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Deficiência de apolipoproteína A-I
ORPHA:425CID-10 · E78.6CID-11 · 5C81.0DOENÇA RARA

Doença de Alzheimer é uma doença neurodegenerativa crónica e a forma mais comum de demência. A doença manifesta-se lentamente e vai-se agravando ao longo do tempo. O sintoma inicial mais comum é a perda de memória a curto prazo, com dificuldades em recordar eventos recentes. Os primeiros sintomas são geralmente confundidos com o processo normal de envelhecimento ou manifestações de stresse. À medida que a doença evolui, o quadro de sintomas inclui dificuldades na linguagem, desorientação, perder-se com facilidade, alterações de humor, perda de motivação, desinteresse por cuidar de si próprio, desinteresse por tarefas quotidianas e comportamento agressivo. Em grande parte dos casos, a pessoa com Alzheimer afasta-se progressivamente da família e da sociedade.

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Introdução

O que você precisa saber de cara

📋

Doença genética rara autossômica dominante associada a mutações nos genes ABCA1 ou APOA1, caracterizada por baixos níveis de HDL e apoA-I. Manifesta-se com aterosclerose prematura, angina, xantelasma e opacificação corneana, levando à visão turva.

Publicações científicas
22 artigos
Último publicado: 2019 May-Jun

Escala de raridade

CLASSIFICAÇÃO ORPHANET · BRASIL 2024
<1 / 1 000 000
Ultra-rara
<1/50k
Muito rara
1/20k
Rara
1/10k
Pouco freq.
1/5k
Incomum
1/2k
Prevalência
0.0
Worldwide
Casos conhecidos
30
pacientes catalogados
Início
All ages
🏥
SUS: Cobertura mínimaScore: 15%
CID-10: E78.6
🇧🇷Dados SUS / DATASUS
PROCEDIMENTOS SIGTAP (6)
0202010279
Dosagem de aminoácidos (erros inatos)metabolic_test
0202010295
Dosagem de ácidos orgânicos na urinagenetic_test
0202010490
Teste de triagem para erros inatos do metabolismonewborn_screening
0202010694
Sequenciamento completo do exoma (WES)rehabilitation
0202080013
Teste do pezinho (triagem neonatal)
0301070040
Atendimento em reabilitação — doenças raras
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Entender a doença

Do básico ao detalhe, leia no seu ritmo

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Sinais e sintomas

O que aparece no corpo e com que frequência cada sintoma acontece

Partes do corpo afetadas

👁️
Olhos
1 sintomas
😀
Face
1 sintomas

+ 7 sintomas em outras categorias

Características mais comuns

90%prev.
Opacificação do estroma corneano
Muito frequente (99-80%)
90%prev.
Concentração diminuída de colesterol HDL
Muito frequente (99-80%)
90%prev.
Concentração anormal de lipídios circulantes
Muito frequente (99-80%)
90%prev.
Aterosclerose
Muito frequente (99-80%)
55%prev.
Visão turva
Frequente (79-30%)
55%prev.
Xantomatose
Frequente (79-30%)
9sintomas
Muito frequente (4)
Frequente (5)

Os sintomas variam de pessoa para pessoa. Abaixo estão as 9 características clínicas mais associadas, ordenadas por frequência.

Opacificação do estroma corneanoOpacification of the corneal stroma
Muito frequente (99-80%)90%
Concentração diminuída de colesterol HDLDecreased HDL cholesterol concentration
Muito frequente (99-80%)90%
Concentração anormal de lipídios circulantesAbnormal circulating lipid concentration
Muito frequente (99-80%)90%
AteroscleroseAtherosclerosis
Muito frequente (99-80%)90%
Visão turvaBlurred vision
Frequente (79-30%)55%

Linha do tempo da pesquisa

Publicações por ano — veja quando o interesse científico cresceu
Anos de pesquisa7desde 2019
Total histórico22PubMed
Últimos 10 anos25publicações
Pico20157 papers
Linha do tempo
20202019Hoje · 2026🧪 2004Primeiro ensaio clínico📈 2015Ano de pico
Publicações por ano (últimos 10 anos)

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Genética e causas

O que está alterado no DNA e como passa nas famílias

Genes associados

2 genes identificados com associação a esta condição. Padrão de herança: Autosomal dominant.

