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APOE associations with severe CAA-associated vasculopathic changes: collaborative meta-analysis

Objectives Cerebral amyloid angiopathy (CAA) is associated with lobar intracerebral haemorrhage (ICH). While only the ε4 allele of the apolipoprotein E (APOE) gene is associated with the presence of CAA, both APOE-ε4 and ε2 are associated with lobar ICH. The generally accepted explanation is that AP... Full description

Journal Title: Journal of neurology neurosurgery and psychiatry, 2014-03, Vol.85 (3), p.300-305
Main Author: Rannikmäe, Kristiina
Other Authors: Kalaria, Rajesh N , Greenberg, Steven M , Chui, Helena C , Schmitt, Frederick A , Samarasekera, Neshika , Al-Shahi Salman, Rustam , Sudlow, Cathie L M
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: England: BMJ Publishing Group Ltd
ID: ISSN: 0022-3050
Link: https://www.ncbi.nlm.nih.gov/pubmed/24163429
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title: APOE associations with severe CAA-associated vasculopathic changes: collaborative meta-analysis
format: Article
creator:
  • Rannikmäe, Kristiina
  • Kalaria, Rajesh N
  • Greenberg, Steven M
  • Chui, Helena C
  • Schmitt, Frederick A
  • Samarasekera, Neshika
  • Al-Shahi Salman, Rustam
  • Sudlow, Cathie L M
subjects:
  • Aged
  • Aged, 80 and over
  • Amyloidosis
  • Apolipoprotein E2 - genetics
  • Apolipoprotein E4 - genetics
  • Apolipoproteins
  • Apolipoproteins E
  • Apolipoproteins E - genetics
  • Article
  • Blood circulation disorders
  • Cerebral Amyloid Angiopathy
  • Cerebral Amyloid Angiopathy - complications
  • Cerebral Amyloid Angiopathy - genetics
  • Cerebral Amyloid Angiopathy - pathology
  • Cerebral Hemorrhage
  • Complications and side effects
  • Disease Progression
  • Female
  • Genetic Association Studies
  • Genotype
  • Humans
  • Influence
  • Intracranial Hemorrhages - etiology
  • Intracranial Hemorrhages - genetics
  • Male
  • Meta-analysis
  • Risk factors
  • Severity of Illness Index
  • Systematic Review
  • Usage
ispartof: Journal of neurology, neurosurgery and psychiatry, 2014-03, Vol.85 (3), p.300-305
description: Objectives Cerebral amyloid angiopathy (CAA) is associated with lobar intracerebral haemorrhage (ICH). While only the ε4 allele of the apolipoprotein E (APOE) gene is associated with the presence of CAA, both APOE-ε4 and ε2 are associated with lobar ICH. The generally accepted explanation is that APOE-ε4 promotes vascular amyloid deposition, while APOE-ε2 promotes progression to severe CAA with associated vasculopathic changes that cause vessel rupture and ICH. We assessed the evidence for these allele-specific effects. Methods We systematically identified published studies with data on APOE genotype and histopathological assessment of postmortem brains for CAA severity. We obtained unpublished data from these for meta-analyses of the effects of ε4-containing (ε4+) and ε2-containing (ε2+) genotypes on progression to severe CAA. Results Of six eligible studies (543 eligible participants), data were available from 5 (497 participants, 353 with CAA). Meta-analyses showed a possible association of ε4+ genotypes with severe CAA (ε4+ vs ε4−: severe vs mild/moderate CAA, OR 2.5, 95% CI 1.4 to 4.5, p=0.002; severe vs moderate CAA, OR 1.7, 95% CI 0.9 to 3.1, p=0.11). For ε2+ versus ε2− genotypes, there was no significant association, but the very small number of participants with ε2+ genotypes (22) precluded reliable estimates. Conclusions We found a possible association of severe CAA with APOE-ε4 but not APOE-ε2. However, our findings do not exclude a biologically meaningful association between APOE-ε2 and severe CAA. Further work is needed to elucidate fully the allele-specific associations of APOE with CAA and their mechanisms.
language: eng
source:
identifier: ISSN: 0022-3050
fulltext: no_fulltext
issn:
  • 0022-3050
  • 1468-330X
url: Link


