Article Text
Statistics from Altmetric.com
Recent reports, primarily in patients with secondary progressive and relapsing-remitting multiple sclerosis have suggested that the apolipoprotein (APOE) ε4 allele may be associated with a worse prognosis.1-3 The ε class of APOE is involved in lipid transport and plays a part in brain development, synapse repair, and response to neuronal injury. It has been postulated that patients possessing the ε4 allele might have a reduced capacity for neuronal remodelling after multiple sclerosis relapses.3
There is general agreement that patients with primary progressive multiple sclerosis have a worse outcome both in relation to development of disability over time and in mortality. Such patients do not have a relapsing course. Moreover, there are pathological and imaging differences between primary progressive and secondary progressive multiple sclerosis suggesting that primary progressive disease may be a less inflammatory form of the disease.4 The relation between APOE and outcome has not been specifically considered in patients with primary progressive multiple sclerosis, although 11 patients with …