“…The young brain may have mechanisms in place to cope with inefficient APOE4 lipid transport; but aging leads to decreased cholesterol synthesis in astrocytes (Boisvert et al, 2018), which, when combined with lower efflux from APOE4, could tip the balance and culminate in neuronal lipid deficits. Furthermore, Aβ inhibits SREBP2 in primary cultured cells from mouse cortex (Mohamed et al, 2018), suggesting that amyloid deposition could make neurons even more dependent on astrocytic lipids, which would be lacking in ε4 carriers. Although cholesterol has been the most extensively studied, changes in other lipid classes are also observed in serum samples from AD patients, including sterols, sphingomyelin, phosphatidylcholine, glycerophosphoethanolamine, lysophosphatidylcholine, diacylglycerols, and triacylglycerols (Anand et al, 2017); therefore, APOE4 status could exacerbate other age-related changes in lipid homeostasis.…”