Peripheral versus central nervous system APOE in Alzheimer's disease: Interplay across the blood-brain barrier. (24th August 2019) - Chernick, Dustin
Highlights: APOE exists in two distinct pools, in the periphery and in the brain. APOE regulates multiple molecular pathways in addition to cholesterol homeostasis. The three APOE isoforms exert differential effects on Alzheimer-related processes. Both peripheral and central pools of APOE contribute to Alzheimer's disease risk. Promising APOE-targeted therapeutic strategies have emerged for Alzheimer's disease. Abstract: The apolipoprotein E ( APOE ) ε4 allele has been demonstrated as the preeminent genetic risk factor for late onset Alzheimer's disease (AD), which comprises greater than 90% of all AD cases. The discovery of the connection between different APOE genotypes and AD risk in the early 1990s spurred three decades of intense and comprehensive research into the function of APOE in the normal and diseased brain. The importance of APOE in the periphery has been well established, due to its pivotal role in maintaining cholesterol homeostasis and cardiovascular health. The influence of vascular factors on brain function and AD risk has been extensively studied in recent years. As a major apolipoprotein regulating multiple molecular pathways beyond its canonical lipid-related functions in the periphery and the central nervous system, APOE represents a critical link between the two compartments, and may influence AD risk from both sides of the blood-brain barrier. This review discusses recent advances in understanding the different functions of APOE in the periphery and in the brain, and highlights several promising APOE-targeted therapeutic strategies for AD.