Apolipoprotein E aggregation in microglia initiates Alzheimer’s disease pathology by seeding β-amyloidosis
Open accessAbstract
The seeded growth of pathogenic protein aggregates underlies the pathogenesis of Alzheimer's disease (AD), but how this pathological cascade is initiated is not fully understood. Sporadic AD is linked genetically to apolipoprotein E (APOE) and other genes expressed in microglia related to immune, lipid, and endocytic functions. We generated a transgenic knockin mouse expressing HaloTag-tagged APOE and optimized experimental protocols for the biochemical purification of APOE, which enabled us to identify fibrillary aggregates of APOE in mice with amyloid-β (Aβ) amyloidosis and in human AD brain autopsies. These APOE aggregates that stained positive for β sheet-binding dyes triggered Aβ amyloidosis within the endo-lysosomal system of microglia, in a process influenced by microglial lipid metabolism and the JAK/STAT signaling pathway. Taking these observations together, we propose a model for the onset of Aβ amyloidosis in AD, suggesting that the endocytic uptake and aggregation of APOE by microglia can initiate Aβ plaque formation.
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Aβ can bind to lipoproteins such as clusterin (ApoJ) and ApoE in the brain, which facilitates its clearance by microglia via TREM2.
“However, Aβ can bind to lipoproteins such as clusterin (ApoJ) and ApoE in the brain82–84, which facilitates its clearance by microglia via TREM281.”
From INPP5D/SHIP1 regulates endo-lysosomal function and cargo-selective phagocytosis in human microglia (2025) · cites this paper as [81]
In the lysosomal dysfunction section (p. 10), TREM2-deficient microglia have more APOE/Aβ-associated aggregates, supporting a role for TREM2 in limiting their accumulation. The paper does not establish that binding of Aβ to ApoE or clusterin facilitates its clearance via TREM2; its uptake experiments (pp. 12, 15) concern ApoE and do not test that full mechanism. (LLM, conf=0.82)
Experimental — accuracy not yet measuredTREM2 has been shown to bind to Aβ and facilitate its uptake.
“Although TREM2 has been shown to bind to Aβ and facilitate its uptake80,81, the surface expression changes of other receptors involved in Aβ recognition and uptake might have counteracted the effects of increased TREM2 signaling upon INPP5D haploinsufficiency83,84.”
From INPP5D/SHIP1 regulates endo-lysosomal function and cargo-selective phagocytosis in human microglia (2025) · cites this paper as [81]
The reference list (Article, p. 19) names a study reporting that TREM2 binds apolipoproteins and thereby facilitates microglial uptake of Aβ. It does not say TREM2 binds Aβ directly. The TREM2-knockout experiments (p. 10) examine aggregate formation, not direct binding. (LLM, conf=0.83)
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Johnston, R. J., Torres, N. A. P., Li, Y., & Han, C. Z. (2026) · Advances in immunology · doi:10.1016/bs.ai.2026.06.005
Neurodegeneration as a dysregulation of neuroimmune crosstalk
Bennett, F. C., Hong, S. Y., Jiang, N. J., & Marazzi, I. (2026) · Cell · doi:10.1016/j.cell.2026.07.015 · Cited by 2 · see citing works
- Authors
- Kaji, S., Berghoff, S. A., Spieth, L., Schlaphoff, L., Sasmita, A. O., Vitale, S., Büschgens, L., Kedia, S., Zirngibl, M., Nazarenko, T., Damkou, A., Hosang, L., Depp, C., Kamp, F., Scholz, P., Ewers, D., Giera, M., Ischebeck, T., Wurst, W., Wefers, B., Schifferer, M., Willem, M., Nave, K.-A., Haass, C., Arzberger, T., Jäkel, S., Wirths, O., Saher, G., & Simons, M.
- Affiliations
- German Center for Neurodegenerative Diseases (DE)
- Max Planck Institute for Multidisciplinary Sciences (DE)
- Universitätsmedizin Göttingen (DE)
- University of Göttingen (DE)
- Leiden University Medical Center (NL)
- University of Münster (DE)
- Munich Cluster for Systems Neurology (DE)
- Ludwig-Maximilians-Universität München (DE)
- LMU Klinikum (DE)
- Institut für Schlaganfall- und Demenzforschung (DE)
- Corresponding author
- Berghoff, Stefan A.
- Simons, Mikael
- ORCID
- Kaji, Seiji
- Berghoff, Stefan A.
- Spieth, Lena
- Schlaphoff, Lennart
- Sasmita, Andrew O.
- Büschgens, Luca
- Kedia, Shreeya
- Zirngibl, Martin
- Damkou, Alkmini
- Depp, Constanze
- Kamp, Frits
- Scholz, Patricia
- Ewers, David
- Giera, Martin
- Ischebeck, Till
- Wurst, Wolfgang
- Wefers, Benedikt
- Schifferer, Martina
- Willem, Michael
- Nave, Klaus-Armin
- Haass, Christian
- Jäkel, Sarah
- Wirths, Oliver
- Saher, Gesine
- Simons, Mikael
- Venue
- Immunity
- Publisher
- Elsevier BV
- Published
- 2024-11
- Volume
- 57
- Issue
- 11
- Pages
- 2651-2668.e12
- ISSN
- 1074-7613 (ISSN-L)
- OpenAlex
- W4403455151
- Cited by
- 104
- References
- 81
- Citations by year
- 2026: 38 · 2025: 58 · 2024: 8
- FWCI
- 29.60
- Type
- journal article
- Language
- en
- Update notices
- erratum (2025-01-14)
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Immunity (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PuSH - Publication Server of Helmholtz Zentrum München (submittedVersion, cc-by)
- Leiden Repository (Leiden University) (submittedVersion, cc-by)
- Open access LMU (Ludwid Maxmilian's Universitat Munchen) (submittedVersion, cc-by)
- mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
- DZNE Pub (submittedVersion, cc-by)
- GoeScholar The Publication Server of the Georg-August-Universität Göttingen (Georg-August-Universität Göttingen) (submittedVersion, cc-by)
- Funders
- HORIZON EUROPE European Research Council
- Topics
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- apolipoprotein E, protein aggregation, microglia, Alzheimer's disease, amyloid-beta, seeding, endolysosomal system, JAK/STAT signaling, endocytic uptake, amyloid plaques, HaloTag
- MeSH terms
- Alzheimer Disease, Amyloidosis, Animals, Apolipoproteins E, Brain, Disease Models, Animal, Humans, Mice, Transgenic, Signal Transduction, Amyloid beta-Peptides, Microglia, Lipid Metabolism, STAT Transcription Factors, Mice, Janus Kinases, Plaque, Amyloid, Protein Aggregation, Pathological
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