Apolipoprotein E (APO-E) is a chylomicron lipoprotein that is necessary for the metabolism of lipoproteins and lipid transport.  The APO-E gene has three alleles, termed APO-E2, APO-E3, and APO-E4.  The APO-E allelic proteins differ by only one or two amino acids, but have different biological structures and functions.  APO-E3 is the most common and neutral allele.  The APO-E4 allele is associated with an increased risk for Alzheimer’s Disease (AD) and coronary artery disease (CAD).  The APO-E4 protein morphology decreases the ability of APO-E4 to clear beta-amyloid protein from the brain, resulting in AD progression.  The APO-E2 allele is associated with type III hyperlipoproteinemia, which is characterized by defects in the clearance of plasma lipoproteins.  APO-E2 may also have a protective effect against AD.

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