Apolipoprotein E potently inhibits ferroptosis by blocking ferritinophagy

Allelic variation to the APOE gene confers the greatest genetic risk for sporadic Alzheimer’s disease (AD). Independent of genotype, low abundance of apolipoprotein E (apoE), is characteristic of AD CSF, and predicts cognitive decline. The mechanisms underlying the genotype and apoE level risks are...

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Published inMolecular psychiatry Vol. 29; no. 2; pp. 211 - 220
Main Authors Belaidi, Abdel Ali, Masaldan, Shashank, Southon, Adam, Kalinowski, Pawel, Acevedo, Karla, Appukuttan, Ambili T., Portbury, Stuart, Lei, Peng, Agarwal, Puja, Leurgans, Sue E., Schneider, Julie, Conrad, Marcus, Bush, Ashley I., Ayton, Scott
Format Journal Article
LanguageEnglish
Published London Nature Publishing Group UK 01.02.2024
Nature Publishing Group
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ISSN1359-4184
1476-5578
1476-5578
DOI10.1038/s41380-022-01568-w

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Abstract Allelic variation to the APOE gene confers the greatest genetic risk for sporadic Alzheimer’s disease (AD). Independent of genotype, low abundance of apolipoprotein E (apoE), is characteristic of AD CSF, and predicts cognitive decline. The mechanisms underlying the genotype and apoE level risks are uncertain. Recent fluid and imaging biomarker studies have revealed an unexpected link between apoE and brain iron, which also forecasts disease progression, possibly through ferroptosis, an iron-dependent regulated cell death pathway. Here, we report that apoE is a potent inhibitor of ferroptosis (EC 50  ≈ 10 nM; N27 neurons). We demonstrate that apoE signals to activate the PI3K/AKT pathway that then inhibits the autophagic degradation of ferritin (ferritinophagy), thus averting iron-dependent lipid peroxidation. Using postmortem inferior temporal brain cortex tissue from deceased subjects from the Rush Memory and Aging Project (MAP) ( N  = 608), we found that the association of iron with pathologically confirmed clinical Alzheimer’s disease was stronger among those with the adverse APOE -ε4 allele. While protection against ferroptosis did not differ between apoE isoforms in vitro, other features of ε4 carriers, such as low abundance of apoE protein and higher levels of polyunsaturated fatty acids (which fuel ferroptosis) could mediate the ε4 allele’s heighted risk of AD. These data support ferroptosis as a putative pathway to explain the major genetic risk associated with late onset AD.
AbstractList Allelic variation to the APOE gene confers the greatest genetic risk for sporadic Alzheimer’s disease (AD). Independent of genotype, low abundance of apolipoprotein E (apoE), is characteristic of AD CSF, and predicts cognitive decline. The mechanisms underlying the genotype and apoE level risks are uncertain. Recent fluid and imaging biomarker studies have revealed an unexpected link between apoE and brain iron, which also forecasts disease progression, possibly through ferroptosis, an iron-dependent regulated cell death pathway. Here, we report that apoE is a potent inhibitor of ferroptosis (EC 50  ≈ 10 nM; N27 neurons). We demonstrate that apoE signals to activate the PI3K/AKT pathway that then inhibits the autophagic degradation of ferritin (ferritinophagy), thus averting iron-dependent lipid peroxidation. Using postmortem inferior temporal brain cortex tissue from deceased subjects from the Rush Memory and Aging Project (MAP) ( N  = 608), we found that the association of iron with pathologically confirmed clinical Alzheimer’s disease was stronger among those with the adverse APOE -ε4 allele. While protection against ferroptosis did not differ between apoE isoforms in vitro, other features of ε4 carriers, such as low abundance of apoE protein and higher levels of polyunsaturated fatty acids (which fuel ferroptosis) could mediate the ε4 allele’s heighted risk of AD. These data support ferroptosis as a putative pathway to explain the major genetic risk associated with late onset AD.
