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No association between the APOE ε4 allele and outcome and susceptibility in primary progressive multiple sclerosis
  1. S J M WEATHERBY,
  2. C L A MANN,
  3. A A FRYER,
  4. R C STRANGE,
  5. C P HAWKINS
  1. Centre for Cell and Molecular Medicine, Postgraduate Medical School, Keele University, North Staffordshire Hospitals, Stoke-on-Trent ST4 7LN, UK
  2. University Department of Clinical Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK
  1. Dr S J M Weatherby, Department of Neurology and Neurophysiology, School of Postgraduate Medicine, Keele University, North Staffordshire Hospitals, Princes Road, Stoke-on-Trent ST4 7LN, UK med13{at}keele.ac.uk
  1. V L STEVENSON,
  2. S M LEARY,
  3. A J THOMPSON
  1. Centre for Cell and Molecular Medicine, Postgraduate Medical School, Keele University, North Staffordshire Hospitals, Stoke-on-Trent ST4 7LN, UK
  2. University Department of Clinical Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK
  1. Dr S J M Weatherby, Department of Neurology and Neurophysiology, School of Postgraduate Medicine, Keele University, North Staffordshire Hospitals, Princes Road, Stoke-on-Trent ST4 7LN, UK med13{at}keele.ac.uk

https://doi.org/10.1136/jnnp.68.4.532

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    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 …

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