Department of Neurology and Neurological Sciences, FIND Lab, Stanford University, Stanford, CA 94304, USA.
Department of Neurology and Neurological Sciences, FIND Lab, Stanford University, Stanford, CA 94304, USA.
Neuron. 2019 Mar 6;101(5):820-838. doi: 10.1016/j.neuron.2019.01.056.
Alzheimer's disease (AD) is considered a polygenic disorder. This view is clouded, however, by lingering uncertainty over how to treat the quasi "monogenic" role of apolipoprotein E (APOE). The APOE4 allele is not only the strongest genetic risk factor for AD, it also affects risk for cardiovascular disease, stroke, and other neurodegenerative disorders. This review, based mostly on data from human studies, ranges across a variety of APOE-related pathologies, touching on evolutionary genetics and risk mitigation by ethnicity and sex. The authors also address one of the most fundamental question pertaining to APOE4 and AD: does APOE4 increase AD risk via a loss or gain of function? The answer will be of the utmost importance in guiding future research in AD.
阿尔茨海默病(AD)被认为是一种多基因疾病。然而,载脂蛋白 E(APOE)的准“单基因”作用如何治疗仍存在不确定性,这使得这种观点变得模糊不清。APOE4 等位基因不仅是 AD 的最强遗传风险因素,还会影响心血管疾病、中风和其他神经退行性疾病的风险。本综述主要基于人类研究数据,涵盖了各种与 APOE 相关的病理学,涉及进化遗传学以及种族和性别对风险的缓解。作者还探讨了与 APOE4 和 AD 相关的最基本问题之一:APOE4 通过功能丧失或获得增加 AD 风险吗?这个答案对于指导 AD 的未来研究至关重要。