Apolipoprotein E (APOE) is a multifunctional protein that transports lipids and also helps to repair brain injuries. By far the strongest genetic risk factor for late-onset Alzheimer's disease (AD) is the inheritance of APOE epsilon4 alleles (APOE4), increasing AD likelihood by at least 4-fold per epsilon4 copy - a risk elevation for which mechanisms remain unclear. The APOE genotype influences clearance of protein aggregates from the brain, in particular peri-neuronal aggregates containing amyloid-beta and intra-neuronal tau aggregates - two hallmark aggregates for AD. We found that under neuronal stress, APOE4 protein translocates to the nucleus and competes with the transcription factor EB (TFEB) for binding to CLEAR enhancer sites in DNA, thus impeding transcription of TFEB targets, many of which are part of the lysosomal/ autophagy pathway. APOE4, but not APOE3, binds to CLEAR sites and prevents transcription of key autophagy proteins
p62/SQSTM1, LAMP2, and LC3B. In the absence of these gene products, the autophagic aggregate-clearance response to starvation/neuronal stress is blunted, resulting in an APOE4-specific increase in protein aggregation. Although C. elegans lacks an APOE ortholog, it expresses the
hlh-30 ortholog of TFEB for which the CLEAR binding-motif targets are almost perfectly conserved. It therefore provides a model in which APOE4 may compete for CLEAR sites free of any lipid-transport or other function. We devised a novel protocol to introduce human APOE4 protein directly into transgenic C. elegans models of AD. In adult worms expressing human Abeta42 in muscle, beta-amyloid accumulation is increased by APOE4 relative to E3; whereas worms expressing Abeta42 in neurons showed less chemotaxis after E4. We also identified a novel therapeutic small molecule targeting APOE4 protein preferentially over APOE3, which alleviates the age- and aggregation-mediated chemotactic decline in worms expressing neuronal Abeta42.