Abstract

The role of high-density lipoproteins (HDL) in the cardiovascular system has been extensively studied and the cardioprotective effects of HDL are well established. As HDL particles are formed both in the systemic circulation and in the central nervous system, the role of HDL and its associated apolipoproteins in the brain has attracted much research interest in recent years. Alzheimer’s disease (AD) is the most prevalent neurodegenerative disorder and the leading cause of dementia worldwide, for which there currently exists no approved disease modifying treatment. Multiple lines of evidence, including a number of large-scale human clinical studies, have shown a robust connection between HDL levels and AD. Low levels of HDL are associated with increased risk and severity of AD, whereas high levels of HDL are correlated with superior cognitive function. Although the mechanisms underlying the protective effects of HDL in the brain are not fully understood, many of the functions of HDL, including reverse lipid/cholesterol transport, anti-inflammation/immune modulation, anti-oxidation, microvessel endothelial protection, and proteopathy modification, are thought to be critical for its beneficial effects. This review describes the current evidence for the role of HDL in AD and the potential of using small peptides mimicking HDL or its associated apolipoproteins (HDL-mimetic peptides) as therapeutics to treat AD.

Highlights

  • Alzheimer’s disease (AD) is a progressive, age-related neurodegenerative disorder

  • As a major apolipoprotein involved in maintaining lipid/cholesterol homeostasis and cardiovascular health, APOE has ignited research into the connections between cardiovascular disease and AD, and raised the possibility that therapeutic strategies developed for preventing atherosclerosis may be repurposed to mitigate AD

  • Among all three APOE isoforms, APOE2 and APOE3 are preferentially associated with high-density lipoproteins (HDL) while APOE4 with LDL and VLDL, lipoproteins that are strongly associated with cardiovascular diseases and AD [65,66]

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Summary

Introduction

Alzheimer’s disease (AD) is a progressive, age-related neurodegenerative disorder. AD is characterized by the presence in the brain of amyloid-β (Aβ) deposited in senile plaques and cerebral vessels, neurofibrillary tangles, and eventually the loss of neurons [1]. While aging is the primary contributor to the development of AD, inheritance of the apolipoprotein (APO) E4 gene was identified as the strongest genetic risk factor for sporadic, late onset AD [4,5,6], which has been confirmed by meta-analyses of many studies [7,8,9]. As a major apolipoprotein involved in maintaining lipid/cholesterol homeostasis and cardiovascular health, APOE has ignited research into the connections between cardiovascular disease and AD, and raised the possibility that therapeutic strategies developed for preventing atherosclerosis may be repurposed to mitigate AD

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