APOA1Apolipoprotein A-IDisease-causing germline mutation(s) inTolerante
FUNÇÃO

Participates in the reverse transport of cholesterol from tissues to the liver for excretion by promoting cholesterol efflux from tissues and by acting as a cofactor for the lecithin cholesterol acyltransferase (LCAT). As part of the SPAP complex, activates spermatozoa motility

LOCALIZAÇÃO

Secreted

VIAS BIOLÓGICAS (2)
Post-translational protein phosphorylationRegulation of Insulin-like Growth Factor (IGF) transport and uptake by Insulin-like Growth Factor Binding Proteins (IGFBPs)
MECANISMO DE DOENÇA

Hypoalphalipoproteinemia, primary, 2

An autosomal recessive disorder of lipoprotein metabolism, biochemically characterized by severe apoA-I deficiency and severely reduced serum high-density lipoprotein cholesterol (HDL-C). Affected individuals have undetectable serum levels of apoA-I, and develop xanthomas and corneal opacities. The disease is generally associated with atherosclerosis and markedly increased cardiovascular risk.

OUTRAS DOENÇAS (4)
hypoalphalipoproteinemia, primary, 2, intermediateamyloidosis, hereditary systemic 3hypoalphalipoproteinemia, primary, 2AApoAI amyloidosis
HGNC:600UniProt:P02647
ABCA1Phospholipid-transporting ATPase ABCA1Disease-causing germline mutation(s) inRestrito
FUNÇÃO

Catalyzes the translocation of specific phospholipids from the cytoplasmic to the extracellular/lumenal leaflet of membrane coupled to the hydrolysis of ATP (PubMed:24097981, PubMed:35974019). Thereby, participates in phospholipid transfer to apolipoproteins to form nascent high density lipoproteins/HDLs (PubMed:14754908). Transports preferentially phosphatidylcholine over phosphatidylserine (PubMed:24097981). May play a similar role in the efflux of intracellular cholesterol to apolipoproteins

LOCALIZAÇÃO

Cell membraneEndosome

VIAS BIOLÓGICAS (2)
PPARA activates gene expressionNR1H3 & NR1H2 regulate gene expression linked to cholesterol transport and efflux
MECANISMO DE DOENÇA

Tangier disease

An autosomal recessive disorder characterized by near absence of plasma high density lipoproteins, low serum HDL cholesterol, and massive tissue deposition of cholesterol esters. Clinical features include large yellow-orange tonsils, hepatomegaly, splenomegaly, enlarged lymph nodes, and often sensory polyneuropathy.

OUTRAS DOENÇAS (2)
hypoalphalipoproteinemia, primary, 1Tangier disease
HGNC:29UniProt:O95477

Variantes genéticas (ClinVar)

280 variantes patogênicas registradas no ClinVar.

🧬 ABCA1: NM_005502.4(ABCA1):c.1804C>T (p.Gln602Ter) ()
🧬 ABCA1: NM_005502.4(ABCA1):c.843dup (p.Arg282fs) ()
🧬 ABCA1: NM_005502.4(ABCA1):c.847C>T (p.Gln283Ter) ()
🧬 ABCA1: NM_005502.4(ABCA1):c.1265del (p.Lys422fs) ()
🧬 ABCA1: NM_005502.4(ABCA1):c.1758dup (p.Arg587fs) ()
Ver todas no ClinVar

Classificação de variantes (ClinVar)

Distribuição de 2 variantes classificadas pelo ClinVar.

1
1
Patogênica (50.0%)
VUS (50.0%)
VARIANTES MAIS SIGNIFICATIVAS
APOA1-AS: NC_000011.10:g.(?_116800700)_(116841000_?)del [Pathogenic]
APOA1: NM_000039.3(APOA1):c.566C>G (p.Pro189Arg) [Uncertain significance]

Diagnóstico

Os sinais que médicos procuram e os exames que confirmam

Carregando...

Tratamento e manejo

Remédios, cuidados de apoio e o que precisa acompanhar

Carregando informações de tratamento...

