Preclinical effects of APOE ε4 on cerebrospinal fluid Aβ42 concentrations

Ronald Lautner1,2, Philip S Insel3,4,5, Tobias Skillbäck6,7

  • 1Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden. ronald.lautner@neuro.gu.se.

Abstract

Insights

The APOE ε4 allele is linked to earlier decreases in cerebrospinal fluid beta-amyloid42 in healthy individuals. This suggests an APOE ε4-driven period of altered amyloid homeostasis precedes cognitive decline in Alzheimer's disease.

Area of Science:

  • Neuroscience
  • Genetics
  • Biochemistry

Background:

  • The apolipoprotein E (APOE) ε4 allele is a known risk factor for Alzheimer's disease (AD).
  • APOE genotype influences cerebrospinal fluid (CSF) beta-amyloid42 (Aβ42) levels in individuals with cognitive decline and healthy controls.
  • Previous research indicates a link between APOE genotype and Aβ42 concentrations, but its age-dependent effects in healthy individuals require further investigation.

Purpose of the Study:

  • To investigate how the APOE genotype's effect on CSF Aβ42 concentrations varies with age in cognitively healthy individuals.
  • To understand the association between APOE genotype and the early stages of preclinical Alzheimer's disease.

Main Methods:

  • Analysis of APOE genotype and CSF Aβ42 concentration in 716 cognitively healthy individuals.
  • Cohort age range: 17-99 years.
  • Data collected from nine different clinical research centers.

Main Results:

  • CSF Aβ42 concentrations were lower in APOE ε4 carriers compared to noncarriers, in a gene dose-dependent manner.
  • The impact of APOE ε4 on CSF Aβ42 levels was found to be age-dependent.
  • CSF Aβ42 began decreasing around age 50 in APOE ε4-negative individuals, age 43 in heterozygous carriers, and showed a steady decline in homozygous carriers.

Conclusions:

  • Individuals with the APOE ε4 allele exhibit decreased CSF Aβ42 levels nearly a decade earlier than noncarriers, starting in early middle age.
  • Homozygous APOE ε4 carriers may experience Aβ42 deposition throughout the studied age range.
  • These findings suggest an APOE ε4-dependent window for early amyloid homeostasis alterations, potentially preceding downstream pathologies and cognitive decline in Alzheimer's disease.