Epidemiologic and laboratory results consistently implicate the APOE g
ene in the pathogenesis of late-onset Alzheimer's disease (AD): the ep
silon 4 allele increases risk in a dose-dependent fashion, while epsil
on 2 confers protection. Individuals are susceptible for AD in varying
degrees depending on which combination of APOE alleles has been inher
ited, APOE promoter polymorphism and other factors. Deposition of both
senile plaques and neurofibrillary tangles, the pathologic hallmarks
of AD, are enhanced by epsilon 4 from the earliest lesions onward - di
ffuse plaques consisting of A beta 1-42 and neurofibrillary tangles in
the entorhinal cortex. Transgenic APOE mice carrying an APP mutation
and 0, 1 or 2 copies of APOE showed dose-related increases in plaque d
eposition in the hippocampus and cortex, a clear indication that APOEp
promotes A beta deposition. The presence of each additional APOE epsi
lon 4 allele leads to an earlier onset of the histopathological proces
s of about 1 decade, on average. The association of both types of AD-r
elated changes with the occurrence of epsilon 4 suggests that the APOE
polymorphism causally contributes to the pathogenesis Of AD.