Meningeal lymphatics affect microglia responses and anti-Aβ immunotherapy
Open accessAbstract
Alzheimer’s disease (AD) is the most prevalent cause of dementia1. Although there is no effective treatment for AD, passive immunotherapy with monoclonal antibodies against amyloid beta (Aβ) is a promising therapeutic strategy2,3. Meningeal lymphatic drainage has an important role in the accumulation of Aβ in the brain4, but it is not known whether modulation of meningeal lymphatic function can influence the outcome of immunotherapy in AD. Here we show that ablation of meningeal lymphatic vessels in 5xFAD mice (a mouse model of amyloid deposition that expresses five mutations found in familial AD) worsened the outcome of mice treated with anti-Aβ passive immunotherapy by exacerbating the deposition of Aβ, microgliosis, neurovascular dysfunction, and behavioural deficits. By contrast, therapeutic delivery of vascular endothelial growth factor C improved clearance of Aβ by monoclonal antibodies. Notably, there was a substantial overlap between the gene signature of microglia from 5xFAD mice with impaired meningeal lymphatic function and the transcriptional profile of activated microglia from the brains of individuals with AD. Overall, our data demonstrate that impaired meningeal lymphatic drainage exacerbates the microglial inflammatory response in AD and that enhancement of meningeal lymphatic function combined with immunotherapies could lead to better clinical outcomes. Meningeal lymphatic drainage can affect the microglial inflammatory response and anti-amyloid-β immunotherapy in mouse models of Alzheimer’s disease.
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- Findingcitation
mAducanumab treatment induces overexpression of genes in synapse organization, regulation of membrane potential, and neurotransmitter transport pathways in aged APPswe mouse hippocampus.
“Treatment with mAducanumab induced an overexpression of genes involved in synapse organization (GO:0050808), regulation of membrane potential (GO:0042391) and neurotransmitter transport (GO:0006836; Extended Data Fig. 8k) pathways, which might be attributed to the enhanced clearance of soluble Aβ seeds28 from the brain of aged APPswe mice.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [28] Uhlmann, R. E. et al. Acute targeting of pre-amyloid seeds in transgenic mice reduces Alzheimer-like pathology later in life. Nat. Neurosci. 23, 1580–1588 (2020). source
Not checked in the free run.
- Findingown data
Meningeal lymphatic function is linked to microglial activation and the brain vascular response in Alzheimer's disease.
“Here, using transcriptional profiling of mouse meningeal lymphatic endothelial cells (LECs), microglia and brain blood endothelial cells (BECs), we show that meningeal lymphatic function is coupled to microglia activation and brain vascular response in AD.”
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Up-regulated genes in microglia from mice with impaired meningeal lymphatics belong to Gene Ontology pathways including positive regulation of cytokine production, leukocyte migration, cell chemotaxis, and myeloid leukocyte activation.
“Up-regulated genes in microglia from mice with impaired meningeal lymphatics were involved in Gene Ontology (GO) pathways such as positive regulation of cytokine production (GO:0001819), leukocyte migration (GO:0050900), cell chemotaxis (GO:0060326) and myeloid leukocyte activation (GO:0002274; Fig. 1m).”
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Microglia from 5xFAD mice with impaired meningeal lymphatics express higher levels of Apoe, Lyz2, Fth1, Timp2, H2-d1, Axl, Cst7, Spp1, and Lpl.
“Analysis of homeostatic and disease-associated microglia (DAM) gene signatures in microglia from 5xFAD mice with impaired meningeal lymphatics revealed higher expression of Apoe, Lyz2, Fth1, Timp2, H2-d1, Axl, Cst7, Spp1 and Lpl (Extended Data Fig. 6e, f and Supplementary Table 2), which are involved in the transition from homeostatic to activated microglia21,26.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [21] Keren-Shaul, H. et al. A unique microglia type associated with restricting development of Alzheimer’s disease. Cell 169, 1276–1290.e17 (2017). source
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- cites [26] Zhou, Y. et al. Human and mouse single-nucleus transcriptomics reveal TREM2-dependent and TREM2-independent cellular responses in Alzheimer’s disease. Nat. Med. 26, 131–142 (2020). source
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- Findingown data
Viral-mediated mVEGF-C treatment alters the transcriptional signature of meningeal lymphatic endothelial cells in 20-24-month-old mice, linked to activation of mitochondrial gene expression, fatty acid homeostasis, and smoothened signaling pathways.
“Here we show that transcriptional signature of meningeal LECs in 20–24-month-old mice is altered following viral-mediated mVEGF-C treatment, which is linked to the activation of gene pathways such as mitochondrial gene expression (GO:0140053), fatty acid homeostasis (GO:0055089) and smoothened signaling pathway (GO:0007224; Extended Data Fig. 7n–q).”
Quote in the paperSubstantial claim
- Findingown data
Meningeal lymphatic endothelial cells from 6-month-old 5xFAD mice show altered expression of genes tied to exocytosis, phospholipase D signaling, and low-density lipoprotein response.
“We also found that LECs isolated from the meninges of 6-month-old 5xFAD mice showed significant changes in the expression of genes involved in processes such as exocytosis, phospholipase D signaling, and response to low-density lipoprotein (Extended Data Fig. 1f–k), suggesting that meningeal Aβ deposition might affect meningeal LECs early on through deleterious processes previously implicated in”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [14] Cruchaga, C. et al. Rare coding variants in the phospholipase D3 gene confer risk for Alzheimer’s disease. Nature 505, 550–554 (2014). source
Not checked in the free run.
- cites [15] Yamazaki, Y., Zhao, N., Caulfield, T. R., Liu, C. C. & Bu, G. Apolipoprotein E and Alzheimer disease: pathobiology and targeting strategies. Nat. Rev. Neurol. 15, 501–518 (2019). source
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- Findingown data
In 5xFAD mice, meningeal leukocyte populations show significantly more B cells, CD4+ T cells, and CD8+ T cells at 11-12 months than at 5-6 months.
“Mass cytometric analysis of different meningeal leukocyte populations in 5xFAD mice at 5–6 and 11–12 months revealed a significant increase in the numbers of B cells, CD4+ T cells and CD8+ T cells in the older mice (Extended Data Fig. 2a–e) that can also be indicative of an accelerated impairment of meningeal lymphatic vasculature12.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [12] Louveau, A. et al. CNS lymphatic drainage and neuroinflammation are regulated by meningeal lymphatic vasculature. Nat. Neurosci. 21, 1380–1391 (2018). source
Not checked in the free run.
- Findingown data
Down-regulated gene sets in brain capillary blood endothelial cells from 5xFAD mice with impaired meningeal lymphatics include interferon-gamma response, chemokine- and cytokine-mediated signaling, and monocyte chemotaxis.
“Interestingly, down-regulated gene-sets in brain capillary BECs from 5xFAD mice with impaired meningeal lymphatics included response to interferon-gamma (GO:0034341), chemokine- and cytokine-mediated signaling pathways (GO:0070098 and GO:0019221) and monocyte chemotaxis (GO:0002548; Extended Data Fig. 6j).”
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The decrease in amyloid-beta load and microgliosis in 5xFAD mice treated with mVEGF-C and mAb158 is accompanied by expansion of lymphatic vasculature around the transverse sinus.
“The reduction in Aβ load and microgliosis in 5xFAD mice treated with mVEGF-C and mAb158 was accompanied by an expansion of lymphatic vasculature around the transverse sinus (Extended Data Fig. 7h–m).”
