title: Apo E in multiple sclerosis and optic neuritis: the apo E-epsilon4 allele is associated with progression of multiple sclerosis.
abstract: OBJECTIVE
  To investigate the association between apolipoprotein E (Apo E) genotype in multiple sclerosis (MS) and acute monosymptomatic optic neuritis (ON) in a genetically homogeneous population with a high frequency of the Apo epsilon4 allele.
  
  
  BACKGROUND
  The association between heterozygosity of Apo epsilon4 and the development of MS is thoroughly investigated, while the association between homozygosity of Apo epsilon4 and the development of MS is insufficiently studied. The association between Apo E genotype and disease progression remains controversial.
  
  
  METHODS
  475 patients were included, 385 with MS and 90 with ON, consecutively seen in the MS clinic in the County of Copenhagen. Clinical data were obtained from medical records and degree of disability was determined prospectively using the Kurtzke expanded disability status scale (EDSS). Blood samples were used for Apo E genotyping. Disease progression was evaluated by the progression index (PI = EDSS/disease duration). Apo E genotype distribution was compared with 361 healthy controls.
  
  
  RESULTS
  The Apo epsilon genotype distribution in the MS and ON groups was similar to the controls. The rate of disease progression in the group of MS patients with a disease duration of 10 years or less was significantly faster in the Apo epsilon4 positive group (heterozygosity and homozygosity for Apo epsilon4) (PI = 1.41) compared to the Apo epsilon4 negative group (PI =0.92) (P =0.009). Observing the MS subgroups, we found that the group of patients with RRMS had a faster rate of disease progression in the Apo epsilon4 positive group (PI =1.12) compared to the Apo epsilon4 negative group (P =0.77) (P =0.024).
  
  
  CONCLUSIONS
  Apo E genotypes do not influence the development of MS and ON. The Apo epsilon4 allele seems to predispose carriers with MS to a faster progression of disease.
authors.affiliation: Department of Neurology, Glostrup Hospital University of Copenhagen, DK-2600 Glostrup S, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Pinholt
authors.forename: J L
authors.initials: JL
authors.lastname: Frederiksen
authors.forename: P S
authors.initials: PS
authors.lastname: Andersen
authors.forename: M
authors.initials: M
authors.lastname: Christiansen
mesh_terms: D000328:Adult; D017668:Age of Onset; D000483:Alleles; D053327:Apolipoprotein E4; D001057:Apolipoproteins E / Q000235:genetics*; D018450:Disease Progression; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000235:genetics* / Q000503:physiopathology*; D009902:Optic Neuritis / Q000235:genetics* / Q000503:physiopathology*; D010641:Phenotype
chemical_list: D053327:Apolipoprotein E4; D001057:Apolipoproteins E