Skip to main content

The Role of Apolipoprotein E in the Pathological Events Following Subarachnoid Hemorrhage: A Review

  • Conference paper
Early Brain Injury or Cerebral Vasospasm

Part of the book series: Acta Neurochirurgica Supplements ((NEUROCHIRURGICA,volume 110/2))

Abstract

Subarachnoid hemorrhage (SAH) strikes individuals with devastating neurological results. Traditional viewpoints do not explain all the differences that are usually found in clinical practice. The role of genetic predisposition in SAH has recently been investigated. Particular attention has been paid to the apolipoprotein E (apoE) genotype. APOE genotype is a major prognostic factor in patient outcome after spontaneous aneurysmal SAH. In patients with SAH, the expression of the apoE ε4 allele is associated with a higher risk of negative outcome and delayed ischemia. Evidence from experimental and clinical studies confirms that apoE plays an important role in the pathological events after SAH. This article reviews related research and surveys the links between the pathological events of SAH and apoE.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Aono M, Lee Y, Grant ER, Zivin RA, Pearlstein RD, Warner DS, et al. Apolipoprotein E protects against NMDA excitotoxicity. Neurobiol Dis. 2002;11:214–220.

    Article  PubMed  CAS  Google Scholar 

  2. Chiang VL, Claus EB, Awad IA. Toward more rational prediction of outcome in patients with high-grade subarachnoid hemorrhage. Neurosurgery 2000;46:28–35; discussion 35–26.

    Article  PubMed  CAS  Google Scholar 

  3. Dietrich HH, Dacey RG, Jr. Molecular keys to the problems of cerebral vasospasm. Neurosurgery 2000;46:517–530.

    Article  PubMed  CAS  Google Scholar 

  4. Dreier JP, Ebert N, Priller J, Megow D, Lindauer U, Klee R, et al. Products of hemolysis in the subarachnoid space inducing spreading ischemia in the cortex and focal necrosis in rats: a model for delayed ischemic neurological deficits after subarachnoid hemorrhage? J Neurosurg. 2000;93:658–666.

    Article  PubMed  CAS  Google Scholar 

  5. Fassbender K, Hodapp B, Rossol S, Bertsch T, Schmeck J, Schutt S, et al. Endothelin-1 in subarachnoid hemorrhage: an acute-phase reactant produced by cerebrospinal fluid leukocytes. Stroke 2000;31:2971–2975.

    Article  PubMed  CAS  Google Scholar 

  6. Gallek MJ, Conley YP, Sherwood PR, Horowitz MB, Kassam A, Alexander SA. APOE genotype and functional outcome following aneurysmal subarachnoid hemorrhage. Biol Res Nurs. 2009;10:205–212.

    Article  PubMed  CAS  Google Scholar 

  7. Gao J, Wang H, Sheng H, Lynch JR, Warner DS, Durham L, et al. A novel apoE-derived therapeutic reduces vasospasm and improves outcome in a murine model of subarachnoid hemorrhage. Neurocrit Care. 2006;4:25–31.

    Article  PubMed  CAS  Google Scholar 

  8. Kaushal R, Woo D, Pal P, Haverbusch M, Xi H, Moomaw C, et al. Subarachnoid hemorrhage: tests of association with apolipoprotein E and elastin genes. BMC Med Genet. 2007;8:49.

    Article  PubMed  Google Scholar 

  9. Kay A, Petzold A, Kerr M, Keir G, Thompson E, Nicoll J. Decreased cerebrospinal fluid apolipoprotein E after subarachnoid hemorrhage: correlation with injury severity and clinical outcome. Stroke 2003;34:637–642.

    Article  PubMed  CAS  Google Scholar 

  10. Kusaka G, Ishikawa M, Nanda A, Granger DN, Zhang JH. Signaling pathways for early brain injury after subarachnoid hemorrhage. J Cereb Blood Flow Metab. 2004;24:916–925.

    Article  PubMed  CAS  Google Scholar 

  11. Lanterna LA, Biroli F. Significance of apolipoprotein E in subarachnoid hemorrhage: neuronal injury, repair, and therapeutic perspectives–a review. J Stroke Cerebrovasc Dis. 2009;18:116–123.

