Lipoprotein glomerulopathy (LPG) is a rare disorder characterized by lipoprotein thrombi in the intraglomerular capillaries and high serum concentrations of apolipoprotein E (apoE). In 1989, Saito et al. [2,3]. Patients with LPG usually present with nephrotic syndrome and a relatively rapid progression to end-stage renal failure. Human apoE is composed of 299 amino acids and mediates tissue uptake of triglyceride-rich lipoproteins through both low-density lipoprotein (LDL) receptor and LDL-receptor-related protein pathways. Genetic variations at the apoE gene locus code for three different major isoforms designated E2, E3 and E4, representing their migration characteristics of isoelectric focusing (IEF). The wild-type allele is apoE3, while apoE2 (Arg158Cys) and apoE4 (Cys112Arg) are less common. ApoE3 and apoE4 are thought to bind equally to the lipoprotein receptors, whereas apoE2 is defective in its lipoprotein receptor binding [4]. Homozygosity for apoE2 (Arg158Cys) results in the development of type III hyperlipoproteinemia [5]. ApoE4 may be a risk factor for atherosclerosis and Alzheimer's disease [6].
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Kinomura et al. (2007) studied this question.