Quote in the paperSubstantial claim - Findingown data
In 13-14-month-old 5xFAD mice, dorsal meningeal lymphatic deterioration coincides with a significant rise in amyloid-beta deposition throughout the meninges, including along blood and lymphatic vessels.
“The deterioration of the lymphatic vasculature at the dorsal meninges observed in 13–14-month-old 5xFAD mice was accompanied by a significant increase in Aβ deposition throughout the meninges (Extended Data Fig. 1c–e), with extensive Aβ deposition along the blood and lymphatic vasculature (Extended Data Fig. 1a, insets) at anatomical locations previously shown as ‘hot spots’ along meningeal lymph”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [12] Louveau, A. et al. CNS lymphatic drainage and neuroinflammation are regulated by meningeal lymphatic vasculature. Nat. Neurosci. 21, 1380–1391 (2018). source
Not checked in the free run.
- cites [13] Rustenhoven, J. et al. Functional characterization of the dural sinuses as a neuroimmune interface. Cell 184, 1000–1016.e27 (2021). source
Not checked in the free run.
- Findingown data
Meningeal lymphatic ablation in 5xFAD mice induces transcriptional changes in brain blood endothelial cells.
“Transcriptional changes were also induced in brain BECs by meningeal lymphatic ablation in 5xFAD mice (Extended Data Fig. 6h–p and Supplementary Table 1).”
Quote in the paperSubstantial claim - Findingown data
Down-regulated pathways in microglia from 5xFAD mice with reduced meningeal lymphatic drainage include antigen processing and presentation via MHC class II and T cell activation.
“On the other hand, regulation of antigen processing and presentation of peptide antigen via major histocompatibility complex class II (GO:0002586) and T cell activation (GO:0042110) were among the down-regulated pathways in microglia from 5xFAD mice with reduced meningeal lymphatic drainage (Extended Data Fig. 6g).”
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Combining enhanced meningeal lymphatic drainage with anti-amyloid-beta monoclonal antibodies produces a synergistic effect on plaque clearance in Alzheimer's disease mouse models.
“We also demonstrate a synergistic effect of combining meningeal lymphatic drainage enhancement and anti-Aβ monoclonal antibodies in plaque clearance from the brain in AD mouse models.”
Quote in the paperSubstantial claim - Findingown data
Cerebrospinal fluid injection of mVEGF-C-expressing virus plus mAb158 into 4-5-month-old 5xFAD mice synergistically enhances amyloid-beta plaque clearance.
“Injections of mVEGF-C-expressing virus and mAb158 into the CSF of 4–5-month-old 5xFAD mice (Extended Data Fig. 7a) had a synergistic effect on Aβ plaque clearance (Extended Data Fig. 7b, c).”
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LAMP1-positive dystrophic neurites are significantly more numerous in 5xFAD mice with dysfunctional meningeal lymphatics.
“LAMP1+ dystrophic neurites were significantly increased in 5xFAD mice with dysfunctional meningeal lymphatics (Fig. 1b, e and Extended Data Fig. 3g, l).”
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Reduced meningeal lymphatic drainage does not significantly alter expression of genes involved in amyloid-beta efflux or transport by brain blood endothelial cells.
“Interestingly, the gene expression values were also comparable between brain BECs from the Vis. plus mIgG and the Vis./photo plus mIgG groups, which suggests that reducing meningeal lymphatic drainage does not significantly affect the expression of genes involved in Aβ efflux/transport by brain BECs.”
Quote in the paperNot a substantial claim - Findingown data
Extended treatment with mAducanumab or mAb158 does not improve 5xFAD mouse performance in the open field or Morris water maze.
“Prolonged treatments with mAducanumab or mAb158 did not improve the performance of 5xFAD mice in the open field or the Morris water maze (Extended Data Fig. 4a–n).”
Quote in the paperSubstantial claim - Findingown data
The hippocampal gene expression profile of aged APPswe mice shows treatment-specific effects.
“The gene expression profile in the hippocampi of aged APPswe mice revealed treatment-specific effects (Fig. 2a, b).”
Quote in the paperSubstantial claim - Findingown data
Cerebrospinal fluid delivery of antibodies with mVEGF-C-expressing virus significantly reduces amyloid-beta plaque coverage in APPswe mice aged 26-30 months and J20 mice aged 14-16 months.
“CSF delivery of antibodies along with mVEGF-C-expressing virus resulted in a significant decrease in Aβ plaque coverage in APPswe (26–30 months; Extended Data Fig. 8a–e) and J20 (14–16 months; Extended Data Fig. 8f–j) mice.”
Quote in the paperSubstantial claim - Findingown data
In 5xFAD mice, meningeal lymphatic coverage around the petrosquamosal and sigmoid sinuses remains unchanged between the compared age groups.
“No changes in meningeal lymphatic coverage around the petrosquamosal (PSS) and sigmoid (SS) sinuses were observed between the two groups (Extended Data Fig. 1e).”
Quote in the paperNot a substantial claim - Findingown data
Peripheral mAducanumab administration to 22-26-month-old APPswe mice does not produce detectable changes in amyloid-beta plaques.
“We were unable to detect changes in Aβ plaques upon peripheral administration of mAducanumab to 22–26-month-old APPswe mice (Extended Data Fig. 7r–t)”
Quote in the paperSubstantial claim - Findingown data
5xFAD mice with dysfunctional meningeal lymphatics that receive mAducanumab or mAb158 have significantly greater amyloid-beta plaque coverage than controls with intact meningeal lymphatics.
“However, 5xFAD mice with dysfunctional meningeal lymphatics (Vis./photo. groups) that received mAducanumab or mAb158 showed significantly higher Aβ plaque coverage, when compared to their controls with intact meningeal lymphatics (Vis. groups; Fig. 1d and Extended Data Fig. 3k).”
Quote in the paperSubstantial claim - Findingown data
The top three Gene Ontology pathways induced in hippocampus by mVEGF-C treatment alone are dendrite development, protein folding, and learning and memory.
“The top three GO pathways induced in the hippocampus by mVEGF-C treatment alone (in the mVEGF-C plus mIgG group; Fig. 2c) were dendrite development (GO:0016358), protein folding (GO:0006457) and learning and memory (GO:0007611).”
Quote in the paperNot a substantial claim - Findingown data
Microglia with comparable activation signatures are found in the brains of Alzheimer's disease patients and in Alzheimer's disease transgenic mice whose meningeal lymphatics were ablated.
“Interestingly, we identified microglia with similar activation signatures in the brains of AD patients and of AD transgenic mice with ablated meningeal lymphatics, supporting the potential role of the meningeal lymphatic system in modulating the neuroinflammatory response in AD.”
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Up-regulated genes in brain blood endothelial cells from the Vis./photo. plus mIgG group participate in pathways linked to vascular activation, endothelial cell migration, and proliferation.
“Regardless of their arterial, capillary or venous origin, up-regulated genes in BECs from the Vis./photo. plus mIgG group were involved in similar pathways linked to vascular activation, endothelial cell migration and proliferation (Extended Data Fig. 6i, l, n).”
Quote in the paperNot a substantial claim - Findingown data
Microglia from 5xFAD mice with ablated meningeal lymphatics show significant gene expression changes compared with microglia from control 5xFAD mice with intact meningeal lymphatics.
“We observed significant changes in gene expression between microglia isolated from the brains of 5xFAD mice with ablated meningeal lymphatics (Vis./photo plus mIgG) and control 5xFAD mice with intact meningeal lymphatic function (Vis. plus mIgG; Fig. 1k–m and Supplementary Table 1).”
