Cited by 136Alzheimer's disease research and treatmentsNeuroinflammation and Neurodegeneration MechanismsNeurological Disease Mechanisms and Treatments

The DOI matches its Crossref record; 55 of the 55 references it cites were found in a registry or an index; 29 of the 44 sources its claims cite were checked for support.

Overexpressing low‐density lipoprotein receptor reduces tau‐associated neurodegeneration in relation to apoE‐linked mechanisms

Open access

Abstract

APOE is the strongest genetic risk factor for late-onset Alzheimer's disease. ApoE exacerbates tau-associated neurodegeneration by driving microglial activation. However, how apoE regulates microglial activation and whether targeting apoE is therapeutically beneficial in tauopathy is unclear. Here, we show that overexpressing an apoE metabolic receptor, LDLR (low-density lipoprotein receptor), in P301S tauopathy mice markedly reduces brain apoE and ameliorates tau pathology and neurodegeneration. LDLR overexpression (OX) in microglia cell-autonomously downregulates microglial Apoe expression and is associated with suppressed microglial activation as in apoE-deficient microglia. ApoE deficiency and LDLR OX strongly drive microglial immunometabolism toward enhanced catabolism over anabolism, whereas LDLR-overexpressing microglia also uniquely upregulate specific ion channels and neurotransmitter receptors upon activation. ApoE-deficient and LDLR-overexpressing mice harbor enlarged pools of oligodendrocyte progenitor cells (OPCs) and show greater preservation of myelin integrity under neurodegenerative conditions. They also show less reactive astrocyte activation in the setting of tauopathy.

Overview

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Written from the paper’s full text.

TL;DR

Overexpressing LDLR in P301S tauopathy mice markedly lowers brain apoE and reduces tau pathology, neurodegeneration, synaptic loss, and microglial activation. The protective effects are linked to apoE-dependent microglial metabolic reprogramming, with additional preservation of myelin and OPC pools.

Key findings

  • LDLR overexpression (OX) in P301S mice at 9 months reduced brain atrophy, synaptic loss, and postsynaptic density loss, and shifted p-tau staining toward an early-disease pattern; CSF and soluble brain apoE were reduced by ~90%, and p-tau was significantly reduced in RAB and RIPA fractions, while total human tau was unchanged.
  • Microglial LDLR OX cell-autonomously downregulated microglial *Apoe* expression and intracellular apoE, and was associated with suppressed microglial activation; in 20-month mice, LDLR microglia showed reduced “DAM” and proinflammatory gene expression, and P301S/LDLR mice had less CD68+ microglial activation than P301S mice.
  • snRNAseq of 31,785 nuclei identified 10 cell clusters; microglial subclustering found a P301S-enriched DAM cluster, a P301S/LDLR-unique cluster, and an apoE-deficiency-associated cluster. ApoE-deficient and LDLR microglia shifted toward catabolism with upregulated lysosomal genes and LGMN, downregulated anabolic/mTOR pathways, and LDLR microglia uniquely upregulated ion channels and neurotransmitter receptors.
  • ApoE-deficient and LDLR-overexpressing mice had enlarged OPC pools and greater myelin preservation: OPC cluster representation was ~20% in EKO/P301S/EKO, 10–13% in LDLR/P301S/LDLR, and 3–5% in WT/P301S; P301S/LDLR and P301S/EKO mice also showed less demyelination and lower axonal G-ratio than P301S mice, with less reactive astrocyte activation.

Methods

  • LDLR Tg mice were crossed to P301S and apoE KO mice; experiments used male mice except where stated, at ages including 3, 9, 20, and 24 months, with primary microglia, acutely isolated microglia, FACS, qPCR, western blot, ELISA, immunohistochemistry, electron microscopy, and lysosomal enzyme activity assays.
  • Single-nuclei RNAseq used 10x Genomics on pooled hippocampi from 7–8 mice per genotype, yielding 31,785 nuclei; Seurat was used for clustering, MAST for differential expression, and Metascape for pathway analysis.
  • Statistics used mean ± SEM, normality testing, t-tests or one-way ANOVA with Tukey post hoc, or Mann-Whitney/Kruskal-Wallis with Dunn’s post hoc, with significance thresholds *p*<0.05 to *p*<0.0001.

Limitations

  • The paper states that further study is required to carefully address whether LDLR affects pathological tau spreading, and that functional characterization of reactive astrocytes in neurodegeneration needs future studies.
  • Evident from the text: snRNAseq pooled 7–8 mice per genotype into a single sample per genotype, limiting animal-level statistical inference for transcriptomic comparisons.
  • Evident from the text: male mice were used for all experiments except a few cases where sex was specifically stated, limiting generalization across sexes; the paper also notes that absolute tau and p-tau ELISA values cannot be directly compared because of different standards and antibody-binding capacities.

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Integrity signals

Registry

Crossref · 10.1016/j.neuron.2021.05.034

Cites

55 of 55 references verified0 citation errors · 0 not checkable

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29 of 44 cited sources checked · 22 supported · 1 flagged · accuracy not yet measured

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  • Probably not a substantial claim. 31
  • It may state two separate claims as one. 37
59 of 59
  • The paper relies on this without support.

    Male P301S mice start developing overt tau pathology from ~5-6 months of age and show severe brain atrophy at 9 months of age.

    “Male P301S mice start developing overt tau pathology from ~5-6 months of age and show severe brain atrophy at 9 months of age.”
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  • The stated Naglu substrate has the wrong linkage

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    The paper identifies Naglu as an α-glucosaminidase but lists a β-linked substrate for its activity assay. Cleavage of that substrate would not specifically measure the stated Naglu activity, undermining the reported increase in activity for that enzyme.

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Metadata

Authors
Shi, Y., Andhey, P. S., Ising, C., Wang, K., Snipes, L. L., Boyer, K., Lawson, S., Yamada, K., Qin, W., Manis, M., Serrano, J. R., Benitez, B. A., Schmidt, R. E., Artyomov, M., Ulrich, J. D., & Holtzman, D. M.
Affiliations
  • Washington University in St. Louis (US)
  • University Hospital Bonn (DE)
  • The University of Tokyo (JP)
Corresponding author
  • Ulrich, Jason D.
  • Holtzman, David M.
Venue
Neuron
Publisher
Elsevier BV
Published
2021-08
Volume
109
Issue
15
Pages
2413-2426.e7
ISSN
0896-6273 (ISSN-L)
OpenAlex
W3177458716
Cited by
135
References
55
Citations by year
2026: 21 · 2025: 31 · 2024: 25 · 2023: 21 · 2022: 28 · 2021: 9
FWCI
13.02
Type
journal article
Language
en
Open access
Locations
  • Neuron (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • DZNE Pub (submittedVersion)
Funders
  • JPB Foundation
  • National Institutes of Health (AG047644, NS090934)
  • University of Washington
  • Genentech
  • Diabetes Research Center
  • Tau Consortium
  • Merck
Topics
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
  • Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
  • Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
Keywords
LDL receptor, apolipoprotein E, tauopathy, Alzheimer's disease, microglial activation, oligodendrocyte precursor cells, myelin integrity, reactive astrocytes, ion channels, neurotransmitter receptors, neurodegeneration
MeSH terms
Animals, Apolipoproteins E, Male, Nerve Degeneration, Receptors, LDL, Microglia, Mice, Knockout, Tauopathies, Mice

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