Promoting cycling of ApoE4 isoform

1. A method of decreasing surface expression of ApoER2, NMDA NR2B, GluR1 and GluR2/R3 receptors in a person in need thereof, the method comprising a step of contacting the person with an effective amount of a pharmaceutically-acceptable modulator of intracellular ApoE4 transport vesicle pH and wherein the modulator is a sodium-hydrogen exchanger (NHE) inhibitor.

2. The method of claim 1 wherein the modulator is an isoform-selective NHE inhibitor.

3. The method of claim 1 wherein the modulator is an NHE inhibitor that is selected from (a) an aroylguanidine; (b) a 6-membered heteroaroylguanidine; (c) a 5-membered heteroaroylguanidine; and (d) a spacer-stretched aroylguanidine.

4. The method of claim 1 wherein the modulator is an NHE inhibitor that is an aroylguanidine selected from: cariporide mesilate (Hoe 642); eniporide; EMD 87580 (N-(2-methyl-4,5-bis(methylsulfonyl)benzoyl)guanidine); KB-R9032 (Kanebo); BIIB 513 (Boehringer Ingelheim); and FR-183998 (Fujisawa).

5. The method of claim 1 wherein the modulator is an NHE inhibitor that is a 6-membered heteroaroylguanidine selected from: amiloride; 5-N-dimethylamiloride (DMA); 5-(N-methyl-N-isobutyl)-amiloride (MIA); 5-(N-ethyl-N-isopropyl)-amiloride (EIPA); TY-12533 (To a Eiyo); and MS-31-038 (Mitsui Toatsu).

6. The method of claim 1 wherein the modulator is an NHE inhibitor that is a 5-membered heteroaroylguanidine selected from: Zoniporide (Pfizer); SM-20220 (Sumitomo Pharmaceuticals); and SMP-300 (Sumitomo Pharmaceuticals).

7. The method of claim 1 wherein the modulator is an NHE inhibitor that is spacer-stretched aroylguanidine selected from: S10519 (Aventis Pharma Deutschland GmbH); and BMX-284640 (Bristol-Myers Squibb).

8. The method of claim 1 wherein the modulator is an NHE inhibitor that is EMD 87580 (N-(2-methyl-4,5-bis(methylsulfonyl)benzoyl)guanidine).

9. The method of claim 1 wherein the person is determined to have a neurodegenerative disease selected from: Alzheimer's disease (AD) or frontotemporal dementia (FTD), neurotrauma or pathogenically elevated plasma LDL.

10. The method of claim 1 further comprising a step of detecting a resultant increase in ApoE4 cycling or trafficking.

11. The method of claim 1 wherein the effective amount is administered chronically.

12. The method of claim 1 further comprising an antecedent step of determining the person is an ApoE4 carrier.

13. The method of claim 1 further comprising an antecedent step of determining the person is a homozygote ApoE4 carrier.

14. A method of decreasing surface expression of ApoER2, NMDA NR2B, GluR1 and GluR2/R3 in a person in need thereof, the method comprising steps of:

(a) determining the person is an ApoE4 carrier; and

(b) contacting the person with an effective amount of a pharmaceutically-acceptable sodium-hydrogen exchanger (NHE) inhibitor selected from an aroylguanidine, a heteroaroylguanidine, and a spacer-stretched aroylguanidine.

15. The method of claim 14 wherein the NHE inhibitor is an aroylguanidine selected from: cariporide mesilate (Hoe 642); eniporide; EMD 87580 (N-(2-methyl-4,5-bis(methylsulfonyl)benzoyl)guanidine); KB-R9032 (Kanebo); BIIB 513 (Boehringer Ingelheim); and FR-183998 (Fujisawa).

16. A method of decreasing surface expression of ApoER2, NMDA NR2B, GluR1 and GluR2/R3 in a cell in need thereof, the method comprising a step of contacting the cell with an effective amount of a pharmaceutically-acceptable modulator of intracellular ApoE4 transport vesicle pH, wherein the modulator is an NHE inhibitor that is an aroylguanidine selected from: cariporide mesilate (Hoe 642); eniporide; EMD 87580 (N-(2-methyl-4,5-bis(methylsulfonyl)benzoyl)guanidine); KB-R9032 (Kanebo); BIIB 513 (Boehringer Ingelheim); and FR-183998 (Fujisawa).

17. The method of claim 16 further comprising a step of detecting a resultant increase in ApoE receptor recycling.

18. The method of claim 17 wherein the NHE inhibitor is an aroylguanidine that is EMD 87580 (N-(2-methyl-4,5-bis(methylsulfonyl)benzoyl)guanidine).