Onde tratar no SUS

Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)

🇧🇷 Atendimento SUS — Deficiência de apolipoproteína A-I

🗺️

Selecione um estado ou use sua localização para ver resultados.

Dados de DATASUS/CNES, SBGM, ABNeuro e Ministério da Saúde. Sempre confirme a disponibilidade diretamente com o estabelecimento.

Pesquisa ativa

Ensaios clínicos abertos e novidades científicas recentes

Pesquisa e ensaios clínicos

Nenhum ensaio clínico registrado para esta condição.

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Publicações mais relevantes

Timeline de publicações
3 papers (10 anos)
#1

Apolipoprotein A1 deficiency increases macrophage apoptosis and necrotic core development in atherosclerotic plaques in a Bim-dependent manner.

Journal of lipid research2025 May

In advanced atherosclerotic lesions, macrophage apoptosis contributes to plaque progression and the formation of necrotic cores, rendering plaques vulnerable to rupture. The proapoptotic protein B-cell lymphoma 2 [Bcl-2] interacting mediator of cell death (Bim) plays a crucial role in mediating apoptosis in macrophages under prolonged endoplasmic reticulum stress. HDL has been shown to suppress macrophage apoptosis induced by endoplasmic reticulum stressors. To investigate the impact of apolipoprotein A1 (ApoA1) deficiency, associated with reduced HDL levels, on necrotic core growth and plaque apoptosis, we introduced ApoA1 deficiency into low-density lipoprotein receptor (LDLR) knockout mice and fed them a high-fat diet for 10 weeks. ApoA1-deficient Ldlr KO mice developed advanced plaques characterized by large necrotic cores, increased apoptosis, and elevated Bim expression in macrophages within the plaques. To assess whether deletion of Bim could mitigate this development, mice underwent bone marrow transplantation with bone marrow from either Bim-deficient mice or from mice with a deletion of myeloid-derived Bim driven by LyzM-cre. Inhibiting Bim in all bone marrow-derived cells led to leukocytosis, reductions in plasma cholesterol and triglyceride levels, and decreased plaque apoptosis, necrotic core, and plaque sizes in ApoA1 and Ldlr double-KO mice but not in Ldlr KO mice. Likewise, conditional deletion of Bim in the myeloid compartment of ApoA1 and Ldlr double-KO mice also reduced apoptosis, necrotic core sizes, and plaque sizes, without inducing leukocytosis or lowering plasma cholesterol levels. These findings suggest that ApoA1 deficiency triggers apoptosis in myeloid cells through a Bim-dependent pathway, significantly contributing to the development of necrotic cores and the progression of atherosclerotic plaques.

#2

The lack of apoA-I in apoE-KO mice affects the liver transcriptome.

Nutrition, metabolism, and cardiovascular diseases : NMCD2025 Aug

Liver is the major organ involved in apoA-I synthesis and HDL-C turnover, but the impact of apoA-I/HDL on hepatic transcriptome has never been investigated before. In the present study, a transcriptomic analysis by high-throughput RNA-seq was conducted in the liver of atherosclerosis-prone mice, with the aim of identifying new genes/pathways modulated by apoA-I/HDL with a potential effect on atherosclerosis development. Eight-week-old apoE knockout (apoEKO) mice lacking apoA-I/HDL (DKO) and with physiological levels of apoA-I/HDL (DKO/hA-I) were fed either a standard rodent diet (SRD) or a Western diet (WD) for 22 weeks. After both dietary treatments, DKO mice were characterized by lower cholesterol levels, but increased atherosclerosis development, compared to DKO/hA-I mice. The liver transcriptome of DKO and DKO/hA-I mice fed SRD diverged in a relatively small number of genes, suggestive of a greater activation of the PPAR signaling pathway and the retinoid metabolism pathway in DKO/hA-I mice. Following WD, transcriptomic analysis highlighted in both genotypes an upregulated expression of immune/inflammatory genes and a reduced activation of the retinoid metabolism. The evaluation of the hepatic response of the two genotypes to the dietary switch from SRD to WD revealed strong divergences in genes involved in metabolic pathways only in the presence of apoA-I/HDL, with reduced endogenous sterol biosynthesis and glutathione metabolism, together with increased glucose metabolism. The presence or absence of apoA-I expression differently alters hepatic pathways involved not only in cholesterol metabolism, but also in those of glutathione and glucose metabolism.

