Central Nervous System Lipoproteins: ApoE and Regulation of Cholesterol Metabolism

Arterioscler Thromb Vasc Biol. 2016 Jul;36(7):1305-15. doi: 10.1161/ATVBAHA.116.307023. Epub 2016 May 12.


ApoE on high-density lipoproteins is primarily responsible for lipid transport and cholesterol homeostasis in the central nervous system (CNS). Normally produced mostly by astrocytes, apoE is also produced under neuropathologic conditions by neurons. ApoE on high-density lipoproteins is critical in redistributing cholesterol and phospholipids for membrane repair and remodeling. The 3 main structural isoforms differ in their effectiveness. Unlike apoE2 and apoE3, apoE4 has markedly altered CNS metabolism, is associated with Alzheimer disease and other neurodegenerative disorders, and is expressed at lower levels in brain and cerebrospinal fluid. ApoE4-expressing cultured astrocytes and neurons have reduced cholesterol and phospholipid secretion, decreased lipid-binding capacity, and increased intracellular degradation. Two structural features are responsible for apoE4 dysfunction: domain interaction, in which arginine-61 interacts ionically with glutamic acid-255, and a less stable conformation than apoE3 and apoE2. Blocking domain interaction by gene targeting (replacing arginine-61 with threonine) or by small-molecule structure correctors increases CNS apoE4 levels and lipid-binding capacity and decreases intracellular degradation. Small molecules (drugs) that disrupt domain interaction, so-called structure correctors, could prevent the apoE4-associated neuropathology by blocking the formation of neurotoxic fragments. Understanding how to modulate CNS cholesterol transport and metabolism is providing important insights into CNS health and disease.

Keywords: Alzheimer disease; apolipoproteins E; astrocytes; cholesterol; lipoproteins, HDL; neurodegenerative diseases; receptors, LDL.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alzheimer Disease / metabolism
  • Animals
  • Apolipoproteins E / cerebrospinal fluid
  • Apolipoproteins E / chemistry
  • Apolipoproteins E / metabolism*
  • Astrocytes / metabolism*
  • Astrocytes / pathology
  • Biological Transport
  • Central Nervous System / metabolism*
  • Central Nervous System / pathology
  • Central Nervous System / physiopathology
  • Cholesterol / cerebrospinal fluid
  • Cholesterol / metabolism*
  • Humans
  • Models, Animal
  • Nerve Degeneration
  • Neurodegenerative Diseases / metabolism*
  • Neurodegenerative Diseases / pathology
  • Neurodegenerative Diseases / physiopathology
  • Neurons / metabolism*
  • Neurons / pathology
  • Protein Binding
  • Protein Interaction Domains and Motifs


  • Apolipoproteins E
  • Cholesterol