APOE4 is the strongest genetic risk factor for
late-onset Alzheimer’s disease (AD). ApoE4 increases brain
amyloid-β (Aβ) pathology relative to other ApoE
isoforms1. However,
whether APOE independently influences tau pathology, the other
major proteinopathy of AD and other tauopathies, or tau-mediated
neurodegeneration, is not clear. By generating P301S tau transgenic mice on
either a human ApoE knockin (KI) or ApoE knockout (KO) background, we show that
P301S/E4 mice have significantly higher tau levels in the brain and a greater
extent of somatodendritic tau redistribution by 3 months of age compared to
P301S/E2, P301S/E3 and P301S/EKO mice. By 9 months of age, P301S mice with
different ApoE genotypes display distinct p-tau staining patterns. P301S/E4 mice
develop markedly more brain atrophy and neuroinflammation than P301S/E2 and
P301S/E3 mice, whereas P301S/EKO mice are largely protected from these changes.
In vitro, E4-expressing microglia exhibit higher innate immune reactivity
following LPS treatment. Co-culturing P301S tau-expressing neurons with
E4-expressing mixed glia results in a significantly higher level of TNFα
secretion and markedly reduced neuronal viability compared to neuron/E2 and
neuron/E3 co-cultures. Neurons co-cultured with EKO glia showed the greatest
viability with the lowest level of secreted TNFα. Treatment of P301S
neurons with recombinant ApoE (E2, E3, E4) also leads to some neuronal damage
and death compared to the absence of ApoE, with ApoE4 exacerbating the effect.
In individuals with a sporadic primary tauopathy, the presence of an
ε4 allele is associated with more severe regional
neurodegeneration. In Aβ-pathology positive individuals with symptomatic
AD who usually have tau pathology, ε4-carriers
demonstrate greater rates of disease progression. Our results demonstrate that
ApoE affects tau pathogenesis, neuroinflammation, and tau-mediated
neurodegeneration independent of Aβ pathology. ApoE4 exerts a
“toxic” gain of function whereas the absence of ApoE is
protective.