#3

Apolipoprotein A1 deficiency in mice primes bone marrow stem cells for T cell lymphopoiesis.

Journal of cell science2022 Mar 01

The bone marrow has emerged as a potentially important target in cardiovascular disease as it generates all leukocytes involved in atherogenesis. In the current study, we evaluated whether a change in bone marrow functionality underlies the increased atherosclerosis susceptibility associated with high-density lipoprotein (HDL) deficiency. We found that HDL deficiency in mice due to the genetic lack of hepatocyte-derived apolipoprotein A1 (APOA1) was associated with an increase in the Lin-Sca-1+Kit+ (LSK) bone marrow stem cell population and lymphoid-primed multipotent progenitor numbers, which translated into a higher production and systemic flux of T cell subsets. In accordance with APOA1 deficiency-associated priming of stem cells to increase T lymphocyte production, atherogenic diet-fed low-density lipoprotein receptor knockout mice transplanted with bone marrow from APOA1-knockout mice displayed marked lymphocytosis as compared to wild-type bone marrow recipients. However, atherosclerotic lesion sizes and collagen contents were similar in the two groups of bone marrow recipients. In conclusion, systemic lack of APOA1 primes bone marrow stem cells for T cell lymphopoiesis. Our data provide novel evidence for a regulatory role of HDL in bone marrow functioning in normolipidemic mice.

#4

Serum apolipoprotein A-I depletion is causative to silica nanoparticles-induced cardiovascular damage.

Proceedings of the National Academy of Sciences of the United States of America2021 Nov 02

The rapid development of nanotechnology has greatly benefited modern science and engineering and also led to an increased environmental exposure to nanoparticles (NPs). While recent research has established a correlation between the exposure of NPs and cardiovascular diseases, the intrinsic mechanisms of such a connection remain unclear. Inhaled NPs can penetrate the air-blood barrier from the lung to systemic circulation, thereby intruding the cardiovascular system and generating cardiotoxic effects. In this study, on-site cardiovascular damage was observed in mice upon respiratory exposure of silica nanoparticles (SiNPs), and the corresponding mechanism was investigated by focusing on the interaction of SiNPs and their encountered biomacromolecules en route. SiNPs were found to collect a significant amount of apolipoprotein A-I (Apo A-I) from the blood, in particular when the SiNPs were preadsorbed with pulmonary surfactants. While the adsorbed Apo A-I ameliorated the cytotoxic and proinflammatory effects of SiNPs, the protein was eliminated from the blood upon clearance of the NPs. However, supplementation of Apo A-I mimic peptide mitigated the atherosclerotic lesion induced by SiNPs. In addition, we found a further declined plasma Apo A-I level in clinical silicosis patients than coronary heart disease patients, suggesting clearance of SiNPs sequestered Apo A-I to compromise the coronal protein's regular biological functions. Together, this study has provided evidence that the protein corona of SiNPs acquired in the blood depletes Apo A-I, a biomarker for prediction of cardiovascular diseases, which gives rise to unexpected toxic effects of the nanoparticles.

#5

The HDL from septic-ARDS patients with composition changes exacerbates pulmonary endothelial dysfunction and acute lung injury induced by cecal ligation and puncture (CLP) in mice.

