CSF1R inhibitors induce a sex-specific resilient microglial phenotype and functional rescue in a tauopathy mouse model
Open accessAbstract
Microglia are central to pathogenesis in many neurological conditions. Drugs targeting colony-stimulating factor-1 receptor (CSF1R) to block microglial proliferation in preclinical disease models have shown mixed outcomes, thus the therapeutic potential of this approach remains unclear. Here, we show that CSF1R inhibitors given by multiple dosing paradigms in the Tg2541 tauopathy mouse model cause a sex-independent reduction in pathogenic tau and reversion of non-microglial gene expression patterns toward a normal wild type signature. Despite greater drug exposure in male mice, only female mice have functional rescue and extended survival. A dose-dependent upregulation of immediate early genes and neurotransmitter dysregulation are observed in the brains of male mice only, indicating that excitotoxicity may preclude functional benefits. Drug-resilient microglia in male mice exhibit morphological and gene expression patterns consistent with increased neuroinflammatory signaling, suggesting a mechanistic basis for sex-specific excitotoxicity. Complete microglial ablation is neither required nor desirable for neuroprotection and therapeutics targeting microglia must consider sex-dependent effects.
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Studies using transgenic P301STau mice report that microglial depletion reduced neurodegeneration and the accumulation of phosphorylated tau.
“In line with our findings, studies using transgenic P301STau mice report that microglial depletion reduced neurodegeneration and the accumulation of phosphorylated tau (Johnson et al., 2023; Mancuso et al., 2019; Shi et al., 2019).”
From A novel molecular class that recruits HDAC/MECP2 complexes to PU.1 motifs reduces neuroinflammation (2023) · cites this paper as Johnson et al., 2023
The Results section on pathogenic tau reports that CSF1R-inhibitor treatment reduced phosphorylated tau in P301S Tg2541 mice. But the Results section on CNS injury reports reduced plasma NfL, a marker of neuronal injury, in treated females and increased NfL in treated males under the continuous-treatment regimen. Thus, the unqualified claim that microglial depletion reduced neurodegeneration omits an important sex-dependent limitation. No page numbers are available in our copy. (LLM, conf=0.88)
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Hyperactivity with Agitative-Like Behavior in a Mouse Tauopathy Model
Jul, P., Volbracht, C., de Jong, I. E. M., Helboe, L., Elvang, A. B., & Pedersen, J. T. (2015) · Journal of Alzheimer s Disease · doi:10.3233/jad-150292 · Cited by 57 · see citing works
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Microglial depletion and activation: A [11C]PBR28 PET study in nonhuman primates
Hillmer, A. T., Holden, D., Fowles, K., Nabulsi, N., West, B. L., Carson, R. E., & Cosgrove, K. (2017) · EJNMMI Research · doi:10.1186/s13550-017-0305-0 · Cited by 49 · see citing works
Wang, X., Smith, K. D. B., Pearson, M. S., Hughes, A. C., Cosden, M. L., Marcus, J., Hess, J. F., Savage, M. J., Rosahl, T. W., Smith, S. M., et al. (2018) · PLoS ONE · doi:10.1371/journal.pone.0195486 · Cited by 35 · see citing works
Sex- and region-biased depletion of microglia/macrophages attenuates CLN1 disease in mice
Berve, K., West, B. L., Martini, R., & Groh, J. (2020) · Journal of Neuroinflammation · doi:10.1186/s12974-020-01996-x · Cited by 27 · see citing works
Evidence for sortilin modulating regional accumulation of human tau prions in transgenic mice
Johnson, N. R., Condello, C., Guan, S., Oehler, A., Becker, J., Gavidia, M., Carlson, G. A., Giles, K., & Prusiner, S. B. (2017) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1717193114 · Cited by 26 · see citing works
Prion biology: implications for Alzheimer's disease therapeutics
Condello, C., DeGrado, W. F., & Prusiner, S. B. (2020) · The Lancet Neurology · doi:10.1016/s1474-4422(20)30274-x · Cited by 19 · see citing works
Tau impairs neural circuits, dominating amyloid-beta effects, in Alzheimer models in vivo
