毒性作用或恢复载脂蛋白E的生理保护功能。此外,通过低密度脂蛋白(LDL)受体家族成员和ATP结合盒转运体A1(ABCA1)对载脂蛋白E蛋白水平和脂化状态的调节可能作为未来的治疗靶点加以利用。
The ε4 allele of apolipoprotein E (APOE) is the major genetic risk factor for Alzheimer’s disease (AD). Although there have been numerous studies attempting to elucidate the underlying mechanism for this increased risk, the manner in which apoE4 influences AD onset and progression has yet to be proven. However, prevailing evidence suggests that the differential effects of apoE isoforms on Aβ aggregation and clearance play the major role in AD pathogenesis. Other potential mechanisms, such as the differential modulation of neurotoxicity and tau phosphorylation by apoE isoforms as well as its role in synaptic plasticity and neuroinflammation, have not been ruled out. Inconsistent results among studies have made it difficult to define whether the APOE ε4 allele represents a gain of toxic function, a loss of neuroprotective function, or both. Therapeutic strategies based on apoE propose to reduce the toxic effects of apoE4 or to restore the physiological, protective functions of apoE. In addition, modulation of apoE protein levels and lipidation state by low-density lipoprotein (LDL) receptor family members and ATP-binding cassette transporter A1 (ABCA1) may be useful to exploit as future therapeutic targets.
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