The Relation between Apolipoprotein A-I and Dementia: The Honolulu-Asia Aging Study

University of Hawaiʻi at Mānoa, Honolulu, Hawaii, United States
American Journal of Epidemiology (Impact Factor: 5.23). 06/2007; 165(9):985-92. DOI: 10.1093/aje/kwm027
Source: PubMed


The association between apolipoproteins and neurodegeneration is unclear. The authors examined the association of dementia
with serum levels of apolipoprotein A-I (ApoA-I) alone and in combination with the apolipoprotein E genotype (ApoE). Subjects were Japanese-American men in Hawaii followed since 1965 in the Honolulu Heart Program cohort and the Honolulu-Asia
Aging Study. Lipid levels were assessed in 1980–1982. Dementia was diagnosed in 1991–1993, 1994–1996, and 1997–1999 by using
a multistep procedure and international guidelines. The sample consisted of 929 men (107 dementia cases). The relation between
ApoA-I and dementia was examined by using Cox proportional hazards models adjusted for age, education, and cardiovascular
risk factors. Compared with men in the lowest quartile, men in the highest quartile of ApoA-I concentration had a significantly
lower risk of dementia (hazard ratio = 0.25, 95% confidence interval: 0.08, 0.78). Compared with men with both risk factors,
those with a high ApoA-I concentration and no ApoE ε4 had a significantly lower risk of dementia (hazard ratio = 0.21, 95% confidence interval: 0.08, 0.52). Previous work has
demonstrated an inverse relation between ApoA-I and cardiovascular disease, and the authors extended these findings to the
risk of dementia. These results raise the possibility that different lipoprotein components of cholesterol may be differentially
associated with dementia.

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    • "Serum apoA-I levels positively correlate with Mini- Mental State Examination (MMSE) and Cognitive Ability Screening Instrument (CASI) scores at mid-life in cognitively normal and AD subjects [42,43]. High mid-life serum apoA-I levels significantly lower dementia risk decades later (hazard ratio (HR) 0.25) [44], and high serum HDL-C levels (N 55 mg/dL) in cognitively normal elderly are associated with a significantly reduced risk (HR 0.4) for AD even after adjusting for vascular risk factors and APOE, a major AD genetic risk factor [45]. Conversely, low plasma HDL-C and apoA-I levels are associated with and predict higher amyloid Pittsburgh compound B binding independent of APOE in cognitively normal and mild cognitive impairment (MCI) elderly subjects [46]. "
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    ABSTRACT: Many lines of evidence suggest a protective role for high-density lipoprotein (HDL) and its major apolipoprotein (apo)A-I in Alzheimer's Disease (AD). HDL/apoA-I particles are produced by the liver and intestine and, in addition to removing excess cholesterol from the body, are increasingly recognized to have vasoprotective functions. Here we tested the ability of reconstituted HDL (rHDL) consisting of human apoA-I reconstituted with soy phosphatidylcholine for its ability to lower amyloid beta (Aβ) levels in symptomatic APP/PS1 mice, a well-characterized preclinical model of amyloidosis. Animals were treated intravenously either with four weekly doses (chronic study) or a single dose of 60mg/kg of rHDL (acute study). The major finding of our acute study is that soluble brain Aβ40 and Aβ42 levels were significantly reduced within 24h of a single dose of rHDL. By contrast, no changes were observed in our chronic study with respect to soluble or deposited Aβ levels in animals assessed 7days after the final weekly dose of rHDL, suggesting that beneficial effects diminish as rHDL is cleared from the body. Further, rHDL-treated animals showed no change in amyloid burden, cerebrospinal fluid (CSF) Aβ levels, neuroinflammation, or endothelial activation in the chronic study, suggesting that the pathology-modifying effects of rHDL may indeed be acute and may be specific to the soluble Aβ pool. That systemic administration of rHDL can acutely modify brain Aβ levels provides support for further investigation of the therapeutic potential of apoA-I-based agents for AD.
    Full-text · Article · Oct 2015 · Biochimica et Biophysica Acta
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    • "Greater ↑FA was associated with decreases in serum ApoA1 between Time 1 and Time 3 while greater ↓FA was associated with increases in serum ApoA1 (Figure 5). Although low serum ApoA1 levels are believed to increase the risk of dementia [38], [39], their relationship to post-TBI neurodegeneration has yet to be determined. "
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    ABSTRACT: Repetitive head impacts (RHI) sustained in contact sports are thought to be necessary for the long-term development of chronic traumatic encephalopathy (CTE). Our objectives were to: 1) characterize the magnitude and persistence of RHI-induced white matter (WM) changes; 2) determine their relationship to kinematic measures of RHI; and 3) explore their clinical relevance. Prospective, observational study of 10 Division III college football players and 5 non-athlete controls during the 2011-12 season. All subjects underwent diffusion tensor imaging (DTI), physiologic, cognitive, and balance testing at pre-season (Time 1), post-season (Time 2), and after 6-months of no-contact rest (Time 3). Head impact measures were recorded using helmet-mounted accelerometers. The percentage of whole-brain WM voxels with significant changes in fractional anisotropy (FA) and mean diffusivity (MD) from Time 1 to 2, and Time 1 to 3 was determined for each subject and correlated to head impacts and clinical measures. Total head impacts for the season ranged from 431-1,850. No athlete suffered a clinically evident concussion. Compared to controls, athletes experienced greater changes in FA and MD from Time 1 to 2 as well as Time 1 to 3; most differences at Time 2 persisted to Time 3. Among athletes, the percentage of voxels with decreased FA from Time 1 to 2 was positively correlated with several helmet impact measures. The persistence of WM changes from Time 1 to 3 was also associated with changes in serum ApoA1 and S100B autoantibodies. WM changes were not consistently associated with cognition or balance. A single football season of RHIs without clinically-evident concussion resulted in WM changes that correlated with multiple helmet impact measures and persisted following 6 months of no-contact rest. This lack of WM recovery could potentially contribute to cumulative WM changes with subsequent RHI exposures.
    Full-text · Article · Apr 2014 · PLoS ONE
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    • "In addition to its role in lipid homeostasis, apoA-I has been recently shown to exhibit antioxidant and anti-inflammatory properties [5] and to inhibit the aggregation and neurotoxicity of the amyloid-β peptide, the main neurotoxin in Alzheimer's disease [6]. Although the possible association between apolipoproteins and neurodegeneration is unclear, increasing apoA-I concentrations have been reported to correlate with decreasing risk of dementia [7], raising the possibility of a novel role of apoA-I in physiological mechanisms of protection against neurological disorders. "
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    ABSTRACT: Amyloidoses constitute a group of diseases in which soluble proteins aggregate and deposit extracellularly in tissues. Nonhereditary apolipoprotein A-I (apoA-I) amyloid is characterized by deposits of nonvariant protein in atherosclerotic arteries. Despite being common, little is known about the pathogenesis and significance of apoA-I deposition. In this work we investigated by fluorescence and biochemical approaches the impact of a cellular microenvironment associated with chronic inflammation on the folding and pro-amyloidogenic processing of apoA-I. Results showed that mildly acidic pH promotes misfolding, aggregation, and increased binding of apoA-I to extracellular matrix elements, thus favoring protein deposition as amyloid like-complexes. In addition, activated neutrophils and oxidative/proteolytic cleavage of the protein give rise to pro amyloidogenic products. We conclude that, even though apoA-I is not inherently amyloidogenic, it may produce non hereditary amyloidosis as a consequence of the pro-inflammatory microenvironment associated to atherogenesis.
    Full-text · Article · Jul 2011 · PLoS ONE
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