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The signature of microglia from 5xFAD mice with dysfunctional meningeal lymphatics (54 genes) overlaps significantly more with the transcriptional profile of human microglia from clusters 2, 3, and 4 than with cluster 1.
“Moreover, there was a significantly stronger overlap between the signature of microglia from 5xFAD mice with dysfunctional meningeal lymphatics (composed of 54 genes; Supplementary Table 5) and the transcriptional profile of human microglia from clusters 2, 3 and 4 compared to cluster 1 (Fig. 3f, g).”
Quote in the paperSubstantial claim - Findingown data
The set of highly expressed genes in meningeal lymphatic endothelial cells is significantly associated with CSF Aβ42 levels (P = 0.021).
“A significant association was also observed between the set of meningeal LECs’ highly expressed genes and the levels of Aβ42 in the CSF (P = 0.021; Supplementary Table 3).”
Quote in the paperSubstantial claim - Findingown data
A considerable fraction of genes associated with Parkinson's disease, multiple sclerosis, and Alzheimer's disease are highly expressed in mouse lymphatic endothelial cells.
“Interestingly, a considerable fraction of genes that have been associated with Parkinson’s, multiple sclerosis and Alzheimer’s are highly expressed in mouse LECs (Extended Data Fig. 9a–i).”
Quote in the paperNot a substantial claim - Findingown data
Gene single nucleotide polymorphisms in the 1 Mb region of Alzheimer's disease-associated genes highly expressed in meningeal lymphatic endothelial cells are associated with altered microglial gene expression in the human parietal cortex.
“Using single-nucleus RNA-seq data from the brains of AD and neuropathology-free donors, we show that gene SNPs in the 1 Mb region of AD-associated genes highly expressed in meningeal LECs are associated with altered microglial gene expression in the human parietal cortex (Fig. 3a).”
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Human microglia cluster 3 represents an alternative activation phenotype with high expression of both homeostatic and activation genes.
“Cluster 3 microglia denoted an alternative activation phenotype characterized by high expression of both homeostatic and activation genes”
Quote in the paperNot a substantial claim - Findingown data
In the synapse organization pathway, mAducanumab treatment alone drives gene up-regulation.
“The opposite was observed in the synapse organization pathway (Extended Data Fig. 8m), where mAducanumab treatment alone drove gene up-regulation.”
Quote in the paperNot a substantial claim - Findingown data
The increase in brain Aβ plaque clearance caused by mVEGF-C and mAb158 is associated with transcriptional reprogramming of meningeal lymphatic endothelial cells.
“Improved brain Aβ plaque clearance by delivery of mVEGF-C and mAb158 into the CSF is correlated with lymphatic vessel expansion at the dorsal meninges and transcriptional reprogramming of meningeal LECs.”
Quote in the paperSubstantial claim - Findingown data
In 5xFAD mice, ablating meningeal lymphatic vessels and administering mAducanumab changes the transcriptomes of microglia and blood endothelial cells.
“Effects of meningeal lymphatic vessel ablation and mAducanumab immunotherapy on the microglial and blood endothelial cell transcriptomes in 5xFAD mice.”
Quote in the paperSubstantial claim - Findingown data
The increase in brain Aβ plaque clearance caused by mVEGF-C and mAb158 is associated with expansion of lymphatic vessels at the dorsal meninges.
“Improved brain Aβ plaque clearance by delivery of mVEGF-C and mAb158 into the CSF is correlated with lymphatic vessel expansion at the dorsal meninges and transcriptional reprogramming of meningeal LECs.”
Quote in the paperSubstantial claim - Findingown data
Treatment with mVEGF-C separates the transcriptomes of meningeal lymphatic endothelial cells from those treated with eGFP.
“PCA plot showing segregation between eGFP (orange) and mVEGF-C (blue) meningeal LEC transcriptomes.”
Quote in the paperNot a substantial claim - Findingown data
In dendrite development and protein folding pathways, hippocampal gene up-regulation is evident only in groups that received mVEGF-C.
“In the dendrite development and protein folding pathways (Fig. 2d, e), hippocampal gene up-regulation was only obvious in the groups that received mVEGF-C.”
Quote in the paperNot a substantial claim - Findingown data
Human microglia clusters 4 and 5 consist of activated microglia with lower expression of homeostatic SELPLG, P2RY13, and TMEM119 and intermediate expression of GPNMB, IL1B, JUN, LPL, and TNFAIP3.
“clusters 4 and 5 were composed by activated microglia that expressed lower levels of the homeostatic SELPLG, P2RY13 and TMEM119 genes and intermediate expression levels of GPNMB, IL1B, JUN, LPL and TNFAIP3”
Quote in the paperSubstantial claim - Findingown data
Cluster 2 microglia make up the largest fraction of activated microglia from familial and sporadic AD patient brains.
“Cluster 2 microglia composed the biggest fraction of activated microglia isolated from the brains of familial and sporadic AD patients (Fig. 3e).”
Quote in the paperSubstantial claim - Findingown data
In 5xFAD mice, meningeal lymphatic dysfunction is accelerated.
“Extended Data Figure 1 | Morphological assessment and functional enrichment analysis of differentially expressed genes show accelerated meningeal lymphatic dysfunction in 5xFAD mice.”
Quote in the paperSubstantial claim - Findingown data
Most top Gene Ontology terms induced in microglia and brain blood endothelial cells from APPswe mice treated with mVEGF-C indicate interferon responses and antigen processing and presentation via MHC class I.
“Interestingly, the majority of the top GO terms induced in microglia (Fig. 2j) and BECs (Fig. 2k and Extended Data Fig. 8q, s) from the brains of APPswe mice treated with mVEGF-C, pointed to an induction of interferon responses and of antigen processing and presentation via major histocompatibility complex class I.”
Quote in the paperNot a substantial claim - Findingown data
Mouse meningeal lymphatic endothelial cells and brain blood endothelial cells have a higher proportion of highly expressed Alzheimer's disease-associated genes than microglia from the 5xFAD cortex.
“Mouse meningeal LECs and brain BECs presented a higher proportion of highly expressed AD-associated genes (Extended Data Fig. 9g–k), when compared to microglia from the 5xFAD cortex (Extended Data Fig. 9l–n).”
Quote in the paperNot a substantial claim - Findingown data
Human microglia cluster 1 has a resting-state phenotype with higher expression of homeostatic genes BIN1, CX3CR1, MED12L, SELPLG, P2RY12, P2RY13, and TMEM119.
“Based on the human microglia nuclei gene expression profiles, we identified a resting-state phenotype in cluster 1 with higher expression of the homeostatic genes BIN1, CX3CR1, MED12L, SELPLG, P2RY12, P2RY13 and TMEM119 (Fig. 3c and Extended Data Fig. 10b).”
Quote in the paperNot a substantial claim - Findingown data
Up-regulated genes in microglia from aged APPswe mice treated with mVEGF-C are associated with AD age at onset (P = 0.014) and risk (P = 0.045).
“On the other hand, up-regulated genes in microglia isolated from aged APPswe mice treated with mVEGF-C were associated with AD age at onset (P = 0.014) and risk (P = 0.045; Supplementary Table 6).”
Quote in the paperSubstantial claim - Findingown data
Injecting mVEGF-C and mAb158 into the cerebrospinal fluid increases clearance of Aβ plaques in the brain.
