Johansson Per, Almqvist Erik G, Bjerke Maria, Wallin Anders, Johansson Jan-Ove, Andreasson Ulf, Blennow Kaj, Zetterberg Henrik, Svensson Johan
Department of Neuropsychiatry, Skaraborg Central Hospital, Falköping, Sweden.
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
J Alzheimers Dis. 2017;59(3):1017-1026. doi: 10.3233/JAD-170226.
Apolipoprotein E (ApoE) has been extensively studied in Alzheimer's disease (AD), but little is known of apolipoprotein A-I (ApoA-I) in cerebrospinal fluid (CSF).
Plasma lipids as well as ApoA-I and ApoE in plasma and CSF were determined and related to Mini-Mental State Examination (MMSE) score, APOE genotype, and CSF AD biomarkers.
Consecutive patients with AD (n = 29), stable mild cognitive impairment (n = 13), other dementias (n = 14), and healthy controls (n = 18) were included at a single center.
AD patients had higher plasma triglycerides and lower CSF ApoA-I concentration than controls (both p < 0.05). CSF ApoE concentration was reduced in other dementias (p < 0.01). In AD as well as other dementias, the ratios between CSF and plasma concentrations of both ApoA-I and ApoE were lower than those in the controls. ApoA-I and ApoE in plasma and CSF were not influenced by APOEɛ4 allele distribution. In the total study population (n = 74), CSF ApoA-I correlated positively with MMSE score (r = 0.26, p < 0.05) and negatively with CSF P-tau (r = -0.25, p < 0.05). CSF ApoE correlated positively with CSF concentrations of T-tau and P-tau in the total study population and in AD patients.
CSF ApoA-I was reduced in AD patients and associated with measures of cognitive function and AD disease status. The mechanisms underlying the decreased CSF:plasma ratios of ApoA-I and ApoE in AD and other dementias need to be explored in further studies.
载脂蛋白E（ApoE）在阿尔茨海默病（AD）中已得到广泛研究，但对脑脊液（CSF）中的载脂蛋白A-I（ApoA-I）却知之甚少。
测定血浆脂质以及血浆和脑脊液中的ApoA-I和ApoE，并将其与简易精神状态检查表（MMSE）评分、APOE基因型和脑脊液AD生物标志物相关联。
在一个单一中心纳入了连续的AD患者（n = 29）、稳定的轻度认知障碍患者（n = 13）、其他痴呆患者（n = 14）和健康对照者（n = 18）。
与对照组相比，AD患者的血浆甘油三酯水平较高，脑脊液ApoA-I浓度较低（两者p < 0.05）。其他痴呆患者的脑脊液ApoE浓度降低（p < 0.01）。在AD以及其他痴呆中，脑脊液与血浆中ApoA-I和ApoE浓度的比值均低于对照组。血浆和脑脊液中的ApoA-I和ApoE不受APOEɛ4等位基因分布的影响。在整个研究人群（n = 74）中，脑脊液ApoA-I与MMSE评分呈正相关（r = 0.26，p < 0.05），与脑脊液P-tau呈负相关（r = -0.25，p < 0.05）。在整个研究人群和AD患者中，脑脊液ApoE与脑脊液T-tau和P-tau浓度呈正相关。
AD患者脑脊液ApoA-I降低，且与认知功能和AD疾病状态指标相关联。AD和其他痴呆中脑脊液与血浆ApoA-I和ApoE比值降低的潜在机制有待进一步研究探索。
