Aldrich, Gregory J, Nkiliza, Aurore, Ferguson, Scott et al. · Environmental toxicology and pharmacology · 2025 · DOI
Researchers studied whether a genetic variant called APOE4 makes people more vulnerable to neurological problems from brevetoxins—toxic chemicals released by harmful algae blooms in coastal Florida waters. They found that people carrying the APOE4 gene variant reported more memory problems and fatigue during red tide events compared to those without this variant. This suggests that certain genetic factors may increase how vulnerable someone's brain is to environmental toxins.
This study identifies a potential genetic risk factor that could explain variable neurological responses to environmental toxins, relevant to understanding post-environmental exposure syndromes including those with ME/CFS-like features. The finding of gene-environment interactions may help identify vulnerable subpopulations and informs mechanistic research into toxin-induced neurological injury. For ME/CFS patients with potential toxicant exposure history, APOE4 status could represent a biomarker for increased susceptibility.
This study does not prove that APOE4 causes neurological symptoms or that brevetoxin exposure directly causes ME/CFS—it only shows an association in one geographic population. The cross-sectional design cannot establish temporal relationships or exclude reverse causality. APOE4 frequency varies significantly by ancestry, and the extent to which these findings generalize beyond coastal Florida is unclear.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Aldrich, Gregory J, Nkiliza, Aurore, Ferguson, Scott, Niedospial, Daniel, Helgager, Dakota, Keegan, Andrew P, et al. (2025). The impact of APOE4 on neurological symptoms after exposure to K. brevis neurotoxin.. Environmental toxicology and pharmacology. https://doi.org/10.1016/j.etap.2024.104621
BibTeX
@article{mecfsatlas-aldrich-2025-impact-apoe4,
author = {Aldrich, Gregory J and Nkiliza, Aurore and Ferguson, Scott and Niedospial, Daniel and Helgager, Dakota and Keegan, Andrew P and Paris, Daniel and Kirkpatrick, Barbara and Crawford, Fiona and Mullan, Michael and Abdullah, Laila},
title = {The impact of APOE4 on neurological symptoms after exposure to K. brevis neurotoxin.},
journal = {Environmental toxicology and pharmacology},
year = {2025},
doi = {10.1016/j.etap.2024.104621},
note = {PubMed: 39710124},
url = {https://www.mecfsatlas.com/evidence/aldrich-2025-impact-apoe4},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/aldrich-2025-impact-apoe4
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