“Improved brain Aβ plaque clearance by delivery of mVEGF-C and mAb158 into the CSF is correlated with lymphatic vessel expansion at the dorsal meninges and transcriptional reprogramming of meningeal LECs.”
Quote in the paperSubstantial claim - Findingown data
Treatment with mVEGF-C changes gene expression in meningeal lymphatic endothelial cells relative to eGFP.
“Volcano plot showing the significantly down-regulated (in blue) and up-regulated (in orange) genes between meningeal LECs from the mVEGF-C and eGFP groups.”
Quote in the paperNot a substantial claim - Findingown data
In aged APPswe mice, mVEGF-C improves antibody-mediated clearance of Aβ.
“Therapeutic effects of mVEGF-C on the clearance of Aβ by antibodies in old APPswe mice and the gene expression profile of brain cells.”
Quote in the paperSubstantial claim - Findingown data
Human microglia cluster 2 has low homeostatic gene expression and higher levels of ABCA1, C5AR1, FCGR2B, GPNMB, CD68, CD83, JUN, LGMN, LPL, and TNFAIP3, indicating an activated phenotype.
“Cluster 2 microglia presented low expression of the homeostatic genes and higher levels of ABCA1, C5AR1, FCGR2B, GPNMB, CD68, CD83, JUN, LGMN, LPL and TNFAIP3 (Fig. 3d and Extended Data Fig. 10c), indicative of an activated phenotype.”
Quote in the paperSubstantial claim - Premisecitation
The EMERGE and ENGAGE trials of Aducanumab produced inconsistent results: cognitive decline slowed significantly at the highest dose in EMERGE but not in ENGAGE.
“Two clinical trials with anti-Aβ monoclonal antibody Aducanumab10, EMERGE and ENGAGE, have recently yielded inconsistent results, since cognitive decline was significantly slowed down in patients receiving the highest dose (10 mg/kg) in the EMERGE cohort but not in the ENGAGE cohort11.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [11] Howard, R. & Liu, K. Y. Questions EMERGE as Biogen claims aducanumab turnaround. Nat. Rev. Neurol. 16, 63–64 (2020). source
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- Interpretationown data
Initial lymphatics at the dorsal brain meninges are important for cerebrospinal fluid drainage.
“These results emphasize the importance of initial lymphatics at the dorsal brain meninges in CSF drainage5,12,18.”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [5] Mawuenyega, K. G. et al. Decreased clearance of CNS beta-amyloid in Alzheimer’s disease. Science 330, 1774 (2010). source
Not checked in the free run.
- cites [12] Louveau, A. et al. CNS lymphatic drainage and neuroinflammation are regulated by meningeal lymphatic vasculature. Nat. Neurosci. 21, 1380–1391 (2018). source
Not checked in the free run.
- cites [18] Louveau, A. et al. Structural and functional features of central nervous system lymphatic vessels. Nature 523, 337–341 (2015). source
Not checked in the free run.
- Interpretationown data
Transcriptional profiling of brain cells from 5xFAD mice with ablated meningeal lymphatics indicates harmful microglial activation and aberrant vascular repair and leukocyte transmigration mechanisms following increased brain amyloidosis.
“Altogether, transcriptional profiling of cells from the brains of 5xFAD mice with ablated meningeal lymphatics pointed to a deleterious microglia activation and aberrant induction of vascular repair and leukocyte transmigration mechanisms that follow the surge in brain amyloidosis.”
Quote in the paperSubstantial claim - Study design and conductown data
Photoablation of meningeal lymphatics significantly reduces cerebrospinal fluid tracer drainage into the deep cervical lymph nodes.
“Lymphatic photoablation results in significant reduction in drainage of CSF tracers into the deep cervical lymph nodes (dCLNs) (Extended Data Fig. 3d, e and Supplementary Videos 1, 2).”
Quote in the paperSubstantial claim - Study design and conductcitation
Photoablation of meningeal lymphatics removes lymphatic vasculature lining the transverse sinus in the dorsal meninges.
“Meningeal lymphatic dysfunction was induced by a previously described method of photoablation5,12 that results in the loss of lymphatic vasculature lining the transverse sinus (in the dorsal meninges; Extended Data Fig. 3a, b).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [5] Mawuenyega, K. G. et al. Decreased clearance of CNS beta-amyloid in Alzheimer’s disease. Science 330, 1774 (2010). source
Not checked in the free run.
- cites [12] Louveau, A. et al. CNS lymphatic drainage and neuroinflammation are regulated by meningeal lymphatic vasculature. Nat. Neurosci. 21, 1380–1391 (2018). source
Not checked in the free run.
- Study design and conductown data
The photoablation procedure leaves lymphatic vessels around the sigmoid and petrosquamosal sinuses in the basal meninges unaffected.
“This method does not affect the lymphatic vessels around the SS and PSS (in the basal meninges; Extended Data Fig. 3a, c).”
Quote in the paperSubstantial claim - Interpretationown data
Removal of meningeal lymphatic vessels blocks mAb158 from clearing brain Aβ plaques when the antibody is given into the CSF.
“Extended Data Figure 5 | Meningeal lymphatic vessel ablation precludes brain Aβ plaque clearance by mAb158 administered into the CSF.”
Quote in the paperSubstantial claim - Interpretationown data
It may be possible to develop therapies that target both microglia and brain blood vasculature by modulating lymphatic vasculature function at the brain borders.
“Our data provided here suggests that it might be possible to devise strategies to therapeutically target both microglia and the brain blood vasculature, two important players in AD pathophysiology4,21,23,38–40, by modulating the function of the lymphatic vasculature at the brain borders.”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [4] Da Mesquita, S. et al. Functional aspects of meningeal lymphatics in ageing and Alzheimer’s disease. Nature 560, 185–191 (2018). source
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- cites [21] Keren-Shaul, H. et al. A unique microglia type associated with restricting development of Alzheimer’s disease. Cell 169, 1276–1290.e17 (2017). source
Not checked in the free run.
- cites [23] Hong, S. et al. Complement and microglia mediate early synapse loss in Alzheimer mouse models. Science 352, 712–716 (2016). source
Not checked in the free run.
- May combine two claims. 29
- Classified as probably not a substantial claim. 36
May combine two claims.
Findingown dataIn 5xFAD mice with impaired meningeal lymphatic drainage, IBA1+ cell coverage, peri-plaque IBA1+ cell counts, CD68 levels on IBA1+ cells, and fibrinogen coverage indicate aberrant myeloid activation and elevated brain fibrinogen.
“Accordingly, measurements of IBA1+ cell coverage, number of peri-Aβ plaque IBA1+ cells, levels of CD68 on IBA1+ cells and fibrinogen coverage revealed an aberrant activation of myeloid cells and increased fibrinogen levels in the brain of mice with impaired meningeal lymphatic drainage (Fig. 1f–j and Extended Data Fig. 3m–q).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataNeither mAducanumab nor mAb158 changes the average size of amyloid-beta plaques in 5xFAD mice.
“Neither mAducanumab nor mAb158 affected the average size of Aβ plaques (Extended Data Fig. 3i, j).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataTreatment with mAducanumab or mAb158 reduces amyloid-beta plaque density in 5xFAD mice.
“Treatments with mAducanumab or mAb158 proved to be efficient in reducing the density of Aβ plaques (Fig. 1b, c and Extended Data Fig. 3g, h).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown datamAducanumab treatment lowers expression of disease-related genes in microglia and significantly raises expression of the homeostatic genes P2ry12, Tmem119, and Selplg.