    Article  PubMed  Google Scholar 

  12. Lanterna LA, Rigoldi M, Tredici G, Biroli F, Cesana C, Gaini SM, et al. APOE influences vasospasm and cognition of noncomatose patients with subarachnoid hemorrhage. Neurology 2005;64:1238–1244.

    Article  PubMed  CAS  Google Scholar 

  13. Laskowitz DT, Goel S, Bennett ER, Matthew WD. Apolipoprotein E suppresses glial cell secretion of TNF alpha. J Neuroimmunol. 1997;76:70–74.

    Article  PubMed  CAS  Google Scholar 

  14. Laskowitz DT, Thekdi AD, Thekdi SD, Han SK, Myers JK, Pizzo SV, et al. Downregulation of microglial activation by apolipoprotein E and apoE-mimetic peptides. Exp Neurol. 2001;167:74–85.

    Article  PubMed  CAS  Google Scholar 

  15. Leung CH, Poon WS, Yu LM, Wong GK, Ng HK. Apolipoprotein e genotype and outcome in aneurysmal subarachnoid hemorrhage. Stroke. 2002;33:548–552.

    Article  PubMed  CAS  Google Scholar 

  16. Lynch JR, Tang W, Wang H, Vitek MP, Bennett ER, Sullivan PM, et al. APOE genotype and an ApoE-mimetic peptide modify the systemic and central nervous system inflammatory response. J Biol Chem. 2003;278:48529–48533.

    Article  PubMed  CAS  Google Scholar 

  17. Niskakangas T, Ohman J, Niemela M, Ilveskoski E, Kunnas TA, Karhunen PJ. Association of apolipoprotein E polymorphism with outcome after aneurysmal subarachnoid hemorrhage: a preliminary study. Stroke 2001;32:1181–1184.

    Article  PubMed  CAS  Google Scholar 

  18. Paris D, Town T, Parker TA, Humphrey J, Mullan M. Isoform-specific vasoconstriction induced by apolipoprotein E and modulation of this effect by Alzheimer’s beta-amyloid peptide. Neurosci Lett. 1998;256:73–76.

    Article  PubMed  CAS  Google Scholar 

  19. Rao R, Tah V, Casas JP, Hingorani A, Whittaker J, Smeeth L, et al. Ischaemic stroke subtypes and their genetic basis: a comprehensive meta-analysis of small and large vessel stroke. Eur Neurol. 2009;61:76–86.

    Article  PubMed  Google Scholar 

  20. Sun XC, Jiang Y. Genetic susceptibility to traumatic brain injury and apolipoprotein E gene. Chin J Traumatol. 2008;11:247–252.

    PubMed  CAS  Google Scholar 

  21. Tang J, Zhao J, Zhao Y, Wang S, Chen B, Zeng W. Apolipoprotein E epsilon4 and the risk of unfavorable outcome after aneurysmal subarachnoid hemorrhage. Surg Neurol. 2003;60:391–6; discussion 396–397.

    Article  PubMed  Google Scholar 

  22. White F, Nicoll JA, Horsburgh K. Alterations in ApoE and ApoJ in relation to degeneration and regeneration in a mouse model of entorhinal cortex lesion. Exp Neurol. 2001;169:307–318.

    Article  PubMed  CAS  Google Scholar 

  23. White F, Nicoll JA, Roses AD, Horsburgh K. Impaired neuronal plasticity in transgenic mice expressing human apolipoprotein E4 compared to E3 in a model of entorhinal cortex lesion. Neurobiol Dis. 2001;8:611–625.

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest statementWe declare that we have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Xiao-chuan Sun .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer-Verlag/Wien

About this paper

Cite this paper

Guo, Zd., Sun, Xc., Zhang, J.H. (2011). The Role of Apolipoprotein E in the Pathological Events Following Subarachnoid Hemorrhage: A Review. In: Feng, H., Mao, Y., Zhang, J.H. (eds) Early Brain Injury or Cerebral Vasospasm. Acta Neurochirurgica Supplements, vol 110/2. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0356-2_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-7091-0356-2_1

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-0355-5

  • Online ISBN: 978-3-7091-0356-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics