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CLOSING REMARKS
CENTRAL AND PERIPHERAL APOE IN ALZHEIMER’S DISEASE
Abstract
Abstract Body
Central and Peripheral ApoE in Alzheimer’s Disease
SciNeuro Pharmaceuticals, Rockville, MD, USA
The ε4 allele of the apolipoprotein E (APOE) gene is the strongest genetic risk factor for late-onset Alzheimer’s disease (AD). In the central nervous system (CNS), apoE4 inhibits the clearance and promotes the aggregation of amyloid-β (Aβ), and has several Aβ-independent effects. ApoE is also abundantly expressed in peripheral tissues including liver where it mediates plasma lipid metabolism. APOE4 carriers have increased risk for hypercholesterolemia and atherosclerosis. To differentiate apoE functions in CNS and periphery, we developed cell type-specific and inducible mouse models expressing apoE isoforms in individual cell types. Some of these mice were further bred to the background of amyloid model APP/PS1 mice. When apoE isoforms were expressed in astrocytes using GFAP-Cre driver, we found that apoE3 but not apoE4 improved synaptic functions and memory performance, whereas apoE4 but not apoE3 inhibited Aβ clearance and accelerated amyloid deposition. Interestingly, expression of apoE4 prior to amyloid deposition had a much greater impact on amyloid pathology than that during the rapid growth period. When apoE isoforms were expressed by microglia with Cx3cr1-Cre driver, we again found apoE3 but not apoE4 enhanced synaptic functions and memory performance. However, different from astrocytic expression, apoE3 but not apoE4 reduced amyloid deposition likely by enhancing microglial clustering and phagocytic function. More interesting, when apoE isoforms were expressed exclusively in the periphery by liver hepatocytes in the Apoe-knockout background, apoE4 inhibited synaptic function, impaired cognition, and was associated with compromised blood-brain barrier integrity and vascular function. These results provide mechanistic insights as to how apoE4 increases the risk for AD through both central and peripheral effects, and what we need to consider when developing apoE isoform-specific targeted therapies.