“Interestingly, treatments with mAducanumab reduced the expression of the aforementioned disease-related genes in microglia, and significantly increased the expression of the homeostatic P2ry12, Tmem119 and Selplg (Extended Data Fig. 6f and Supplementary Table 2).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataMice with impaired meningeal lymphatics spend less time in the open field center and take longer to locate the submerged platform during Morris water maze acquisition than controls.
“Notably, mice with impaired meningeal lymphatics spent less time in the center of the open field arena (Extended Data Fig. 4a–d and h–k) and took more time to find the submerged platform in the acquisition of the Morris water maze test (Extended Data Fig. 4e–g and l–n), when compared to their control counterparts.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn 5xFAD mice with ablated meningeal lymphatics, less mAb158 colocalizes with brain parenchymal amyloid-beta aggregates, while vascular amyloid-beta localization is unchanged.
“Interestingly, although there were no differences in the amount of mAb158 localized to brain vascular Aβ (Extended Data Fig. 5j, k), significantly less mAb158 was found to be colocalized with brain parenchymal Aβ aggregates in 5xFAD mice with ablated meningeal lymphatics (Extended Data Fig. 5j, l).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataProlonged meningeal lymphatic ablation increases amyloid-beta burden in the meninges and brain parenchyma, impairs amyloid-beta plaque clearance by cerebrospinal fluid-injected mAb158, and raises ferric iron deposits.
“Prolonged ablation of meningeal lymphatics led to significantly higher Aβ burden in the meninges and brain parenchyma, interfered with Aβ plaque clearance by CSF-injected mAb158 (Extended Data Fig. 5b–g) and resulted in increased ferric iron deposits (Prussian blue staining) (Extended Data Fig. 5h, i).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataMice treated with mVEGF-C and mAb158 show significantly less peri-amyloid-beta microgliosis and lower CD68 levels in IBA1+ cells.
“Mice treated with mVEGF-C and mAb158 also presented significantly less peri-Aβ microgliosis and decreased levels of CD68 in IBA1+ cells (Extended Data Fig. 7d–g).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn 5xFAD mice, lymphatic vessel coverage along the superior sagittal sinus, transverse sinus, and confluence of sinuses declines significantly by 13-14 months but not at 5-6 months.
“No changes were observed at 5–6 months (Extended Data Fig. 1a–e), but a significant decrease in lymphatic vessel coverage along the superior sagittal sinus (SSS), transverse sinus (TS) and the confluence of sinuses (COS) was evident at 13–14 months in the meninges of 5xFAD mice (Extended Data Fig. 1c, d).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataMouse microglial phenotypes show enrichment for homeostatic microglia in cluster 1, activated microglia in cluster 2 with a disease-associated signature, and alternatively activated microglia in cluster 3.
“Concerning mouse microglial phenotypes, there was an obvious enrichment for homeostatic in cluster 1, activated in cluster 2 (showing a DAM signature) and alternatively activated in cluster 3 (Extended Data Fig. 10d).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe microglia gene set shows significant connections with age at onset (P = 4.82E-12), CSF soluble TREM2 (P = 3.59E-07), Aβ42 (P = 0.021), phospho-Tau (P = 0.029), and Tau (P = 0.005) levels.
“Significant connections were observed between the microglia gene-set and age at onset (P = 4.82E-12), and CSF soluble TREM2 (P = 3.59E-07), Aβ42 (P = 0.021), phospho-Tau (P = 0.029) and Tau (P = 0.005) levels.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataMore than half of microglial nuclei from non-AD patients show a resting-state phenotype, while presymptomatic AD samples are enriched in alternatively activated cluster 3 microglia.
“More than half of the microglial nuclei from the brains of non-AD patients presented a resting-state phenotype, whereas the samples from presymptomatic AD patients (patients showing characteristic AD brain pathology but a clinical dementia rating of 0.5 or less) were enriched in alternatively activated cluster 3 microglia (Fig. 3e).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe brain blood endothelial cell gene set is strongly associated with amyloid imaging (P = 0.0089) and age at onset (P = 1.04E-10).
“A strong association was observed between the brain BECs’ gene-set, amyloid imaging (P = 0.0089) and age at onset (P = 1.04E-10).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataPrincipal component analysis separated meningeal LEC transcriptomes of WT and 5xFAD mice.
“Principal component analysis (PCA) plot showing segregation between WT (blue) and 5xFAD (purple) meningeal LEC transcriptomes.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataBrains of 5xFAD mice with ablated meningeal lymphatics have a significantly lower fraction of cluster 1 resting-state microglia (P = 0.00026) and higher fractions of clusters 2 (P = 0.00191) and 3 (P = 0.03535) activated microglia than mice with intact meningeal lymphatics.
“Noticeably, the brains of 5xFAD mice with ablated meningeal lymphatics showed a significantly lower fraction of cluster 1 resting-state microglia (P = 0.00026) and higher fractions of clusters 2 (P = 0.00191) and 3 (P = 0.03535) activated microglia, when compared to mice with intact meningeal lymphatics (Fig. 3e).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThirty-nine Alzheimer's disease-associated genes lie within the 10th percentile of highly expressed genes in meningeal lymphatic endothelial cells, including Apoe, which is among the few highly expressed genes shared by all three cell types.
“In fact, 39 AD-associated genes were found within the 10th percentile of highly expressed genes in meningeal LECs, including Apoe, which is intrinsically linked to altered risk for late onset AD15,31 and was one of the few highly expressed genes found at the intersection between all three cell types (Extended Data Fig. 9o).”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [15] Yamazaki, Y., Zhao, N., Caulfield, T. R., Liu, C. C. & Bu, G. Apolipoprotein E and Alzheimer disease: pathobiology and targeting strategies. Nat. Rev. Neurol. 15, 501–518 (2019). source
Not checked in the free run.
- cites [31] Corder, E. H. et al. Gene dose of apolipoprotein E type 4 allele and the risk of Alzheimer’s disease in late onset families. Science 261, 921–923 (1993). source
Not checked in the free run.
May combine two claims.
Findingown dataIn 5xFAD mouse meninges at 11-12 months, several immune cell populations increase significantly: B cells, CD4+ T cells 1, CD8+ T cells, ILC3s, and undefined cells.
“Numbers of different meningeal immune cells showing a statistically significant increase in B cells, CD4+ T cells 1, CD8+ T cells, type 3 innate lymphoid cells (ILC3s) and undefined cells in the meninges of 5xFAD mice at 11-12 months of age.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataIn the learning or memory pathway, gene upregulation is amplified when mVEGF-C is given alone and sometimes counteracted when combined with mAducanumab.
“However, in the learning or memory pathway (Extended Data Fig. 8l), gene upregulation was amplified when mVEGF-C was administered alone and, in some instances, counteracted when combined with mAducanumab.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataIn reanalysis of GSE98816, five of seven BEC clusters matched the arterial, capillary, and venous BEC categories from Vanlandewijck et al.
“Five out of the seven identified clusters matched a similar transcriptional profile to the arterial, capillary, and venous BECs identified by Vanlandewijck et al25 and were subset and re-clustered.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Vanlandewijck et al25
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataReclustering produced four brain BEC groups: capillary 1, capillary 2, arterial, and venous.
“This analysis resulted in 4 clusters of brain BECs: capillary 1, capillary 2, arterial and venous (in Extended Data Fig. 9j).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataGene-set analyses show significant correlations between up-regulated genes in microglia from 5xFAD mice with dysfunctional meningeal lymphatics and amyloid imaging (P = 0.017), CSF Tau levels (P = 0.036), age at onset (P = 0.027), and AD risk (P = 0.011).
