Apolipoprotein E varepsilon4 allele has an impact on vascular reactivity in Alzheimer's disease

Seventeen otherwise healthy, non-smoking patients with probable Alzheimer's disease (AD) and 11 healthy, non-smoking, age-matched controls participated in a study of vascular reactivity. Three substances were iontophoresed into the skin: sodium nitroprusside (SNP) delivered at the cathode, and acetylcholine chloride and isoprenaline sulphate delivered at the anode. The resultant vasodilation was mapped through a laser Doppler perfusion imager. The patients harbouring the Apolipoprotein E varepsilon4 allele (ApoE4) (n=9) showed significantly greater vasodilation compared both with patients without the ApoE4 and with controls (one control possessed the ApoE4) when SNP was delivered at the cathode. An additional study of ten of the AD patients and ten controls suggested that the enhanced reactivity in the patients with the ApoE4 depended on a greater sensitivity to the iontophoretic current itself at the cathode rather than to SNP. The quotient between total cholesterol and high-density lipoprotein-cholesterol was higher in the patients with the ApoE4 compared both with patients without the ApoE4 and with controls. A dysfunction of voltage-dependent ion channels and/or other membrane abnormalities in AD patients possessing the ApoE4 is suggested.