Busche, M., Wegmann, S., Dujardin, S., Commins, C., Schiantarelli, J., Klickstein, N., Kamath, T., Carlson, G., Nelken, I., & Hyman, B. (2019) · UCL Discovery (University College London) · Cited by 4 · see citing works
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Microglia-Astrocyte Communication in Alzheimer’s Disease
Wu, Y., & Eisel, U. L. M. (2023) · Journal of Alzheimer s Disease · doi:10.3233/jad-230199 · Cited by 118 · see citing works
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Neuroimmune crosstalk in chronic neuroinflammation: microglial interactions and immune modulation
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de Vries, L. E., Huitinga, I., Kessels, H. W. H. G., Swaab, D. F., & Verhaagen, J. (2024) · Molecular Neurodegeneration · doi:10.1186/s13024-024-00719-7 · Cited by 82 · see citing works
Zhang, X., Li, H., Gu, Y., Ping, A., Chen, J., Qia, Z., Xu, Z., Wang, J., Tang, S., Wang, R., et al. (2025) · Nature Communications · doi:10.1038/s41467-025-58254-y · Cited by 72 · see citing works
The Landscape of SPP1 + Macrophages Across Tissues and Diseases: A Comprehensive Review
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A novel molecular class that recruits HDAC/MECP2 complexes to PU.1 motifs reduces neuroinflammation
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Single-cell sequencing of the substantia nigra reveals microglial activation in a model of MPTP
Liu, Q., Liu, Z., Xie, W., Li, Y., Wang, H., Zhang, S., Wang, W., Hao, J., Geng, D., Yang, J., et al. (2024) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2024.1390310 · Cited by 20 · see citing works
Bobotis, B. C., Halvorson, T., Carrier, M., & Tremblay, M. (2024) · Frontiers in Cellular Neuroscience · doi:10.3389/fncel.2024.1317125 · Cited by 21 · see citing works
Niche-specific therapeutic targeting of myeloid cells in the central nervous system
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A case for seeking sex-specific treatments in Alzheimer’s disease
Lynch, M. A. (2024) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2024.1346621 · Cited by 14 · see citing works
Henningfield, C. M., Soni, N., Lee, R. W., Sharma, R. B., Cleland, J. L., & Green, K. N. (2024) · Alzheimer s Research & Therapy · doi:10.1186/s13195-024-01470-3 · Cited by 14 · see citing works
Norrie, J. L., Lupo, M. S., Little, D. R., Shirinifard, A., Mishra, A., Zhang, Q., Geiger, N., Putnam, D. K., Djekidel, M. N., Ramirez, C. A., et al. (2023) · Developmental Cell · doi:10.1016/j.devcel.2024.12.014 · Cited by 14 · see citing works
Exploring microglial replacement: From disease models to clinical translation
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Le, L., Eliseeva, S. I., Plunk, E. C., Kara-Pabani, K., Li, H., Yarovinsky, F., & Majewska, A. K. (2025) · Cell Reports · doi:10.1016/j.celrep.2024.115176 · Cited by 12 · see citing works
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Holmes, B. B., Weigel, T. K., Chung, J. M., Kaufman, S. K., Apresa, B. I., Byrnes, J. R., Kumru, K. S., Vaquer‐Alicea, J., Gupta, A., Rose, I. V. L., et al. (2025) · Molecular Neurodegeneration · doi:10.1186/s13024-025-00883-4 · Cited by 13 · see citing works
Expansion and pathogenic activation of skeletal muscle–resident macrophages in mdx5cv/Ccr2−/− mice
Wang, Y.-H., Wang, X., Alabdullatif, S., Homma, S. T., Alekseyev, Y. O., & Zhou, L. (2025) · Proceedings of the National Academy of Sciences of the United States of America · doi:10.1073/pnas.2410095122 · Cited by 13 · see citing works
Twenty years of therapeutic development in tauopathy mouse models: a scoping review
Langness, V. F., Simmons, D. A., McHugh, T. L. M., Butler, R. R., Zhou, J., Liu, H., Yang, T., Ellerby, L., & Longo, F. M. (2025) · Alzheimer s & Dementia · doi:10.1002/alz.70578 · Cited by 9 · see citing works
Cao, K., Cheng, W., Qiu, L., Wang, Z., Zhao, Y., Yuan, Y., Wu, W., Xue, J., Zeng, L., Wu, Z.-Y., et al. (2026) · Neuron · doi:10.1016/j.neuron.2025.12.044 · Cited by 12 · see citing works