Allelic variation to the APOE gene confers the greatest genetic risk for sporadic Alzheimer's disease (AD). Independent of genotype, low abundance of apolipoprotein E (apoE), is characteristic of AD CSF, and predicts cognitive decline. The mechanisms underlying the genotype and apoE level risks are uncertain. Recent fluid and imaging biomarker studies have revealed an unexpected link between apoE and brain iron, which also forecasts disease progression, possibly through ferroptosis, an iron-dependent regulated cell death pathway. Here, we report that apoE is a potent inhibitor of ferroptosis (EC50 ≈ 10 nM; N27 neurons). We demonstrate that apoE signals to activate the PI3K/AKT pathway that then inhibits the autophagic degradation of ferritin (ferritinophagy), thus averting iron-dependent lipid peroxidation. Using postmortem inferior temporal brain cortex tissue from deceased subjects from the Rush Memory and Aging Project (MAP) (N = 608), we found that the association of iron with pathologically confirmed clinical Alzheimer's disease was stronger among those with the adverse APOE-ε4 allele. While protection against ferroptosis did not differ between apoE isoforms in vitro, other features of ε4 carriers, such as low abundance of apoE protein and higher levels of polyunsaturated fatty acids (which fuel ferroptosis) could mediate the ε4 allele's heighted risk of AD. These data support ferroptosis as a putative pathway to explain the major genetic risk associated with late onset AD.Allelic variation to the APOE gene confers the greatest genetic risk for sporadic Alzheimer's disease (AD). Independent of genotype, low abundance of apolipoprotein E (apoE), is characteristic of AD CSF, and predicts cognitive decline. The mechanisms underlying the genotype and apoE level risks are uncertain. Recent fluid and imaging biomarker studies have revealed an unexpected link between apoE and brain iron, which also forecasts disease progression, possibly through ferroptosis, an iron-dependent regulated cell death pathway. Here, we report that apoE is a potent inhibitor of ferroptosis (EC50 ≈ 10 nM; N27 neurons). We demonstrate that apoE signals to activate the PI3K/AKT pathway that then inhibits the autophagic degradation of ferritin (ferritinophagy), thus averting iron-dependent lipid peroxidation. Using postmortem inferior temporal brain cortex tissue from deceased subjects from the Rush Memory and Aging Project (MAP) (N = 608), we found that the association of iron with pathologically confirmed clinical Alzheimer's disease was stronger among those with the adverse APOE-ε4 allele. While protection against ferroptosis did not differ between apoE isoforms in vitro, other features of ε4 carriers, such as low abundance of apoE protein and higher levels of polyunsaturated fatty acids (which fuel ferroptosis) could mediate the ε4 allele's heighted risk of AD. These data support ferroptosis as a putative pathway to explain the major genetic risk associated with late onset AD.
Allelic variation to the APOE gene confers the greatest genetic risk for sporadic Alzheimer’s disease (AD). Independent of genotype, low abundance of apolipoprotein E (apoE), is characteristic of AD CSF, and predicts cognitive decline. The mechanisms underlying the genotype and apoE level risks are uncertain. Recent fluid and imaging biomarker studies have revealed an unexpected link between apoE and brain iron, which also forecasts disease progression, possibly through ferroptosis, an iron-dependent regulated cell death pathway. Here, we report that apoE is a potent inhibitor of ferroptosis (EC50 ≈ 10 nM; N27 neurons). We demonstrate that apoE signals to activate the PI3K/AKT pathway that then inhibits the autophagic degradation of ferritin (ferritinophagy), thus averting iron-dependent lipid peroxidation. Using postmortem inferior temporal brain cortex tissue from deceased subjects from the Rush Memory and Aging Project (MAP) (N = 608), we found that the association of iron with pathologically confirmed clinical Alzheimer’s disease was stronger among those with the adverse APOE-ε4 allele. While protection against ferroptosis did not differ between apoE isoforms in vitro, other features of ε4 carriers, such as low abundance of apoE protein and higher levels of polyunsaturated fatty acids (which fuel ferroptosis) could mediate the ε4 allele’s heighted risk of AD. These data support ferroptosis as a putative pathway to explain the major genetic risk associated with late onset AD.
Allelic variation to the APOE gene confers the greatest genetic risk for sporadic Alzheimer’s disease (AD). Independent of genotype, low abundance of apolipoprotein E (apoE), is characteristic of AD CSF, and predicts cognitive decline. The mechanisms underlying the genotype and apoE level risks are uncertain. Recent fluid and imaging biomarker studies have revealed an unexpected link between apoE and brain iron, which also forecasts disease progression, possibly through ferroptosis, an iron-dependent regulated cell death pathway. Here, we report that apoE is a potent inhibitor of ferroptosis (EC 50 ≈10 nM; N27 neurons). We demonstrate that apoE signals to activate the PI3K/AKT pathway that then inhibits the autophagic degradation of ferritin (ferritinophagy), thus averting iron-dependent lipid peroxidation. Using postmortem inferior temporal brain cortex tissue from deceased subjects from the Rush Memory and Aging Project (MAP) (N=608), we found that the association of iron with pathologically confirmed clinical Alzheimer’s disease that was stronger among those with the adverse APOE -ε4 allele. While protection against ferroptosis did not differ between apoE isoforms in vitro , other features of ε4 carriers, such as low abundance of apoE protein and higher levels of polyunsaturated fatty acids (which fuel ferroptosis) could mediate the ε4 allele’s heighted risk of AD. These data support ferroptosis as a putative pathway to explain the major genetic risk associated with late onset AD.