Respiratory research2020 Nov 04

Septic-acute respiratory distress syndrome (ARDS), characterized by the acute lung injury (ALI) secondary to aberrant systemic inflammatory response, has high morbidity and mortality. Despite increased understanding of ALI pathogenesis, the therapies to prevent lung dysfunction underlying systemic inflammatory disorder remain elusive. The high density lipoprotein (HDL) has critical protective effects in sepsis and its dysfunction has a manifested contribution to septic organ failure. However, the adverse changes in HDL composition and function in septic-ARDS patients are large unknown. To investigate HDL remodeling in septic-ARDS, we analyzed the changes of HDL composition from 40 patients with septic-ARDS (A-HDL) and 40 matched normal controls (N-HDL). To determine the deleterious functional remodeling of HDL, A-HDL or N-HDL was administrated to C57BL/6 and apoA-I knock-out (KO) mice after cecal ligation and puncture (CLP) procedure. Mouse lung microvascular endothelial cells (MLECs) were further treated by these HDLs to investigate whether the adverse effects of A-HDL were associated with endothelial dysfunction. Septic-ARDS patients showed significant changes of HDL composition, accompanied with significantly decreased HDL-C. We further indicated that A-HDL treatment aggravated CLP induced ALI. Intriguingly, these deleterious effects of A-HDL were associated with pulmonary endothelial dysfunction, rather than the increased plasma lipopolysaccharide (LPS). Further in vitro results demonstrated the direct effects of A-HDL on MLECs, including increased endothelial permeability, enhanced expressions of adhesion proteins and pro-inflammatory cytokines via activating NF-κB signaling and decreased junction protein expression. Our results depicted the remodeling of HDL composition in sepsis, which predisposes lung to ARDS via inducing ECs dysfunction. These results also demonstrated the importance of circulating HDL in regulating alveolar homeostasis.

Publicações recentes

Ver todas no PubMed

📚 EuropePMC19 artigos no totalmostrando 25

2025

Apolipoprotein A1 deficiency increases macrophage apoptosis and necrotic core development in atherosclerotic plaques in a Bim-dependent manner.

Journal of lipid research
2025

The lack of apoA-I in apoE-KO mice affects the liver transcriptome.

Nutrition, metabolism, and cardiovascular diseases : NMCD
2021

Serum apolipoprotein A-I depletion is causative to silica nanoparticles-induced cardiovascular damage.

Proceedings of the National Academy of Sciences of the United States of America
2022

Apolipoprotein A1 deficiency in mice primes bone marrow stem cells for T cell lymphopoiesis.

Journal of cell science
2020

The HDL from septic-ARDS patients with composition changes exacerbates pulmonary endothelial dysfunction and acute lung injury induced by cecal ligation and puncture (CLP) in mice.

Respiratory research
2020

Serum amyloid A is not incorporated into HDL during HDL biogenesis.

Journal of lipid research
2019

Distinct phospholipid and sphingolipid species are linked to altered HDL function in apolipoprotein A-I deficiency.

Journal of clinical lipidology
2019

Impact of apolipoprotein A1- or lecithin:cholesterol acyltransferase-deficiency on white adipose tissue metabolic activity and glucose homeostasis in mice.

Biochimica et biophysica acta. Molecular basis of disease
2019

LC-MS-Based Metabolomics and Lipidomics Study of High-Density-Lipoprotein-Modulated Glucose Metabolism with an apoA-I Knockout Mouse Model.

Journal of proteome research
2018

Plasma PCSK9 levels and lipoprotein distribution are preserved in carriers of genetic HDL disorders.

Biochimica et biophysica acta. Molecular and cell biology of lipids
2018

A case of apolipoprotein A-I deficiency due to carboxyl-terminal truncation.

Journal of clinical lipidology
2017

Depletion in LpA-I:A-II particles enhances HDL-mediated endothelial protection in familial LCAT deficiency.

Journal of lipid research
2017

Simvastatin treatment aggravates the glucocorticoid insufficiency associated with hypocholesterolemia in mice.

Atherosclerosis
2017

Corneal vesicles accumulate collagen VI associated with tissue remodeling in apolipoprotein a-I deficiency: a case report.

BMC ophthalmology
2016

The 5A apolipoprotein A-I (apoA-I) mimetic peptide ameliorates experimental colitis by regulating monocyte infiltration.

British journal of pharmacology
2016

Type 1 Deiodinase Regulates ApoA-I Gene Expression and ApoA-I Synthesis Independent of Thyroid Hormone Signaling.

Arteriosclerosis, thrombosis, and vascular biology
2016

Apolipoprotein A-1 regulates osteoblast and lipoblast precursor cells in mice.

Laboratory investigation; a journal of technical methods and pathology
2015

Lipidated APOE has effects on cognitive function that are independent of amyloid-β pathology.

Brain : a journal of neurology
2015

Opposing effects of Apoe/Apoa1 double deletion on amyloid-β pathology and cognitive performance in APP mice.