“Furthermore, gene-set based analyses for genome-wide associations of AD-related phenotypes and risk revealed significant correlations between the set of up-regulated genes in microglia isolated from 5xFAD mice with dysfunctional meningeal lymphatics and amyloid imaging (P = 0.017), CSF Tau levels (P = 0.036), age at onset (P = 0.027) and AD risk (P = 0.011; Supplementary Table 6).”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Findingown dataThe meningeal lymphatic dysfunction microglial signature comprised 54 genes with log2 fold change greater than 1 and false discovery rate q-value less than 0.05 that were overexpressed in the Vis./photo. plus mIgG group compared with the Vis. plus mIgG group and mapped to human orthologs.
“A microglial gene signature of meningeal lymphatic dysfunction (Supplementary Table 5) was created by selecting the 54 genes that showed a log2 (fold change) > 1 and were significantly overexpressed (false discovery rate q-value < 0.05) in the Vis./photo. plus mIgG group, when compared to the Vis. plus mIgG group (Fig. 1l), and mapped to a human gene ortholog.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown dataImpaired meningeal lymphatic drainage in 5xFAD mice reduces mAb158 influx from cerebrospinal fluid into the brain, leading to less targeting of amyloid-beta plaques for clearance.
“These findings suggest that impairment of meningeal lymphatic drainage in 5xFAD mice leads to decreased influx of mAb158 from the CSF into the brain, resulting in less targeting of Aβ plaques for clearance.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown dataReduced meningeal lymphatic drainage has a harmful effect on brain fibrinogen levels and neuroinflammation in 5xFAD mice, affecting neuronal function and leading to greater anxiety and faster cognitive decline.
“Altogether, this data is indicative of a deleterious effect of reduced meningeal lymphatic drainage on brain fibrinogen levels and neuroinflammation in 5xFAD mice, which impact neuronal function, as previously shown19, and translate into heightened anxiousness and accelerated cognitive decline.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [19] Ryu, J. K. et al. Fibrin-targeting immunotherapy protects against neuroinflammation and neurodegeneration. Nat. Immunol. 19, 1212–1223 (2018). source
Not checked in the free run.
Classified as probably not a substantial claim. May combine two claims.
PremisecitationAlzheimer's disease involves accumulation of toxic amyloid-beta aggregates in the brain, partly because cleansing mechanisms progressively fail.
“Alzheimer’s disease (AD) is characterized by accumulation of toxic Aβ aggregates in the brain1, in part, due to progressive impairment of cleansing mechanisms2–6.”
Quote in the paperSubstantial claim0 of 6 sources checked- cites [1] Jack, C. R. Jr et al. NIA-AA Research Framework: toward a biological definition of Alzheimer’s disease. Alzheimers Dement. 14, 535–562 (2018). source
Not checked in the free run.
- cites [2] Logovinsky, V. et al. Safety and tolerability of BAN2401—a clinical study in Alzheimer’s disease with a protofibril selective Aβ antibody. Alzheimers Res. Ther. 8, 14 (2016). source
Not checked in the free run.
- cites [3] Sevigny, J. et al. The antibody aducanumab reduces Aβ plaques in Alzheimer’s disease. Nature 537, 50–56 (2016). source
Not checked in the free run.
- cites [4] Da Mesquita, S. et al. Functional aspects of meningeal lymphatics in ageing and Alzheimer’s disease. Nature 560, 185–191 (2018). source
Not checked in the free run.
- cites [5] Mawuenyega, K. G. et al. Decreased clearance of CNS beta-amyloid in Alzheimer’s disease. Science 330, 1774 (2010). source
Not checked in the free run.
- cites [6] Tarasoff-Conway, J. M. et al. Clearance systems in the brain—implications for Alzheimer diseaser. Nat. Rev. Neurol. 12, 248 (2016). source
Not checked in the free run.
May combine two claims.
Interpretationown dataMeningeal lymphatic ablation causes loss of homeostatic microglia and acquisition of a disease-associated microglial signature, effects that passive immunotherapy counteracts.
“These observations suggest that meningeal lymphatic ablation leads to a loss of homeostatic microglia, and acquisition of the DAM signature (and/or the neurodegenerative microglial signature)21,22,26, all of which is counteracted by passive immunotherapy.”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [21] Keren-Shaul, H. et al. A unique microglia type associated with restricting development of Alzheimer’s disease. Cell 169, 1276–1290.e17 (2017). source
Not checked in the free run.
- cites [22] Krasemann, S. et al. The TREM2-APOE pathway drives the transcriptional phenotype of dysfunctional microglia in neurodegenerative diseases. Immunity 47, 566–581.e9 (2017). source
Not checked in the free run.
- cites [26] Zhou, Y. et al. Human and mouse single-nucleus transcriptomics reveal TREM2-dependent and TREM2-independent cellular responses in Alzheimer’s disease. Nat. Med. 26, 131–142 (2020). source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe Morris water maze test was administered by an experimenter who was blinded.
“All MWM testing was performed between 10 a.m. and 6 p.m., during the lights-on phase, by a blinded experimenter.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataSample sizes were generally not recalculated or predetermined by statistical methods.
“In general, statistical methods were not used to re-calculate or predetermine sample sizes.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningDispersion was estimated using estimateGLMRobustDisp to make the analysis more robust to outliers.
“Dispersion was estimated with estimateGLMRobustDisp to increase robustness against outliers and a quasi-likelihood model was fit with glmQLFit.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationBrain single-nucleus RNA-seq data were annotated using a marker gene list curated previously.
“We employed a list of marker genes that we had previously curated64 to annotate brain single-nucleus RNA-seq data.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [64] Del-Aguila, J. L. et al. A single-nuclei RNA sequencing study of Mendelian and sporadic AD in the human brain. Alzheimers Res. Ther. 11, 71 (2019). source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataLow-quality cells were removed based on unique molecular counts, unique gene counts, and mitochondrial gene percentage.
“The resulting gene by count matrices were then read into R and filtered to remove low quality cells based on unique molecular counts, unique genes, and percent mitochondrial gene expression.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationMultiple testing in the eQTL analysis was corrected while accounting for linkage disequilibrium, following an approach used in prior bulk RNA-seq eQTL studies.
“We followed an approach previously employed in bulk RNA-seq expression quantitative trait loci (eQTL) analyses66–69 to correct for multiple testing while accounting for linkage disequilibrium.”
Quote in the paperNot a substantial claim0 of 4 sources checked- cites [66] Sul, J. H. et al. Accurate and fast multiple-testing correction in eQTL studies. Am. J. Hum. Genet. 96, 857–868 (2015). source
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- cites [67] Duong, D. et al. Using genomic annotations increases statistical power to detect eGenes. Bioinformatics 32, i156–i163 (2016). source
Not checked in the free run.
- cites [68] Darnell, G., Duong, D., Han, B. & Eskin, E. Incorporating prior information into association studies. Bioinformatics 28, i147–i153 (2012). source
Not checked in the free run.
- cites [69] Eskin, E. Increasing power in association studies by using linkage disequilibrium structure and molecular function as prior information. Genome Res. 18, 653–660 (2008). source
Not checked in the free run.
May combine two claims.
Interpretationown dataIn 5xFAD mice, meningeal lymphatic dysfunction produces anxious-like behavior and poorer spatial learning and memory.
