APOE

protein-coding

apolipoprotein E, the group of Apolipoproteins

Gene summary

The protein encoded by this gene is a major apoprotein of the chylomicron. It binds to a specific liver and peripheral cell receptor, and is essential for the normal catabolism of triglyceride-rich lipoprotein constituents. This gene maps to chromosome 19 in a cluster with the related apolipoprotein C1 and C2 genes. Mutations in this gene result in familial dysbetalipoproteinemia, or type III hyperlipoproteinemia (HLP III), in which increased plasma cholesterol and triglycerides are the consequence of impaired clearance of chylomicron and VLDL remnants. [provided by RefSeq, Jun 2016]

Previous symbols:
  • AD2

MANE transcript

NM_000041.4

Inheritance

AD, AR

ClinVar variants

P:20U:123B:112

Top phenotype

Hyperlipoproteinemia, type III; Lipoprotein glomerulopathy; Sea-blue histiocyte disease

gnomAD constraint

pLI —, LoF o/e 0.52

Max pathogenic AF

—

Genomic locus

chr19:44,905,791-44,909,393

External References & Databases

Transcript & Mutation Effects

hg38 • Region Span ~3.6 kb
Loading mutation effect viewer...

GenCC Phenotypes & Disease Associations

Curated gene-disease validity assertions and inheritance patterns

lipoprotein glomerulopathySUPPORTIVE

Inheritance Pattern: AD

Disease ID:MONDO:0012725

Submitter: Orphanet

lipoprotein glomerulopathySTRONG

Inheritance Pattern: AD

Disease ID:MONDO:0012725

Submitter: Genomics England PanelApp

hyperlipoproteinemia type 3STRONG

Inheritance Pattern: AD

Disease ID:MONDO:0018473

Submitter: Genomics England PanelApp

lipoprotein glomerulopathySTRONG

Inheritance Pattern: AD

Disease ID:MONDO:0012725

Submitter: Labcorp Genetics (formerly Invitae)

Alzheimer disease 2LIMITED

Inheritance Pattern: Unknown

Disease ID:MONDO:0007089

Submitter: Labcorp Genetics (formerly Invitae)

hyperlipoproteinemia type 3STRONG

Inheritance Pattern: AR

Disease ID:MONDO:0018473

Submitter: Labcorp Genetics (formerly Invitae)

hyperlipoproteinemia type 3STRONG

Inheritance Pattern: AD

Disease ID:MONDO:0018473

Submitter: Labcorp Genetics (formerly Invitae)

lipoprotein glomerulopathyMODERATE

Inheritance Pattern: AD

Disease ID:MONDO:0012725

Submitter: Ambry Genetics

hyperlipoproteinemia type 3MODERATE

Inheritance Pattern: AR

Disease ID:MONDO:0018473

Submitter: Ambry Genetics

hyperlipoproteinemia type 3STRONG

Inheritance Pattern: AR

Disease ID:MONDO:0018473

Submitter: Genomics England PanelApp

Alzheimer disease 2DEFINITIVE

Inheritance Pattern: AD

Disease ID:MONDO:0007089

Submitter: Ambry Genetics

sea-blue histiocyte syndromeLIMITED

Inheritance Pattern: AD

Disease ID:MONDO:0010017

Submitter: Labcorp Genetics (formerly Invitae)

Clinical Genomic Database (CGD)

Hyperlipoproteinemia, type III; Lipoprotein glomerulopathy; Sea-blue histiocyte diseaseAD/AR

Manifestation: Cardiovascular; Gastrointestinal; Hematologic; Neurologic; Renal

Intervention: Cardiovascular; Gastrointestinal; Renal

Rationale: In Hyperlipoproteinemia, type III, dietary and medical measures related to treating abnormal lipid profiles (including apharesis in some individuals) can be beneficial, including as relates to the risk of cardiovascular disease; In LPG, early diagnosis may be advantageous in order to allow medical treatment (eg, with fibrate therapy); In Sea-blue histiocyte disease, individuals may present with splenomegaly with sea-blue histiocytes, hypertriglyceridemia, and thrombocytopenia, and preventive measures and surveillance related to cardiac manifestations may be beneficial, and knowledge that splenectomy can exacerbate hypertriglyceridemia may additionally be advantageous