Brain : a journal of neurology
2015

Dyscholesterolemia Protects Against Ischemia-Induced Ventricular Arrhythmias.

Circulation. Arrhythmia and electrophysiology
2015

Deficiency in apolipoprotein A-I ablates the pharmacological effects of metformin on plasma glucose homeostasis and hepatic lipid deposition.

European journal of pharmacology
2016

Apolipoprotein A-I inhibits experimental colitis and colitis-propelled carcinogenesis.

Oncogene
2015

Myocardial infarction in a 36-year-old man with combined ABCA1 and APOA-1 deficiency.

Journal of clinical lipidology
2015

Associations of ApoAI and ApoB-containing lipoproteins with AngII-induced abdominal aortic aneurysms in mice.

Arteriosclerosis, thrombosis, and vascular biology
2015

Defective functionality of small, dense HDL3 subpopulations in ST segment elevation myocardial infarction: Relevance of enrichment in lysophosphatidylcholine, phosphatidic acid and serum amyloid A.

Biochimica et biophysica acta

Associações

Organizações que acompanham esta doença — pra ter apoio e orientação

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Comunidades

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Doenças relacionadas

Doenças com sintomas parecidos — ajudam quem ainda está buscando diagnóstico

Referências e fontes

Bases de dados externas citadas neste artigo

Publicações científicas

Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.

  1. Apolipoprotein A1 deficiency increases macrophage apoptosis and necrotic core development in atherosclerotic plaques in a Bim-dependent manner.
    Journal of lipid research· 2025· PMID 40120762mais citado
  2. The lack of apoA-I in apoE-KO mice affects the liver transcriptome.
    Nutrition, metabolism, and cardiovascular diseases : NMCD· 2025· PMID 40087046mais citado
  3. Apolipoprotein A1 deficiency in mice primes bone marrow stem cells for T cell lymphopoiesis.
    Journal of cell science· 2022· PMID 34698355mais citado
  4. Serum apolipoprotein A-I depletion is causative to silica nanoparticles-induced cardiovascular damage.
    Proceedings of the National Academy of Sciences of the United States of America· 2021· PMID 34716267mais citado
  5. The HDL from septic-ARDS patients with composition changes exacerbates pulmonary endothelial dysfunction and acute lung injury induced by cecal ligation and puncture (CLP) in mice.
    Respiratory research· 2020· PMID 33148285mais citado
  6. Distinct phospholipid and sphingolipid species are linked to altered HDL function in apolipoprotein A-I deficiency.
    J Clin Lipidol· 2019· PMID 31003938recente
  7. A case of apolipoprotein A-I deficiency due to carboxyl-terminal truncation.
    J Clin Lipidol· 2018· PMID 29396262recente
  8. Corneal vesicles accumulate collagen VI associated with tissue remodeling in apolipoprotein a-I deficiency: a case report.
    BMC Ophthalmol· 2017· PMID 28178939recente
  9. Apolipoprotein A-I deficiency does not affect biliary lipid secretion and gallstone formation in mice.
    Liver Int· 2011· PMID 21134113recente
  10. Apolipoprotein A-I deficiency increases cerebral amyloid angiopathy and cognitive deficits in APP/PS1DeltaE9 mice.
    J Biol Chem· 2010· PMID 20739292recente

Bases de dados e fontes oficiais

Identificadores e referências canônicas usadas para montar este verbete.

  1. ORPHA:425(Orphanet)
  2. MONDO:0700513(MONDO)
  3. Variantes catalogadas(ClinVar)
  4. Busca completa no PubMed(PubMed)
  5. Q12638716(Wikidata)

Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.

Conteúdo mantido por Agente Raras · Médicos e pesquisadores podem colaborar

Deficiência de apolipoproteína A-I
Compêndio · Raras BR

Deficiência de apolipoproteína A-I

ORPHA:425 · MONDO:0700513
Prevalência
<1 / 1 000 000
Casos
30 casos conhecidos
Herança
Autosomal dominant
CID-10
E78.6 · Deficiências de lipoproteínas
CID-11
Início
All ages
Prevalência
0.0 (Worldwide)
MedGen
UMLS
C0342898
EuropePMC
Wikidata
Papers 10a
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