Association of apolipoprotein E genotypes with prognosis in multiple sclerosis

Although the association between apolipoprotein E (APOE) genetic polymorphisms and multiple sclerosis (MS), has been debated, the presence of the epsilon4 allele has been associated with an aggressive disease progression.

Present study aimed to investigate whether or not the APOE allele has an impact on disease progression in patients with MS. The study investigated the presence and clinical correlations of certain APOE genotypes in patients with MS.

Fifty patients were enrolled in the study. APOE genotype was determined by polymerase chain reaction (PCR), the total apoE level was established using the nephelometric method. Expanded Disability Status Scale (EDSS) scores were also established. The progression index (PI) was calculated as the EDSS score/disease duration.

The most common APOE genotype in MS patients was epsilon3/epsilon3 (82.0%). Male patients with MS were significantly more likely to have epsilon4, and at baseline, the disease duration was shorter, the EDSS scores were higher, the serum total ApoE levels were lower, and the PI was significantly higher. The MS onset age, clinical types, EDSS scores, and PI were not significantly correlated with epsilon4 allele-positive. Visual onset and sensory onset are good prognostic factors. There were no patients with visual onset and few patients with sensory onset in the epsilon4-positive group.

The present study established male patients with MS had a higher APOE epsilon4 frequency and disease severity, but were likely to have lower serum ApoE levels. An additional study is needed with a larger sample to include all genotypes.