Evidence mapPaperPMID 40665049Full record

ArticleNature medicine2025

APOE ε4 carriers share immune-related proteomic changes across neurodegenerative diseases.

Artur Shvetcov, Erik C B Johnson, Laura M Winchester, Keenan A Walker, Heather M Wilkins, Terri G Thompson, Jeffrey D Rothstein, Varsha Krish, Farhad B Imam, Global Neurodegeneration Proteomics Consortium (GNPC) and 4 more

Abstract read
In one paragraph

Article in Nature medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

39 citing papers in PubMed.

  1. Article
  2. APOE4 disrupts the central dogma by arresting neuronal proteome dynamics.bioRxiv : the preprint server for biology · 2026
    Article
  3. Review
  4. Review
  5. Review
  6. Article
  7. Review
  8. Proteomic Signatures of ProtectedmedRxiv : the preprint server for health sciences · 2026
    Article
  9. Article
  10. How does type 2 diabetes modify the risk of Alzheimer's disease?Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Review
  11. Review
  12. Review
  13. Article
  14. Article
  15. Review
  16. Article
  17. Article
  18. Plasma Proteomic Analysis ofmedRxiv : the preprint server for health sciences · 2026
    Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Artur ShvetcovNeurodegeneration and Disease Modelling Research Group, Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia. artur.shvetcov@wimr.org.au.ORCID http://orcid.org/0000-0003-0592-984X
Erik C B JohnsonDepartment of Neurology, Emory University, Atlanta, GA, USA.ORCID http://orcid.org/0000-0002-0604-2944
Laura M WinchesterDepartment of Psychiatry, University of Oxford, Oxford, UK.
Keenan A WalkerLaboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD, USA.ORCID http://orcid.org/0000-0002-5989-9853
Heather M WilkinsUniversity of Kansas Alzheimer's Disease Research Centre, University of Kansas Medical Center, Kansas City, KS, USA.
Terri G ThompsonOnPoint Scientific, Inc., San Diego, CA, USA.
Jeffrey D RothsteinBrain Science Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Varsha KrishGates Ventures, Seattle, WA, USA.
Farhad B ImamGates Ventures, Seattle, WA, USA.ORCID http://orcid.org/0000-0003-2854-2568
Global Neurodegeneration Proteomics Consortium (GNPC)
Jeffrey M BurnsUniversity of Kansas Alzheimer's Disease Research Centre, University of Kansas Medical Center, Kansas City, KS, USA.ORCID http://orcid.org/0000-0001-7609-8954
Russell H SwerdlowUniversity of Kansas Alzheimer's Disease Research Centre, University of Kansas Medical Center, Kansas City, KS, USA.ORCID http://orcid.org/0000-0003-2948-7230
Chad SlawsonUniversity of Kansas Alzheimer's Disease Research Centre, University of Kansas Medical Center, Kansas City, KS, USA.ORCID http://orcid.org/0000-0002-6886-4847
Caitlin A FinneyNeurodegeneration and Disease Modelling Research Group, Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia. caitlin.finney@wimr.org.au.ORCID http://orcid.org/0000-0002-9357-8316

