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Fahmy EM, Rabah AM, Hashem SE, Rashed LA, Deraz HA, Ismail RS. Serum Apo Lipoprotein E, Apo Lipoprotein E Gene Polymorphisms, and Parkinson's Disease. Neurol India 2024; 72:319-325. [PMID: 38691476 DOI: 10.4103/ni.ni_940_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 01/18/2023] [Indexed: 05/03/2024]
Abstract
BACKGROUND A central role for apolipoprotein E (APOE) has been suggested in modulating processes of neurodegeneration. OBJECTIVE To study the association between serum APOE levels, APOE gene polymorphisms, and Parkinson's disease (PD). MATERIAL AND METHODS Fifty-five patients with PD and 30 healthy subjects were enrolled. PD patients were assessed using the Unified Parkinson's Disease Rating Scale (UPDRS), Modified Hoehn and Yahr scale, and Schwab-England Activities of Daily Living scale. Serum APOE level and genotyping for APOE polymorphisms were done for PD patients and controls using enzyme-linked immunosorbent assay and polymerase chain reaction, respectively. RESULTS Mean serum APOE level was significantly higher in PD patients compared with healthy controls. APOE ε2/4 genotype was present in a significantly higher proportion of patients compared with controls. APOE ε4 allele was significantly associated with a higher score on the "mentation, behavior, and mood section" of UPDRS compared with ε2 allele. APOE ε2 allele was significantly associated with a shorter disease duration compared with ε3 and ε4 alleles. Mean serum APOE level was significantly higher in patients presenting predominantly by rigidity and bradykinesia compared with those presenting predominantly by tremors. Serum APOE level was positively correlated with mean scores of "mentation, behavior, and mood section" of UPDRS and disease duration. Serum APOE level was a significant predictor for the scores of "mentation, behavior, and mood section" of UPDRS. CONCLUSION APOE ε2/4 genotype might be a susceptibility variant for PD. There may be a possible role for APOE in modulating the process of neurodegeneration in PD.
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Affiliation(s)
- Ebtesam M Fahmy
- Department of Neurology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Amany M Rabah
- Department of Neurology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Saher E Hashem
- Department of Neurology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Laila A Rashed
- Department of Biochemistry, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Heba A Deraz
- Department of Neurology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rania S Ismail
- Department of Neurology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Liampas I, Kyriakoulopoulou P, Siokas V, Tsiamaki E, Stamati P, Kefalopoulou Z, Chroni E, Dardiotis E. Apolipoprotein E Gene in α-Synucleinopathies: A Narrative Review. Int J Mol Sci 2024; 25:1795. [PMID: 38339074 PMCID: PMC10855384 DOI: 10.3390/ijms25031795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/27/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
In this narrative review, we delved into the intricate interplay between Apolipoprotein E (APOE) alleles (typically associated with Alzheimer's disease-AD) and alpha-synucleinopathies (aS-pathies), involving Parkinson's disease (PD), Parkinson's disease dementia (PDD), dementia with Lewy bodies (DLB), and multiple-system atrophy (MSA). First, in-vitro, animal, and human-based data on the exacerbating effect of APOE4 on LB pathology were summarized. We found robust evidence that APOE4 carriage constitutes a risk factor for PDD-APOE2, and APOE3 may not alter the risk of developing PDD. We confirmed that APOE4 copies confer an increased hazard towards DLB, as well. Again APOE2 and APOE3 appear unrelated to the risk of conversion. Of note, in individuals with DLB APOE4, carriage appears to be intermediately prevalent between AD and PDD-PD (AD > DLB > PDD > PD). Less consistency existed when it came to PD; APOE-PD associations tended to be markedly modified by ethnicity. Finally, we failed to establish an association between the APOE gene and MSA. Phenotypic associations (age of disease onset, survival, cognitive-neuropsychiatric- motor-, and sleep-related manifestations) between APOE alleles, and each of the aforementioned conditions were also outlined. Finally, a synopsis of literature gaps was provided followed by suggestions for future research.
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Affiliation(s)
- Ioannis Liampas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, 41100 Larissa, Greece; (V.S.); (P.S.); (E.D.)
| | - Panagiota Kyriakoulopoulou
- Department of Neurology, University Hospital of Patras, School of Medicine, University of Patras, 26504 Rio Patras, Greece; (P.K.); (E.T.); (Z.K.); (E.C.)
| | - Vasileios Siokas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, 41100 Larissa, Greece; (V.S.); (P.S.); (E.D.)
| | - Eirini Tsiamaki
- Department of Neurology, University Hospital of Patras, School of Medicine, University of Patras, 26504 Rio Patras, Greece; (P.K.); (E.T.); (Z.K.); (E.C.)
| | - Polyxeni Stamati
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, 41100 Larissa, Greece; (V.S.); (P.S.); (E.D.)
| | - Zinovia Kefalopoulou
- Department of Neurology, University Hospital of Patras, School of Medicine, University of Patras, 26504 Rio Patras, Greece; (P.K.); (E.T.); (Z.K.); (E.C.)
| | - Elisabeth Chroni
- Department of Neurology, University Hospital of Patras, School of Medicine, University of Patras, 26504 Rio Patras, Greece; (P.K.); (E.T.); (Z.K.); (E.C.)
