The APOE4 Allele is one of the three major genetic variants of the Apolipoprotein E gene, representing the strongest known genetic risk factor for late-onset Alzheimer’s disease and also associated with increased cardiovascular risk. Apolipoprotein E is a multifunctional lipid-binding protein crucial for the transport and metabolism of cholesterol and other lipids in both the plasma and the central nervous system. Carrying one or two copies of this allele significantly impacts lipid homeostasis and neuronal function.
Origin
Apolipoprotein E was identified for its essential role in mediating the binding of lipoproteins to cell-surface receptors to facilitate lipid clearance. The discovery of the APOE gene polymorphism and the subsequent strong association of the epsilon 4 variant with Alzheimer’s disease in the 1990s marked a major breakthrough in neurogenetics and cardiometabolic risk assessment. The name reflects its genetic locus and its function as a lipid transport protein.
Mechanism
The APOE4 isoform, due to a single amino acid substitution, adopts a distinct structure that is less efficient at clearing lipids and cholesterol, particularly in the brain, compared to the more common APOE3 variant. This structural difference impairs lipid transport, increases oxidative stress, and is linked to reduced clearance of amyloid-beta plaques, which are hallmarks of neurodegeneration. Furthermore, the APOE4 variant can dysregulate the metabolism of essential fatty acids, contributing to both cognitive and vascular pathology.
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