Funding

Project 3: Biomarkers for DS Clinical TrialsU19AG068054 · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2025 to 2025
$18.4M
University of Kansas Alzheimer's Disease Research Center (KU ADRC)P30AG072973 · UNIVERSITY OF KANSAS MEDICAL CENTER · 2025 to 2025
$3.0M
A Proteomic Comparison of Sporadic Early-Onset, Late-Onset, and Autosomal Dominant Alzheimer's DiseaseR01AG089497 · EMORY UNIVERSITY · 2025 to 2025
$3.0M
The Emory Alzheimer's Disease CenterP50AG025688 · EMORY UNIVERSITY · 2005 to 2005
$1.4M
Nuclear and Glial Dysfunction in NeurodegenerationR35NS132179 · JOHNS HOPKINS UNIVERSITY · 2025 to 2025
$1.2M
Identifying therapeutic targets that confer synaptic resilience to Alzheimer's diseaseR01AG061800 · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2025 to 2025
$800k
Alzheimer's Association 23AARG-1023Department of Health | National Health and Medical Research Council (NHMRC) MRF2040081NCATS NIH HHS R21 TR003589NIA NIH HHS P30 AG072973NIA NIH HHS P50 AG025688NIA NIH HHS R01 AG053960NIA NIH HHS R01 AG057339NIA NIH HHS R01 AG057911NIA NIH HHS R01 AG061800NIA NIH HHS R01 AG064227NIA NIH HHS R01 AG089497NIA NIH HHS RF1 AG057470NIA NIH HHS RF1 AG057471NIA NIH HHS U01 AG046161NIA NIH HHS U01 AG061357NIA NIH HHS U19 AG068054NINDS NIH HHS R35 NS132179U.S. Department of Health & Human Services | National Institutes of Health (NIH) K08AG08604U.S. Department of Health & Human Services | National Institutes of Health (NIH) P30AG072973U.S. Department of Health & Human Services | National Institutes of Health (NIH) P50AG025688U.S. Department of Health & Human Services | National Institutes of Health (NIH) R01AG064227U.S. Department of Health & Human Services | National Institutes of Health (NIH) R01AG07816U.S. Department of Health & Human Services | National Institutes of Health (NIH) R01AG089497U.S. Department of Health & Human Services | National Institutes of Health (NIH) R21TR003589U.S. Department of Health & Human Services | National Institutes of Health (NIH) R35NS132179U.S. Department of Health & Human Services | National Institutes of Health (NIH) U19AG068054
6 · The paper itself

Abstract

The APOE ε4 genetic variant is the strongest genetic risk factor for late-onset Alzheimer's disease (AD) and is increasingly being implicated in other neurodegenerative diseases. Using the Global Neurodegeneration Proteomics Consortium SomaScan dataset covering 1,346 cerebrospinal fluid (CSF) and 9,924 plasma samples, we used machine learning-based proteome profiling to identify an APOE ε4 proteomic signature shared across individuals with AD, frontotemporal dementia (FTD), Parkinson's disease dementia (PDD), Parkinson's disease (PD), amyotrophic lateral sclerosis (ALS) and nonimpaired controls. This signature was enriched in pro-inflammatory immune and infection pathways as well as immune cells, including monocytes, T cells and natural killer cells. Analysis of the dorsolateral prefrontal cortex proteome for 262 donors from the Accelerating Medicines Partnership for AD UPenn Proteomics Study revealed a consistent APOE ε4 phenotype, independent of neurodegenerative pathology, including amyloid-β tau and gliosis for all diseases, as well as TDP-43 in ALS and FTD cases, and α-synuclein in PD and PDD cases. While systemic proteomic changes were consistent across APOE ε4 carriers, their relationship with clinical and lifestyle factors, such as hypertension and smoking, varied by disease. These findings suggest APOE ε4 confers a systemic biological vulnerability that is necessary but not sufficient for neurodegeneration, emphasizing the need to consider gene-environment interactions. Overall, our study reveals a conserved APOE ε4-associated pro-inflammatory immune signature persistent across the brain, CSF and plasma irrespective of neurodegenerative disease, highlighting a fundamental, disease-independent biological vulnerability to neurodegeneration. This work reframes APOE ε4 as a pleiotropic immune modulator rather than an AD-specific risk gene, providing a foundation for precision biomarker development and early intervention strategies across neurodegenerative diseases.

Indexed as

Apolipoprotein E4Neurodegenerative DiseasesProteomeAgedalpha-SynucleinAlzheimer DiseaseAmyotrophic Lateral SclerosisFemaleFrontotemporal DementiaHeterozygoteHumansMaleMiddle AgedParkinson DiseaseProteomicstau Proteinsalpha-SynucleinApolipoprotein E4Proteometau Proteins

Identifiers

PMID40665049
PMCPMC12353839

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.