Refs: 4242937; 4195998; 6795720; 6289314; 6860421; 6323533; 3721502; 3771793; 3029073; 3038959; 3243553; 2539388; 2556398; 2313204; 2341812; 1864973; 1674745; 1713245; 1360898; 1361196; 1356443; 8488843; 7635945; 7586659; 9176854; 11095479; 15630634; 16094309; 16143024; 16431249; 16690468; 18077821; 20534298; 21534236; 22069485; 22481068; 22949395; 28966924; 30421781; 30685233Source: CGD (NHGRI)

ClinVar Associated Diseases & Phenotypes

Reported disease conditions connected to APOE variants in ClinVar

26 Conditions Cataloged
Cardiovascular phenotypeTotal: 192
not providedTotal: 52
Familial type 3 hyperlipoproteinemiaTotal: 28
Familial hypercholesterolemiaTotal: 23
Alzheimer disease 2Total: 18
Lipoprotein glomerulopathyTotal: 14
APOE-related disorderTotal: 14
Sea-blue histiocyte syndromeTotal: 10

ClinVar Variants & Pathogenicity by Type

Statistics based on transcript NM_000041.4. Only rare variants are included.

We include only reliable ClinVar variants with their consequences to MANE Select, MANE Plus Clinical transcripts, or transcripts with TSL equal to 1. Click a count to filter the variants table below.

Slight differences between displayed counts and ClinVar may occur due to a different transcript/consequence chosen by our variant effect predictor, or because we classify Benign/Likely benign as Likely benign and Pathogenic/Likely pathogenic as Likely pathogenic.

EffectPLPVUSLBBSum
synonymous
2
clinvar
95
clinvar
97
missense
7
clinvar
9
clinvar
116
clinvar
16
clinvar
1
clinvar
149
nonsense
1
clinvar
2
clinvar
3
start loss
0
frameshift
1
clinvar
1
clinvar
2
clinvar
4
splice donor/acceptor (+/-2bp)
1
clinvar
1
clinvar
2
Total9111231111255

Highest pathogenic variant AF is 0.00006327064

Loading ClinVar variants...

Transcript Catalog

Annotated transcript isoforms across RefSeq and Ensembl databases

Showing 4 of 69 transcripts
Transcript IDSourceProtein IDCoding ExonsMANE Status
NM_000041.4RefSeqNP_000032.13MANE Select
ENST00000252486.9EnsemblENSP00000252486.33MANE Select
NM_001302688.2RefSeqNP_001289617.14Standard
NM_001302689.2RefSeqNP_001289618.13Standard

Model Organisms & Knockout Phenotypes

Observed phenotypic effects in mouse and zebrafish models

Gene / ModelOrganismObserved Phenotype
apoeaDanio rerio

Structure: whole organism

Quality: morphology

abnormal

Gene Ontology (GO) Annotations & Pathways

Biological processes, molecular functions, cellular components and pathways

Pathways ConsensusPathDB

  • Alzheimer,s disease - Homo sapiens (human)
  • Cholesterol metabolism - Homo sapiens (human)
  • Statin Pathway, Pharmacodynamics
  • Vitamin B12 Metabolism
  • Alzheimers Disease

Biological Process

  • response to reactive oxygen species
  • retinoid metabolic process
  • negative regulation of endothelial cell proliferation
  • response to dietary excess
  • regulation of transcription by RNA polymerase II

Molecular Function

  • amyloid-beta binding
  • structural molecule activity
  • lipid transporter activity
  • protein binding
  • phospholipid binding

Cellular Component

  • extracellular region
  • extracellular space
  • nucleus
  • cytoplasm
  • early endosome

gnomAD Constraint

Source: gnomAD

Gene type
protein_coding
Transcript type
protein_coding
Transcript
ENST00000252486
Coding exons
3
Length
3640
Individuals with no LoFs
125740
Homozygous LoFs
0
Heterozygous LoFs
8
Defined
125748
p
0.0000318
Z-ScoreObservedExpectedObserved/ExpectedMutation RateTotal Possible
Missense0.7401882190.8590.00001671958
Missense (PolyPhen)6483.5410.76609681
Synonymous1.04871000.8680.00000788658
Loss of Function1.49611.50.5245.01e-7115