“Extended Data Figure 4 | Meningeal lymphatic dysfunction leads to anxious-like behavior and worsened spatial learning and memory in 5xFAD mice.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenTo ensure randomization, animals were selected from different cages within each experimental group.
“Animals from different cages, but within the same experimental group, were selected to assure randomization.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone givenBenjamini-Hochberg correction was applied to differential expression P-values across all datasets, and adjusted P-values below 0.05 were treated as significant.
“The Benjamini-Hochberg correction was used to adjust the associated P-values for differentially expressed genes in all datasets and those with adjusted P-values below 0.05 were considered to be significant.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenFor all independent experiments, experimenters did not know group identities from euthanasia until data collection and analysis ended.
“Experimenters were blinded to the identity of experimental groups from the time of euthanasia until the end of data collection and analysis for all the independent experiments.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenAll quantitative measurements were made by an experimenter who was blinded.
“All measurements were performed by a blinded experimenter, Microsoft Excel was used to calculate average values in each experiment and statistical analysis performed using Prism 8.3.4.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone givenWithin and between independent groups of the same experiment, variance was comparable.
“Variance was similar within independent groups of the same experiment and between groups from independent experiments.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenNeuropathological changes of AD were evaluated with National Institute on Aging-Alzheimer's Association criteria.
“AD neuropathological changes were assessed according to the criteria of the National Institute on Aging-Alzheimer’s Association (NIA-AA).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe results shown in panels a-i were reproduced in two separate experiments.
“Data in a-i are representative of 2 independent experiments”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataIn 5xFAD mice, impairing meningeal lymphatic function restricts mAb158-mediated brain Aβ clearance and changes neuritic dystrophy, microglial activation, and fibrinogen levels.
“Extended Data Figure 3 | Compromising meningeal lymphatic function in 5xFAD mice limits brain Aβ clearance by mAb158 and modulates neuritic dystrophy, microglial activation and fibrinogen levels.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationLive lymphatic endothelial cells were gated as DAPI-negative, CD45-negative, CD31-positive, and PDPN-positive using the same gating strategy as a prior publication.
“The live LECs were then gated as DAPI−CD45−CD31+PDPN + (using the exact same gating strategy as described in a previous publication5) and sorted into a 96-well plate containing 100 μL of RNA extraction lysis buffer using the Influx™ Cell Sorter (BD Biosciences) that is available at the University of Virginia Flow Cytometry Core Facility.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [5] Mawuenyega, K. G. et al. Decreased clearance of CNS beta-amyloid in Alzheimer’s disease. Science 330, 1774 (2010). source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationA previously proposed dynamic model guided removal of nuclei with high mitochondrial gene expression.
“We removed nuclei with high mitochondria gene expression following a previously proposed dynamic model61.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [61] Mathys, H. et al. Single-cell transcriptomic analysis of Alzheimer’s disease. Nature 570, 332–337 (2019). source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationSequencing depth per cell, number of unique features, and mitochondrial gene percentage were regressed out.
“The resulting normalized counts were then transformed from log2 scale to the natural log scale for compatibility with Seurat v355 and the effects of sequencing depth per cell, number of unique features, and percentage of mitochondrial genes were regressed out.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [55] Stuart, T. et al. Comprehensive integration of single-cell data. Cell 177, 1888–1902.e21 (2019). source
Not checked in the free run.
May combine two claims.
Interpretationown dataThe advanced disease stage or advanced age at which antibody therapies are given might explain part of their marginal benefits and potential harmful side effects, which could be due to compromised meningeal lymphatic function.
“The advanced stage of disease (or simply the advanced age) at which antibody-based therapies are administered, might explain part of their marginal beneficial effects (and potential deleterious side effects), which could be attributed to a compromised meningeal lymphatic function.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe open field test was conducted by a blinded experimenter.
“Individual mice were then placed into the open field arena (made of opaque white plastic material, 35 cm × 35 cm) by a blinded experimenter and allowed to explore it for 15 min.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningSamples were barcoded with six palladium isotopes to reduce variability between tubes.
“Individual samples were barcoded using six palladium metal isotopes according to the manufacturer’s instructions (Cell-ID 20-plex Pd barcoding kit, Fluidigm) to reduce tube-to-tube variability.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenNo exclusion criteria were established before the study.
“No exclusion criteria were pre-established.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataOne outlier in the Visudyne group was identified and excluded in Extended Data Fig. 3e.
“An outlier was identified and excluded in Extended Data Fig. 3e, in the Visudyne group (the outlier is indicated in the correspondent source data file).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataPotentially contaminating oligodendrocyte precursor cells, oligodendrocytes, neurons, and astrocytes were identified and removed using Cspg4, Mbp, Cam2ka, and Gfap expression, respectively.
“In the cortical myeloid single-cell dataset obtained using 5xFAD mice, small populations of potentially contaminating oligodendrocyte precursor cells, oligodendrocytes, neurons and astrocytes were identified and removed based on the expression levels of Cspg4, Mbp, Cam2ka, and Gfap genes, respectively.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenAll experiments were approved by the University of Virginia Institutional Animal Care and Use Committee.
“All experiments were approved by the Institutional Animal Care and Use Committee of the University of Virginia.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenFor viSNE visualization, an equal number of cells was randomly sampled from each replicate, totaling 12,000 cells per condition.
“A subset of cells was selected for viSNE visualization by randomly sampling an equal number of cells from each replicate, totaling 12,000 cells from each condition.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataMicroglia are unlikely to respond directly to mVEGF-C because few express Flt4, though a direct effect on brain blood endothelial cells cannot be excluded.
“Although we cannot rule out a direct effect of mVEGF-C on brain BECs, which show some expression of Flt4, microglia are unlikely to respond to mVEGF-C due to the low frequency of Flt4-expressing cells (Extended Data Fig. 8t).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenPotential outliers were identified and discarded using the ROUT test.
“The ROUT test was used to identify and discard potential outliers.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone givenGenes with fewer than five counts in at least two samples, or with high within-sample standard deviations, were removed.
“Genes were filtered to remove those with fewer than five counts in at least two samples as well as those with high intra-sample standard deviations.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationRaw mass cytometry data were normalized for detector sensitivity by adding five element beads.
“Raw data were normalized for detector sensitivity by adding five element beads to the sample and processed as described previously42.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [42] Finck, R. et al. Normalization of mass cytometry data with bead standards. Cytometry A 83, 483–494 (2013). source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataFluorescent microsphere drainage was counted by a blinded experimenter.
“Fluorescent microsphere drainage was analyzed in FIJI software by drawing a line demarcating the draining lymphatic vessel afferent to the dCLN and manually counting the microspheres passing the line by a blinded experimenter.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationDoublets were detected and discarded with Doublet Finder, which removes nuclei whose expression profiles resemble synthetically mixed nuclei.
“To detect and discard doublets, we used Doublet Finder62, which removes nuclei with expression profiles that resemble synthetically mixed nuclei from the dataset.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [62] McGinnis, C. S., Murrow, L. M. & Gartner, Z. J. DoubletFinder: doublet detection in single-cell RNA sequencing data using artificial nearest neighbors. Cell Syst. 8, 329–337.e4 (2019). source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationPower calculations (α = 0.05, power = 0.8) based on similar previously published experiments guided the choice of sample sizes.
“Sample sizes were chosen on the basis of standard power calculations (with α = 0.05 and power of 0.8) performed for similar experiments that were previously published5,12.”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [5] Mawuenyega, K. G. et al. Decreased clearance of CNS beta-amyloid in Alzheimer’s disease. Science 330, 1774 (2010). source
Not checked in the free run.
