Document Detail


Apolipoprotein E genotype and cerebral amyloid angiopathy-related hemorrhage.
MedLine Citation:
PMID:  10818505     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Following the identification of the role of the apolipoprotein E (APOE) gene polymorphism in Alzheimer's disease (AD), this gene was examined in cerebral amyloid angiopathy (CAA). As in AD, the APOE epsilon 4 allele was found to be associated with CAA. Lobar intracerebral hemorrhage is the major clinical manifestation of CAA. Initial studies on a small number of patients with CAA-related hemorrhage (CAAH) identified overrepresentation of APOE epsilon 4. However, it became clear that confounding bias from concomitant AD and the need for pathologically confirmed cases of CAAH would also have to be considered. A larger series of pathologically confirmed cases of CAAH, also assessed for AD pathology, found a surprising overrepresentation of the APOE epsilon 2 allele. Because of the association between CAA and AD, it might have been predicted that patients with CAAH would have a low, rather than a high, epsilon 2 frequency. The overrepresentation of APOE epsilon 2 was present both in patients with and without AD, whereas a high epsilon 4 frequency correlated with concomitant AD. Further studies found that overrepresentation of APOE epsilon 2 is specific for CAAH and is not found in intracranial hemorrhages due to other causes. In CAAH, APOE epsilon 2 may interact with putative risk factors for hemorrhage, including antiplatelet/anticoagulant medication, minor head trauma, and hypertension. Several microvascular abnormalities in amyloid-laden blood vessels have been assumed to antedate CAAH and increase its likelihood. APOE epsilon 2 has now been found to be associated with some of these vascular abnormalities, specifically a "double-barrel" appearance and fibrinoid necrosis. The currently favored interpretation is that APOE epsilon 4 enhances deposition of amyloid-beta protein in the walls of cerebral blood vessels, whereas epsilon 2 is a risk factor for hemorrhage from amyloid-laden blood vessels by promoting specific "CAA-associated vasculopathies."
Authors:
M O McCarron; J A Nicoll
Related Documents :
12657975 - Mesenteric hemodynamic response to circulatory shock.
1188605 - The correlation of sequential changes in the distribution of pulmonary blood flow in he...
2209035 - Effect of blood transfusion on oxygen consumption in pediatric septic shock.
7719445 - Resuscitation with diaspirin crosslinked hemoglobin in a pig model of hemorrhagic shock.
3350395 - Reduced fibrinolytic potential in patients with arterial occlusive disease (aod) in com...
8249905 - The evaluation of a portable clinical analyzer in the emergency department.
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Annals of the New York Academy of Sciences     Volume:  903     ISSN:  0077-8923     ISO Abbreviation:  Ann. N. Y. Acad. Sci.     Publication Date:  2000 Apr 
Date Detail:
Created Date:  2000-06-02     Completed Date:  2000-06-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7506858     Medline TA:  Ann N Y Acad Sci     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  176-9     Citation Subset:  IM    
Affiliation:
Department of Neuropathology, University of Glasgow, Southern General Hospital NHS Trust, United Kingdom. mmc18f@clinmed.gla.ac.uk
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Alzheimer Disease / genetics
Apolipoprotein E2
Apolipoprotein E4
Apolipoproteins E / genetics*
Cerebral Amyloid Angiopathy / complications,  genetics*
Cerebral Hemorrhage / etiology,  genetics*
Genotype
Humans
Risk Factors
Chemical
Reg. No./Substance:
0/Apolipoprotein E2; 0/Apolipoprotein E4; 0/Apolipoproteins E

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Lipoproteins in the central nervous system.
Next Document:  Apolipoprotein E, smooth muscle cells and the pathogenesis of cerebral amyloid angiopathy: the poten...