Allelic variation to the APOE gene confers the greatest genetic risk for sporadic Alzheimer's disease (AD). Independent of genotype, low abundance of apolipoprotein E (apoE), is characteristic of AD CSF, and predicts cognitive decline. The mechanisms underlying the genotype and apoE level risks are uncertain. Recent fluid and imaging biomarker studies have revealed an unexpected link between apoE and brain iron, which also forecasts disease progression, possibly through ferroptosis, an iron-dependent regulated cell death pathway. Here, we report that apoE is a potent inhibitor of ferroptosis (EC  ≈ 10 nM; N27 neurons). We demonstrate that apoE signals to activate the PI3K/AKT pathway that then inhibits the autophagic degradation of ferritin (ferritinophagy), thus averting iron-dependent lipid peroxidation. Using postmortem inferior temporal brain cortex tissue from deceased subjects from the Rush Memory and Aging Project (MAP) (N = 608), we found that the association of iron with pathologically confirmed clinical Alzheimer's disease was stronger among those with the adverse APOE-ε4 allele. While protection against ferroptosis did not differ between apoE isoforms in vitro, other features of ε4 carriers, such as low abundance of apoE protein and higher levels of polyunsaturated fatty acids (which fuel ferroptosis) could mediate the ε4 allele's heighted risk of AD. These data support ferroptosis as a putative pathway to explain the major genetic risk associated with late onset AD.
Author Agarwal, Puja
Kalinowski, Pawel
Ayton, Scott
Masaldan, Shashank
Lei, Peng
Conrad, Marcus
Bush, Ashley I.
Southon, Adam
Schneider, Julie
Acevedo, Karla
Leurgans, Sue E.
Appukuttan, Ambili T.
Belaidi, Abdel Ali
Portbury, Stuart
AuthorAffiliation 4 Helmholtz Zentrum München, Institute of Metabolism and Cell Death, 85764 Neuherberg, Germany; Pirogov Russian National Research Medical University, Laboratory of Experimental Oncology, Moscow 117997, Russia
2 Department of Neurology and State Key Laboratory of Biotherapy, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
3 Rush Alzheimer Disease Center, Rush University Medical Center, Chicago, USA
1 Melbourne Dementia Research Centre, Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria 3052, Australia
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/35484240$$D View this record in MEDLINE/PubMed
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Mon Jul 21 10:04:35 EDT 2025
Fri Jul 25 09:11:57 EDT 2025
Mon Jul 21 05:27:38 EDT 2025
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Tue Jul 01 00:21:57 EDT 2025
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Equal contribution
AAB, AIB and SA designed and funded the study, contributed to acquisition and analysis of data and wrote the manuscript. SM, AS, PK, KA, ATA, SP, PL, PA, SEL, JS, MC contributed to acquisition and analysis of data and reviewed the manuscript.
Authors contributions
ORCID 0000-0003-0792-8728
0000-0002-3479-2427
0000-0002-0274-6653
0000-0003-1140-5612
0000-0003-4960-4983
0000-0003-2536-1665
0000-0001-8259-9069
0000-0001-5652-1962
OpenAccessLink https://www.nature.com/articles/s41380-022-01568-w
PMID 35484240
PQID 3059116780
PQPubID 44096
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ParticipantIDs pubmedcentral_primary_oai_pubmedcentral_nih_gov_9757994
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crossref_citationtrail_10_1038_s41380_022_01568_w
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  day: 01
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PublicationTitle Molecular psychiatry
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Nature Publishing Group
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Snippet Allelic variation to the APOE gene confers the greatest genetic risk for sporadic Alzheimer’s disease (AD). Independent of genotype, low abundance of...
Allelic variation to the APOE gene confers the greatest genetic risk for sporadic Alzheimer's disease (AD). Independent of genotype, low abundance of...
Allelic variation to the APOE gene confers the greatest genetic risk for sporadic Alzheimer’s disease (AD). Independent of genotype, low abundance of...
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StartPage 211
SubjectTerms 1-Phosphatidylinositol 3-kinase
13/1
13/106
13/109
13/51
14/63
631/378
692/699
82/80
82/83
96/31
Aged
Aged, 80 and over
AKT protein
Alleles
Alzheimer Disease - genetics
Alzheimer Disease - metabolism
Alzheimer's disease
Animals
Apolipoprotein E
Apolipoprotein E4 - genetics
Apolipoprotein E4 - metabolism
Apolipoproteins
Apolipoproteins E - genetics
Apolipoproteins E - metabolism
Autophagy
Autopsy
Behavioral Sciences
Biological Psychology
Brain - metabolism
Cell death
Cerebrospinal fluid
Cognitive ability
Female
Ferritin
Ferritins - metabolism
Ferroptosis
Ferroptosis - drug effects
Ferroptosis - physiology
Genotype
Genotypes
Health risk assessment
Humans
Iron
Iron - metabolism
Isoforms
Lipid peroxidation
Lipid Peroxidation - drug effects
Male
Medicine
Medicine & Public Health
Neurodegenerative diseases
Neuroimaging
Neurons - metabolism
Neurosciences
Pharmacotherapy
Polyunsaturated fatty acids
Psychiatry
Temporal lobe
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Title Apolipoprotein E potently inhibits ferroptosis by blocking ferritinophagy
URI https://link.springer.com/article/10.1038/s41380-022-01568-w
https://www.ncbi.nlm.nih.gov/pubmed/35484240
https://www.proquest.com/docview/3059116780
https://www.proquest.com/docview/2658232722
https://pubmed.ncbi.nlm.nih.gov/PMC9757994
Volume 29
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