- cites [12] Louveau, A. et al. CNS lymphatic drainage and neuroinflammation are regulated by meningeal lymphatic vasculature. Nat. Neurosci. 21, 1380–1391 (2018). source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenGenes were retained only if they were expressed in more than five cells.
“Additionally, genes were filtered to retain only those which were expressed more than five cells.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataFor hippocampal bulk RNA sequencing, differential expression results were filtered using a Benjamini-Hochberg adjusted P-value threshold of 0.05.
“Expression differential was tested with empirical Bayes quasi-likelihood F-test and results were then filtered using as threshold a Benjamini-Hochberg adjusted P-value < 0.05 (statistically significant).”
Quote in the paperNot a substantial claim
The paper relies on this without support.
5xFAD mice model Alzheimer's disease pathology in a way that is relevant to human Alzheimer's disease for conclusions about meningeal lymphatics and immunotherapy.
“Ablation of meningeal lymphatics in 5xFAD mice exacerbated Aβ deposition, microgliosis and neurovascular function, affecting the outcome of anti-Aβ passive immunotherapy and behavior.”
The paper relies on this without support.
Gene expression signatures from mouse microglia can be meaningfully compared with human microglia to infer shared activation states.
“We performed an integrated transcriptional analysis of microglia from human donor brains (from non-AD, presymptomatic sporadic AD, familial AD and sporadic AD patients; Supplementary Table 4) and from the brains of 5xFAD mice with intact or defective meningeal lymphatics (Fig. 3b and Extended Data Fig. 10a).”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Meningeal lymphatic dysfunction induces microglial activation and acquisition of DAM signature, accompanied by Aβ deposition in the brains of 5xFAD mice.
“meningeal lymphatic dysfunction induces microglial activation and acquisition of DAM signature, accompanied by Aβ deposition in the brains of 5xFAD mice.”
From Microbiota–gut–brain axis and its therapeutic applications in neurodegenerative diseases (2024) · cites this paper as [687]
Ablation of meningeal lymphatics impedes anti-amyloid-β therapy by exacerbating microgliosis, neurovascular dysfunction, and behavior defects in the 5XFAD model of Alzheimer's disease.
“the ablation of meningeal lymphatics impedes anti-amyloid-β therapy by exacerbating microgliosis, neurovascular dysfunction, and behavior defects in the 5XFAD model of Alzheimer’s disease”
From Living on the Edge of the CNS: Meninges Cell Diversity in Health and Disease (2021) · cites this paper as Da Mesquita et al., 2021
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Microsphere diameter differs between the methods and figure legend
MinorThe methods specify 0.5-μm microspheres for the CSF drainage measurement, but the legend for that experiment specifies 1-μm microspheres.
“One week later, each mouse was injected with 5 μL of a suspension of fluorescent microspheres (1 μm in diameter) into the CSF”
“Upon i.c.m. injection of 5 μL of a suspension of 0.5 μm yellow-green fluorescent (505/515 nm) microspheres (Thermo Fisher Scientific) diluted in artificial CSF”
Cortical microglia count differs between the methods and figure legend
MinorThe methods give 649 as the final number of microglia in the cortical single-cell dataset, whereas the legend describes analysis of 651 microglia from that dataset.
“leading to a final number of 649 microglia.”
“data in l-n resulted from the scRNA-seq analysis of 651 microglia”
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Comprehensive Integration of Single-Cell Data
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Integrating single-cell transcriptomic data across different conditions, technologies, and species
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Salmon provides fast and bias-aware quantification of transcript expression
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- Authors
- Da Mesquita, S., Papadopoulos, Z., Dykstra, T., Brase, L., Farias, F. G., Wall, M., Jiang, H., Kodira, C. D., de Lima, K. A., Herz, J., Louveau, A., Goldman, D. H., Salvador, A. F., Onengut-Gumuscu, S., Farber, E., Dabhi, N., Kennedy, T., Milam, M. G., Baker, W., Smirnov, I., Rich, S. S., Dominantly Inherited Alzheimer Network, Benitez, B. A., Karch, C. M., Perrin, R. J., Farlow, M., Chhatwal, J. P., Holtzman, D. M., Cruchaga, C., Harari, O., & Kipnis, J.
- Affiliations
- Washington University in St. Louis (US)
- University of Virginia (US)
- PureTech (United States) (US)
- Cleveland Clinic (US)
- Harvard University (US)
- Corresponding author
- Kipnis, Jonathan
- ORCID
- Da Mesquita, Sandro
- Papadopoulos, Zachary
- Dykstra, Taitea
- Brase, Logan
- Farias, Fabiana Geraldo
- Jiang, Hong
- de Lima, Kalil Alves
- Herz, Jasmin
- Louveau, Antoine
- Salvador, Andrea Francesca
- Farber, Emily
- Dabhi, Nisha
- Kennedy, Tatiana
- Smirnov, Igor
- Rich, Stephen S.
- Benitez, Bruno A.
- Karch, Celeste M.
- Perrin, Richard J.
- Farlow, Martin
- Chhatwal, Jasmeer P.
- Holtzman, David M.
- Cruchaga, Carlos
- Harari, Oscar
- Kipnis, Jonathan
- Venue
- Nature
- Published
- 2021-04-28
- Volume
- 593
- Issue
- 7858
- Pages
- 255-260
- ISSN
- 0028-0836 (ISSN-L)
- 1476-4687
- PMC
- PMC8817786
- OpenAlex
- W3159116119
- Semantic Scholar
- dd9d22f80fc8ee5da814030e02f7fc430f7e7c4f
- Cited by
- 431
- References
- 72
- Citations by year
- 2026: 84 · 2025: 83 · 2024: 101 · 2023: 77 · 2022: 57 · 2021: 29
- FWCI
- 41.73
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Nature (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Purdue University Indianapolis (Indiana University) (submittedVersion)
- Funders
- Cure Alzheimer's Fund
- Japan Agency for Medical Research and Development
- Korea Health Industry Development Institute
- Deutsches Zentrum für Neurodegenerative Erkrankungen
- Fleni
- National Institutes of Health (AG066444, AG034113)
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University in St. Louis (P30 AG066444)
- National Institute on Aging (RF1AG044546, AG034113, RF1AG057496, R01AG062734, RF1AG053303, AG066444, AG057496, R56AG067764, UF1AG032438, P50AG005681, P01 AG0 3991, P01AG003991, R01AG034113, AG057777, U19AG032438, U01AG032438, RF1AG058501, R01AG057777, R37AG034113, P30AG066444, P01AG026276)
- National Institute of Neurological Disorders and Stroke (R01NS118146)
- Topics
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Cerebrospinal fluid and hydrocephalus
- Keywords
- meningeal lymphatic drainage, Alzheimer's disease, amyloid-beta, anti-amyloid immunotherapy, passive immunotherapy, microglia, microglial activation, microglial inflammation, 5xFAD mice, VEGF-C, neurovascular dysfunction, amyloid deposition
- MeSH terms
- Aging, Alzheimer Disease, Animals, Brain, Disease Models, Animal, Hippocampus, Humans, Immunotherapy, Inflammation, Male, Meninges, Transcription, Genetic, Amyloid beta-Peptides, Microglia, Vascular Endothelial Growth Factor C, Lymphatic Vessels, Mice, Antibodies, Monoclonal, Humanized
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-06.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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