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titleAPOE associations with severe CAA-associated vasculopathic changes: collaborative meta-analysis
creatorRannikmäe, Kristiina ; Kalaria, Rajesh N ; Greenberg, Steven M ; Chui, Helena C ; Schmitt, Frederick A ; Samarasekera, Neshika ; Al-Shahi Salman, Rustam ; Sudlow, Cathie L M
creatorcontribRannikmäe, Kristiina ; Kalaria, Rajesh N ; Greenberg, Steven M ; Chui, Helena C ; Schmitt, Frederick A ; Samarasekera, Neshika ; Al-Shahi Salman, Rustam ; Sudlow, Cathie L M
descriptionObjectives Cerebral amyloid angiopathy (CAA) is associated with lobar intracerebral haemorrhage (ICH). While only the ε4 allele of the apolipoprotein E (APOE) gene is associated with the presence of CAA, both APOE-ε4 and ε2 are associated with lobar ICH. The generally accepted explanation is that APOE-ε4 promotes vascular amyloid deposition, while APOE-ε2 promotes progression to severe CAA with associated vasculopathic changes that cause vessel rupture and ICH. We assessed the evidence for these allele-specific effects. Methods We systematically identified published studies with data on APOE genotype and histopathological assessment of postmortem brains for CAA severity. We obtained unpublished data from these for meta-analyses of the effects of ε4-containing (ε4+) and ε2-containing (ε2+) genotypes on progression to severe CAA. Results Of six eligible studies (543 eligible participants), data were available from 5 (497 participants, 353 with CAA). Meta-analyses showed a possible association of ε4+ genotypes with severe CAA (ε4+ vs ε4−: severe vs mild/moderate CAA, OR 2.5, 95% CI 1.4 to 4.5, p=0.002; severe vs moderate CAA, OR 1.7, 95% CI 0.9 to 3.1, p=0.11). For ε2+ versus ε2− genotypes, there was no significant association, but the very small number of participants with ε2+ genotypes (22) precluded reliable estimates. Conclusions We found a possible association of severe CAA with APOE-ε4 but not APOE-ε2. However, our findings do not exclude a biologically meaningful association between APOE-ε2 and severe CAA. Further work is needed to elucidate fully the allele-specific associations of APOE with CAA and their mechanisms.
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subjectAged ; Aged, 80 and over ; Amyloidosis ; Apolipoprotein E2 - genetics ; Apolipoprotein E4 - genetics ; Apolipoproteins ; Apolipoproteins E ; Apolipoproteins E - genetics ; Article ; Blood circulation disorders ; Cerebral Amyloid Angiopathy ; Cerebral Amyloid Angiopathy - complications ; Cerebral Amyloid Angiopathy - genetics ; Cerebral Amyloid Angiopathy - pathology ; Cerebral Hemorrhage ; Complications and side effects ; Disease Progression ; Female ; Genetic Association Studies ; Genotype ; Humans ; Influence ; Intracranial Hemorrhages - etiology ; Intracranial Hemorrhages - genetics ; Male ; Meta-analysis ; Risk factors ; Severity of Illness Index ; Systematic Review ; Usage
ispartofJournal of neurology, neurosurgery and psychiatry, 2014-03, Vol.85 (3), p.300-305
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1Kalaria, Rajesh N
2Greenberg, Steven M
3Chui, Helena C
4Schmitt, Frederick A
5Samarasekera, Neshika
6Al-Shahi Salman, Rustam
7Sudlow, Cathie L M
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descriptionObjectives Cerebral amyloid angiopathy (CAA) is associated with lobar intracerebral haemorrhage (ICH). While only the ε4 allele of the apolipoprotein E (APOE) gene is associated with the presence of CAA, both APOE-ε4 and ε2 are associated with lobar ICH. The generally accepted explanation is that APOE-ε4 promotes vascular amyloid deposition, while APOE-ε2 promotes progression to severe CAA with associated vasculopathic changes that cause vessel rupture and ICH. We assessed the evidence for these allele-specific effects. Methods We systematically identified published studies with data on APOE genotype and histopathological assessment of postmortem brains for CAA severity. We obtained unpublished data from these for meta-analyses of the effects of ε4-containing (ε4+) and ε2-containing (ε2+) genotypes on progression to severe CAA. Results Of six eligible studies (543 eligible participants), data were available from 5 (497 participants, 353 with CAA). Meta-analyses showed a possible association of ε4+ genotypes with severe CAA (ε4+ vs ε4−: severe vs mild/moderate CAA, OR 2.5, 95% CI 1.4 to 4.5, p=0.002; severe vs moderate CAA, OR 1.7, 95% CI 0.9 to 3.1, p=0.11). For ε2+ versus ε2− genotypes, there was no significant association, but the very small number of participants with ε2+ genotypes (22) precluded reliable estimates. Conclusions We found a possible association of severe CAA with APOE-ε4 but not APOE-ε2. However, our findings do not exclude a biologically meaningful association between APOE-ε2 and severe CAA. Further work is needed to elucidate fully the allele-specific associations of APOE with CAA and their mechanisms.
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16Disease Progression
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18Genetic Association Studies
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23Intracranial Hemorrhages - genetics
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0Rannikmäe, Kristiina
1Kalaria, Rajesh N
2Greenberg, Steven M
3Chui, Helena C
4Schmitt, Frederick A
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abstractObjectives Cerebral amyloid angiopathy (CAA) is associated with lobar intracerebral haemorrhage (ICH). While only the ε4 allele of the apolipoprotein E (APOE) gene is associated with the presence of CAA, both APOE-ε4 and ε2 are associated with lobar ICH. The generally accepted explanation is that APOE-ε4 promotes vascular amyloid deposition, while APOE-ε2 promotes progression to severe CAA with associated vasculopathic changes that cause vessel rupture and ICH. We assessed the evidence for these allele-specific effects. Methods We systematically identified published studies with data on APOE genotype and histopathological assessment of postmortem brains for CAA severity. We obtained unpublished data from these for meta-analyses of the effects of ε4-containing (ε4+) and ε2-containing (ε2+) genotypes on progression to severe CAA. Results Of six eligible studies (543 eligible participants), data were available from 5 (497 participants, 353 with CAA). Meta-analyses showed a possible association of ε4+ genotypes with severe CAA (ε4+ vs ε4−: severe vs mild/moderate CAA, OR 2.5, 95% CI 1.4 to 4.5, p=0.002; severe vs moderate CAA, OR 1.7, 95% CI 0.9 to 3.1, p=0.11). For ε2+ versus ε2− genotypes, there was no significant association, but the very small number of participants with ε2+ genotypes (22) precluded reliable estimates. Conclusions We found a possible association of severe CAA with APOE-ε4 but not APOE-ε2. However, our findings do not exclude a biologically meaningful association between APOE-ε2 and severe CAA. Further work is needed to elucidate fully the allele-specific associations of APOE with CAA and their mechanisms.
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