Population LoF Frequency

PopulationCAFp-valueStatus
African00.0absent
Latino/Admixed American0.0000580.000058rare
Ashkenazi Jewish0.0000990.000099rare
East Asian00.0absent
Finnish00.0absent
European (Non-Finnish)0.0000360.000035rare
South Asian0.0000330.000033rare
Other00.0absent

dbNSFP Gene Annotations

Source: dbNSFP

Function
FUNCTION: Mediates the binding, internalization, and catabolism of lipoprotein particles. It can serve as a ligand for the LDL (apo B/E) receptor and for the specific apo-E receptor (chylomicron remnant) of hepatic tissues. {ECO:0000303|PubMed:3283935}.;
Disease
DISEASE: Hyperlipoproteinemia 3 (HLPP3) [MIM:617347]: A disorder characterized by the accumulation of intermediate-density lipoprotein particles (IDL or broad-beta-lipoprotein) rich in cholesterol. Clinical features include xanthomas, yellowish lipid deposits in the palmar crease, or less specific on tendons and on elbows. The disorder rarely manifests before the third decade in men. In women, it is usually expressed only after the menopause. {ECO:0000269|PubMed:1674745, ECO:0000269|PubMed:22481068, ECO:0000269|PubMed:2556398, ECO:0000269|PubMed:8287539}. Note=The disease is caused by mutations affecting the gene represented in this entry. The vast majority of the patients are homozygous for APOE*2 alleles. More severe cases of HLPP3 have also been observed in individuals heterozygous for rare APOE variants. The influence of APOE on lipid levels is often suggested to have major implications for the risk of coronary artery disease (CAD). Individuals carrying the common APOE*4 variant are at higher risk of CAD.; DISEASE: Alzheimer disease 2 (AD2) [MIM:104310]: A late-onset form of Alzheimer disease. Alzheimer disease is a neurodegenerative disorder characterized by progressive dementia, loss of cognitive abilities, and deposition of fibrillar amyloid proteins as intraneuronal neurofibrillary tangles, extracellular amyloid plaques and vascular amyloid deposits. The major constituents of these plaques are neurotoxic amyloid-beta protein 40 and amyloid- beta protein 42, that are produced by the proteolysis of the transmembrane APP protein. The cytotoxic C-terminal fragments (CTFs) and the caspase-cleaved products, such as C31, are also implicated in neuronal death. {ECO:0000269|PubMed:8346443}. Note=Disease susceptibility is associated with variations affecting the gene represented in this entry. The APOE*4 allele (APOE form E4) is genetically associated with the common late onset familial and sporadic forms of Alzheimer disease. Risk for AD increased from 20% to 90% and mean age at onset decreased from 84 to 68 years with increasing number of APOE*4 alleles in 42 families with late onset AD. Thus APOE*4 gene dose is a major risk factor for late onset AD and, in these families, homozygosity for APOE*4 was virtually sufficient to cause AD by age 80. The mechanism by which APOE*4 participates in pathogenesis is not known. {ECO:0000269|PubMed:8346443}.; DISEASE: Sea-blue histiocyte disease (SBHD) [MIM:269600]: Characterized by splenomegaly, mild thrombocytopenia and, in the bone marrow, numerous histiocytes containing cytoplasmic granules which stain bright blue with the usual hematologic stains. The syndrome is the consequence of an inherited metabolic defect analogous to Gaucher disease and other sphingolipidoses. {ECO:0000269|PubMed:11095479, ECO:0000269|PubMed:16094309}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Lipoprotein glomerulopathy (LPG) [MIM:611771]: Uncommon kidney disease characterized by proteinuria, progressive kidney failure, and distinctive lipoprotein thrombi in glomerular capillaries. {ECO:0000269|PubMed:10432380, ECO:0000269|PubMed:18077821, ECO:0000269|PubMed:9176854}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Familial hypercholesterolemia (FH) [MIM:143890]: A common autosomal dominant disorder characterized by elevated serum low- density lipoprotein (LDL) cholesterol levels, which result in excess deposition of cholesterol in tissues and leads to xanthelasma, xanthomas, accelerated atherosclerosis and increased risk of premature coronary heart disease. The disorder occurs in 2 clinical forms: a mild form that becomes evident in the fourth or fifth decade in individuals carrying heterozygous LDLR mutations; a more severe form that usually manifests in the first two decades of life in individuals with homozygous LDLR mutations. {ECO:0000269|PubMed:22949395, ECO:0000269|PubMed:24267230, ECO:0000269|PubMed:26802169}. Note=The disease may be caused by mutations affecting the gene represented in this entry.;

Recessive Scores

pRec
0.998

Essentials

Essential (CRISPR)
N
Essential (CRISPR2)
N
Essential (gene trap)
N
Indispensability pred.
E
Indispensability score
0.767

Gene Damage Prediction

AllRecessiveDominant
MendelianMediumMediumMedium
Primary ImmunodeficiencyMediumMediumMedium
CancerMediumMediumMedium
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