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, 41100 Larissa, Greece; (V.S.); (P.S.); (E.D.)
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Neuropsychiatric Symptoms in Clinically Defined Parkinson’s Disease: An Updated Review of Literature. Behav Neurol 2022; 2022:1213393. [PMID: 35586201 PMCID: PMC9110237 DOI: 10.1155/2022/1213393] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/22/2022] [Accepted: 03/09/2022] [Indexed: 11/18/2022] Open
Abstract
Background Neuropsychiatric symptoms (NPS) are a common and potentially serious manifestation of Parkinson's disease (PD) but are frequently overlooked in favor of a focus on motor symptomatology. Here, we conducted a literature review of the prevalence and type of NPS experienced by PD patients with a clinically defined course of their illness. Methods We identified reports of NPS in patients with PD and mean disease duration over 3 years. Three databases—PubMed, Scopus, and Dialnet—were searched for relevant literature published between 2010 and 2020. Predefined exclusion criteria were applied prior to a descriptive analysis of the literature base. Results In all, 87 unique reports were identified and 30 met inclusion and exclusion criteria. These included 7142 patients with PD (male: 67.3%; mean age: 66.2 years; mean disease duration: 6.7 years). The most frequent NPS were mood disorders (apathy, depression, and anxiety), psychosis, and impulse control disorders (ICD). Treatment with dopamine agonists was identified as an important risk factor for ICD. Co-occurrence of NPS and cognitive dysfunction was also evidenced in a number of studies. Patients with more significant cognitive deficits and higher levels of NPS appeared to be of older age with a longer disease duration and to have more severe motor symptoms. Conclusions NPS, most commonly mood disorders (apathy, depression, and anxiety), psychosis, and ICDs are frequent manifestations of PD. The results of this review reflect the need to develop unified validated assessment protocols for NPS in PD, as well as to improve their management in clinical practice.
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Sun R, Yang S, Zheng B, Liu J, Ma X. Apolipoprotein E Polymorphisms and Parkinson Disease With or Without Dementia: A Meta-Analysis Including 6453 Participants. J Geriatr Psychiatry Neurol 2019; 32:3-15. [PMID: 30526202 DOI: 10.1177/0891988718813675] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
A large number of case-control studies have investigated the association of apolipoprotein E ( APOE) polymorphisms with Parkinson disease (PD) and Parkinson disease dementia (PDD), with inconsistent results. This meta-analysis aimed to evaluate the relationship between APOE polymorphisms and PD/PDD risk. We searched for published studies in PubMed, Web of Science, WanFang Data (in Chinese), and CNKI (in Chinese) from inception to June 2017. Case-control studies reporting part or complete APOE genotype and allele frequency data were included. Pooled odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated using RevMan 5.3 software. A total of 39 studies involving 6453 cases with PD, with 461 cases with PDD, and 6855 controls were included in this meta-analysis. The results showed that the APOE ε3 allele was a protective factor for PD (OR = 0.90, 95% CI: 0.81-0.99; P = .04), whereas no significant differences in PD risk among all cases compared to controls were found for APOE ε2 and ε4. In Asian subgroups, the APOE ε4 allele was shown to be a risk factor for PD (OR = 1.22, 95% CI: 1.01-1.46; P = .04). Additionally, APOE polymorphisms were significantly associated with PDD risk in the entire case group (ε3: OR = 0.72, 95% CI: 0.58-0.89, P = .003; ε4: OR = 1.46, 95% CI: 1.12-1.88, P = .004) and in Asian subgroups.
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Affiliation(s)
- Ruoyi Sun
- 1 Department of General Practitioner, Jiang Chuan Community Health Service Center, Shanghai, China
| | - Simin Yang
- 2 Department of Laboratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Bing Zheng
- 3 Department of Clinical Laboratory, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jianping Liu
- 4 Department of Geriatrics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaowei Ma
- 3 Department of Clinical Laboratory, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Lange F, Brückner C, Knebel A, Seer C, Kopp B. Executive dysfunction in Parkinson’s disease: A meta-analysis on the Wisconsin Card Sorting Test literature. Neurosci Biobehav Rev 2018; 93:38-56. [DOI: 10.1016/j.neubiorev.2018.06.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 06/14/2018] [Accepted: 06/15/2018] [Indexed: 12/13/2022]
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Rohn TT, Mack JM. Apolipoprotein E Fragmentation within Lewy Bodies of the Human Parkinson's Disease Brain. INTERNATIONAL JOURNAL OF NEURODEGENERATIVE DISORDERS 2018; 1. [PMID: 30272057 PMCID: PMC6159338 DOI: 10.23937/ijnd-2017/1710002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Although harboring the Apolipoprotein E4 (APOE4) allele is a well-known risk factor in Alzheimer’s disease (AD), whether a similar risk holds true for Parkinson’s disease (PD) is currently not known. To investigate whether apoE pathology is present in PD, an immunohistochemical study was undertaken with fixed, human PD brain sections from the substantia nigra utilizing a recently characterized antibody that detects an amino-terminal fragment of apoE. This antibody, termed the apoE cleavage fragment p17 (nApoECFp17) antibody specifically detects an amino-terminal 17 kDa fragment of apoE without reacting with full-length forms of the protein. Application of this antibody revealed the presence of this fragment in Lewy bodies in all cases examined. Colocalization of nApoECFp17 with an antibody to alpha-synuclein (α-Syn), which served as a general marker for Lewy bodies, indicated the presence of this apoE fragment in 87.5% of all identified Lewy bodies. In addition, localization of nApoECFp17 was also evident within oligodendrocytes, the nucleus of melatonin-containing neurons, and blood vessels. Conversely, little staining was observed in the substantia nigra from Pick’s disease or in the frontal cortex of dementia with Lewy bodies (DLB) cases, suggesting a specificity for nApoECFp17 immunoreactivity in PD. Collectively, these data have identified widespread evidence for apoE fragmentation in the human PD brain and documented for the first time the presence of apoE within Lewy bodies, the major pathological marker for this neurodegenerative disease.
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Affiliation(s)
- Troy T Rohn
- Department of Biological Sciences, Boise State University, USA
| | - Jacob M Mack
- Department of Biological Sciences, Boise State University, USA
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Tanhapour M, Miri A, Vaisi-Raygani A, Bahrehmand F, Kiani A, Rahimi Z, Pourmotabbed T, Shakiba E. Synergism between apolipoprotein E Ɛ4 allele and paraoxonase (PON1) 55-M allele is associated with risk of systemic lupus erythematosus. Clin Rheumatol 2017; 37:971-977. [PMID: 29273831 DOI: 10.1007/s10067-017-3859-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 08/19/2017] [Accepted: 09/27/2017] [Indexed: 12/18/2022]
Abstract
Evidences indicate that abnormal lipid metabolism and lipid peroxidation can affect the progression of complications in systemic lupus erythematosus (SLE) patients. Apolipoprotein E (ApoE) and paraoxonase-1 (PON1) play important role in lipid metabolism and protection of lipid peroxidation. The polymorphisms of ApoE and paraoxonase (PON1) L55M (Met < Leu) allele genes lead to disorders in lipid metabolism and are related to atherosclerosis. This study is the first investigation to examine the possible association between ApoE and PON1-L55M polymorphisms and correlation with serum arylesterase (ARE) activities of PON, levels of malondialdehyde (MDA), neopterin, and lipid lipoprotein in SLE patients from Iranian western population. The present case-control study consisted of 107 SLE patients and 101 gender- and age-matched, unrelated, healthy controls from Iran's western population. The ApoE and PON1-L55M genotypes were identified using PCR-RFLP method. The serum level of MDA, neopterin, lipid levels, and ARE activity were determined by HPLC, commercial kits, and spectrophotometry, respectively. Our results showed that ApoE ε4 and PON1-55M alleles act synergistically to increase the risk of SLE by 1.47 times (p = 0.038). We found that the frequency of ApoE Ɛ3/Ɛ4 genotype was higher in SLE patients (11.2%) compared with control subjects (5%), although the difference was not significant (p = 0.087). This study for the first time not only demonstrates that ApoE Ɛ4 and PON-55M alleles synergistically increase the risk of SLE but also reveals that serum levels of MDA, neopterin, and LDL-C are high in SLE patients. This information may be in value for evaluating SLE progression and in the elucidation of the mechanisms of the disease pathogenesis.
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Affiliation(s)
- Maryam Tanhapour
- Fertility and Infertility Research Center, School of Medicine, Kermanshah University of Medical Sciences, Daneshgah Avenue, PO Box 6714869914, Kermanshah, Iran
| | - Ali Miri
- Department of Clinical Biochemistry, Kermanshah University of Medical Sciences, Daneshgah Avenue, PO Box 6714869914, Kermanshah, Iran
| | - Asad Vaisi-Raygani
- Fertility and Infertility Research Center, School of Medicine, Kermanshah University of Medical Sciences, Daneshgah Avenue, PO Box 6714869914, Kermanshah, Iran.
- Department of Clinical Biochemistry, Kermanshah University of Medical Sciences, Daneshgah Avenue, PO Box 6714869914, Kermanshah, Iran.
| | - Fariborz Bahrehmand
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amir Kiani
- Department of Toxicology and Pharmacology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zohreh Rahimi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Tayebeh Pourmotabbed
- Department of Microbiology, Immunology and Biochemistry, University of Tennessee, Health Science Center, Knoxville, TN, USA
| | - Ebrahim Shakiba
- Department of Clinical Biochemistry, Kermanshah University of Medical Sciences, Daneshgah Avenue, PO Box 6714869914, Kermanshah, Iran.
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Fagan ES, Pihlstrøm L. Genetic risk factors for cognitive decline in Parkinson's disease: a review of the literature. Eur J Neurol 2017; 24:561-e20. [DOI: 10.1111/ene.13258] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 01/11/2017] [Indexed: 01/18/2023]
Affiliation(s)
- E. S. Fagan
- Institute of Clinical Medicine; University of Oslo; Oslo Norway
| | - L. Pihlstrøm
- Institute of Clinical Medicine; University of Oslo; Oslo Norway
- Department of Neurology; Oslo University Hospital; Oslo Norway
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Al-Rayes H, Huraib G, Julkhuf S, Arfin M, Tariq M, Al-Asmari A. Apolipoprotein E Gene Polymorphisms in Saudi Patients with Systemic Lupus Erythematosus. CLINICAL MEDICINE INSIGHTS-ARTHRITIS AND MUSCULOSKELETAL DISORDERS 2016; 9:81-7. [PMID: 27257397 PMCID: PMC4877081 DOI: 10.4137/cmamd.s38090] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 01/28/2016] [Accepted: 01/30/2016] [Indexed: 01/29/2023]
Abstract
Apolipoprotein E (APOE) is a glycosylated protein with multiple biological properties. APOE gene polymorphism plays a central role in lipid metabolism and has recently been suggested to regulate inflammation. Our objective is to evaluate whether APOE polymorphism affects susceptibility to SLE. APOE genotyping was performed using ApoE StripAssay™ kit. Results indicated significantly higher frequencies of allele ε4 and genotype ε3/ε4 and lower frequencies of allele ε3 and genotype ε3/ε3 in SLE patients than controls. APOE ε2 allele was found in three patients, whereas it was absent in controls. The frequencies of allele ε4 and genotype ε3/ε4 were significantly higher in SLE patients with renal involvement and those of alleles ε2, ε4 and genotypes ε2/ε3, ε3/ε4 were higher in patients with neuropsychiatric symptoms. It is concluded that APOE allele ε4 is associated with susceptibility risk/clinical manifestations of SLE and ε2 may increase its severity while ε3 is protective for SLE in Saudis.
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Affiliation(s)
- Hannan Al-Rayes
- Department of Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ghaleb Huraib
- Medical Services Department, Ministry of Defence, Riyadh, Saudi Arabia
| | - Saeed Julkhuf
- Medical Services Department, Ministry of Defence, Riyadh, Saudi Arabia
| | - Misbahul Arfin
- Research Centre, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mohammad Tariq
- Research Centre, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Kim HJ, Jeon B. How close are we to individualized medicine for Parkinson's disease? Expert Rev Neurother 2016; 16:815-30. [PMID: 27105072 DOI: 10.1080/14737175.2016.1182021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
INTRODUCTION There is a considerable inter-individual heterogeneity in clinical features, disease course, and treatment response in Parkinson's disease (PD), which can be explained not only by disease process and clinical variables, but also by an impact from genetic factors. Evidence-based medicine relies on large randomized control trials and meta-analysis-average medicine, which ignores individual differences. However, we are now in the early phases of a paradigm shift in medicine relating to individuality and variability. The purpose of individualized medicine is to predict patients' responses to targeted therapy using diagnostic tests based on genetics or other molecular mechanisms, thus providing the right drug at the right dose at the right time. AREAS COVERED In this article, we outline current state of individualized medicine for PD. Expert Commentary: Pharmacogenomics, an important element of individualized medicine, is just beginning to be considered in PD. To advance the clinical use of pharmacogenomics, big data cohort for genomic research and multidisciplinary team approaches are necessary.
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Affiliation(s)
- Hee Jin Kim
- a Department of Neurology , Konkuk University Medical Center , Seoul , South Korea.,b Parkinson Disease Study Group , Seoul National University Hospital , Seoul , South Korea
| | - Beomseok Jeon
- a Department of Neurology , Konkuk University Medical Center , Seoul , South Korea.,c Department of Neurology and Movement Disorder Center, College of Medicine , Seoul National University , Seoul , South Korea
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