Zattoni, M., Bernegger, S., Weinbender, S., Altendorfer, B., Mrowetz, H., Benedetti, A., Poupardin, R., Unger, M. S., & Aigner, L. (2025) · Scientific Reports · doi:10.1038/s41598-025-22137-5 · Cited by 7 · see citing works
Chakif, D., & Furrer, J. (2026) · Frontiers in Pharmacology · doi:10.3389/fphar.2026.1765786 · Cited by 9 · see citing works
Modulation of recovery from neonatal hyperoxic lung injury by sex as a biological variable
Cantu, A., Gutierrez, M. E. C., Dong, X., Leek, C. C., Anguera, M. C., & Lingappan, K. (2023) · Redox Biology · doi:10.1016/j.redox.2023.102933 · Cited by 7 · see citing works
Taylor, I., Patkar, O. L., Liu, Y., Jacquelin, S., Green, E. K., Ranpura, G. N., Carter‐Cusack, D., Rosendahl, N., Ewing, A. D., Kurniawan, N. D., et al. (2025) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2025.01.16.633478 · Cited by 6 · see citing works
Ferreira, A. F. F., Santos-Silva, A. C., Muratori, B. G., & Britto, L. R. G. (2026) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2026.1733682 · Cited by 5 · see citing works
Scott, L., Winzey, K. D., Moreira, D., Bresee, C. J., Vit, J., Tourtellotte, W. G., Karumanchi, S. A., & Lahiri, S. (2024) · Journal of Neuroinflammation · doi:10.1186/s12974-024-03260-y · Cited by 5 · see citing works
Plasma neurofilament light reflects more severe manifestation of Alzheimer’s disease in men
Cheng, X.-Q., Wang, Z.-H., He, K., Xia, Y., Wang, Y., Guo, Q.-H., Xie, F., & Yuan, P. (2025) · Molecular Psychiatry · doi:10.1038/s41380-025-03149-z · Cited by 4 · see citing works
Chen, F., Wang, H., Liu, Y., Liu, Q., Yang, S., Ma, Z., & Yuan, Y. (2025) · Theriogenology · doi:10.1016/j.theriogenology.2025.117756 · Cited by 4 · see citing works
Seifinejad, A., Bandarabadi, M., Haddar, M., Wundt, S., Tafti, M., Vassalli, A., Khani, A., & Monaco, G. (2025) · Communications Biology · doi:10.1038/s42003-025-08781-7 · Cited by 3 · see citing works
Wang, S., Wang, Y., Strehle, J., Wernersbach, I., Papakonstantinou, E., Somnuke, P., Ritter, K., Klein, M., Tegeder, I., & Schäfer, M. K. E. (2025) · Neurotherapeutics · doi:10.1016/j.neurot.2025.e00787 · Cited by 3 · see citing works
Sharma, A., & Singh, T. G. (2026) · Molecular and Cellular Neuroscience · doi:10.1016/j.mcn.2026.104097 · Cited by 5 · see citing works
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iS2C2: a cointelligent platform for mechanistic discovery of disease cellular crosstalk
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Modeling Taupathies in Zebrafish (Danio rerio)
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The role of immune cells in brain injuries and diseases
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Modeling Tauopathies in Zebrafish (Danio rerio)
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- Authors
- Johnson, N. R., Yuan, P., Castillo, E., Lopez, T. P., Yue, W., Bond, A., Rivera, B. M., Sullivan, M. C., Hirouchi, M., Giles, K., Aoyagi, A., & Condello, C.
- Affiliations
- University of California, San Francisco (US)
- Corresponding author
- Condello, Carlo
- ORCID
- Venue
- Nature Communications
- Published
- 2023-01-09
- Volume
- 14
- Issue
- 1
- Pages
- 118-118
- ISSN
- 2041-1723 (ISSN-L)
- PMC
- PMC9829908
- OpenAlex
- W4313829033
- Cited by
- 46
- References
- 86
- Citations by year
- 2026: 10 · 2025: 16 · 2024: 12 · 2023: 8
- FWCI
- 4.72
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Nature Communications (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Natural Science Foundation of Shanghai (22ZR1415000)
- U.S. Department of Health & Human Services | NIH | National Institute on Aging (RF1 AG061874, P01 AG002132)
- Topics
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
- Keywords
- CSF1R inhibitor, microglia, tauopathy, sex differences, excitotoxicity, neuroinflammation, microglial phenotype, neuroprotection, neurotransmitter dysregulation, immediate early genes, microglial ablation, neurodegeneration
- MeSH terms
- Animals, Brain, Disease Models, Animal, Female, Male, Phenotype, Receptors, Colony-Stimulating Factor, Receptors, Granulocyte-Macrophage Colony-Stimulating Factor, Microglia, Tauopathies, Mice
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