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This 2023 review describes evidence suggesting that APOE4, a gene associated with a higher risk of Alzheimer’s disease later in life, confers resistance to gut infections in children – a robust contributor to high childhood mortality. This dual nature of APOE4 may be an example of antagonistic pleiotropy, a theoretical construct that asserts that when a gene has two or more effects – with one beneficial and the other harmful – the beneficial one exerts its effects early in life, while the harmful one takes a toll later.

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