Cited by 203Neuroinflammation and Neurodegeneration MechanismsAlzheimer's disease research and treatmentsNeurological Disease Mechanisms and Treatments

The DOI matches its Crossref record; 90 of the 91 references it cites were found in a registry or an index; 60 of the 83 sources its claims cite were checked for support.

APOE4 impairs the microglial response in Alzheimer’s disease by inducing TGFβ-mediated checkpoints

Open access

Abstract

The APOE4 allele is the strongest genetic risk factor for late-onset Alzheimer's disease (AD). The contribution of microglial APOE4 to AD pathogenesis is unknown, although APOE has the most enriched gene expression in neurodegenerative microglia (MGnD). Here, we show in mice and humans a negative role of microglial APOE4 in the induction of the MGnD response to neurodegeneration. Deletion of microglial APOE4 restores the MGnD phenotype associated with neuroprotection in P301S tau transgenic mice and decreases pathology in APP/PS1 mice. MGnD-astrocyte cross-talk associated with β-amyloid (Aβ) plaque encapsulation and clearance are mediated via LGALS3 signaling following microglial APOE4 deletion. In the brains of AD donors carrying the APOE4 allele, we found a sex-dependent reciprocal induction of AD risk factors associated with suppression of MGnD genes in females, including LGALS3, compared to individuals homozygous for the APOE3 allele. Mechanistically, APOE4-mediated induction of ITGB8-transforming growth factor-β (TGFβ) signaling impairs the MGnD response via upregulation of microglial homeostatic checkpoints, including Inpp5d, in mice. Deletion of Inpp5d in microglia restores MGnD-astrocyte cross-talk and facilitates plaque clearance in APP/PS1 mice. We identify the microglial APOE4-ITGB8-TGFβ pathway as a negative regulator of microglial response to AD pathology, and restoring the MGnD phenotype via blocking ITGB8-TGFβ signaling provides a promising therapeutic intervention for AD.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

Microglial APOE4 cell-autonomously suppresses the neurodegenerative microglia (MGnD) response to Alzheimer’s disease pathology via ITGB8–TGFβ signaling and homeostatic checkpoints such as INPP5D. Deleting microglial APOE4, deleting Inpp5d, or blocking ITGB8 restores MGnD/astrocyte cross-talk and reduces pathology in mouse AD models.

Key findings

  • APOE4-expressing microglia showed upregulated homeostatic genes including *Tgfbr2*, *Inpp5d*, *Spi1* and *Smad3* versus APOE3 microglia (RNA-seq, n = 11–14 mice/group), and after apoptotic-neuron injection APOE4 microglia failed to induce MGnD genes such as *Clec7a*, *Itgax*, *Lilr4b*, *Lpl*, *Lgals3* and *Spp1*; phagocytic FCRLS+CD11b+ microglia were reduced (n = 7 APOE3-KI, n = 9 APOE4-KI).
  • Conditional deletion of microglial APOE4 restored MGnD signatures and was neuroprotective in P301S tau mice, with reduced neuronal loss in cortical layer 5 (n = 7–10 mice/group), and in APP/PS1 mice increased Clec7a^hi Lgals3^hi MGnD, reduced HJ3.4B+ plaque pathology and reduced LAMP1+ dystrophic neurites.
  • Mechanistically, APOE4 induced ITGB8–TGFβ signaling; cortical *Itgb8* deletion or anti-ITGB8 neutralizing antibody induced MGnD genes and reduced Aβ plaque size in APP/PS1 mice (n = 8 IgG-treated, n = 9 anti-ITGB8-treated), while anti-ITGB8 restored CLEC7A and GFAP in APP/PS1:APOE4-KI mice (n = 11 ROIs from 6–7 mice/group). Microglial *Inpp5d* deletion also induced MGnD and reduced plaque load.
  • In human AD brains, APOE3/APOE4 heterozygosity showed sex-dependent effects: females had reduced MGnD/astrocyte genes including *LGALS3*, *GFAP*, *VIM* and *S100A* and increased AD risk genes including *ABCA7*, *IFNAR1*, *APP*, *BIN1*, *CD33*, *HAVCR2* and *SMAD3*; pSMAD3 was increased in IBA1+ cells (n = 27 APOE3/3 cells, n = 33 APOE3/4 cells), and LGALS3 immunoreactivity was reduced (n = 8 APOE3/3, n = 9 APOE3/4 donors). Males showed increased *ITGB8*.

Methods

  • Mouse genetics: APOE3-KI and APOE4-KI mice, conditional microglial deletion via Cx3cr1-CreERT2, and crosses to APP/PS1 and P301S tau models; stereotactic injections of apoptotic neurons, recombinant LGALS3, anti-ITGB8 antibody, PU.1 inhibitor, and adoptive transfer of phagocytic microglia.
  • Human tissue: postmortem AD brain samples from Netherlands Brain Bank and Massachusetts Alzheimer’s Disease Research Center; RNA-seq donors included 12 AD APOE3/3 and 13 AD APOE3/4 cases, with additional IHC and RNAscope cohorts.
  • Main assays/analyses: FACS, bulk RNA-seq/Smart-seq2, scRNA-seq, H3K9ac ChIP-seq, lipidomics, immunohistochemistry, RNAscope, RT-qPCR; DESeq2 likelihood-ratio tests, Seurat clustering, IPA/NicheNet/CellTalkDB cross-talk analysis, t-tests and one-way ANOVA.

Limitations

  • The paper has no dedicated limitations section; it states that Cx3cr1-CreERT2 may also affect border-associated macrophages, albeit to a lesser extent, and cautions that prior LGALS3 literature used global *Lgals3*-KO or pre-cultured Aβ models, so microglial-derived LGALS3 conclusions should be interpreted carefully.
  • Evident from the text: human analyses are cross-sectional postmortem comparisons with modest sex-stratified donor numbers (e.g., RNA-seq male n = 5–7, female n = 6–7; IHC n = 8–9), limiting causal and sex-specific inference.
  • Evident from the text: most mechanistic evidence comes from transgenic mouse models and intracranial injections, so translation to human AD progression and therapeutic dosing remains untested.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1038/s41590-023-01627-6

Cites

90 of 91 references verified0 citation errors · 1 not checkable

Statistics

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Verification

Claims the paper makes

137 Own result · 36 Own interpretation · 25 Own method · 19 Supported · 17 Partly supported · 6 Sources not found · 2 Supported so far · 2 No full text of the sources · 2 No basis given · 1 Not supported · 1 Couldn’t confirm · 1 Not checked yet · accuracy not yet measured

Show all 187 claims

  • It may state two separate claims as one. 28
  • Probably not a substantial claim. 40
  • The quote only partly states this claim. 3
62 of 62
  • The paper relies on this without support.

    The contribution of microglial APOE4 to AD pathogenesis is unknown.

    “The contribution of microglial APOE4 to AD pathogenesis is unknown, although APOE has the most enriched gene expression in neurodegenerative microglia (MGnD).”
  • The paper relies on this without support.

    The cell-autonomous role of APOE4 expressed by microglia in the regulation of AD pathology has not been addressed.

    “Several studies investigated the molecular signature of microglia in mice globally expressing APOE4 (refs. 10,11); however, the cell-autonomous role of APOE4 expressed by microglia in the regulation of AD pathology has not been addressed.”
  • The authors state this as an assumption.

    The impact of microglial APOE4 on astrocyte phenotype and function is unknown.

    “The impact of microglial APOE4 on astrocyte phenotype and function is unknown.”
  • The paper relies on this without support.

    Recombinant LGALS3 injected into hippocampus and cortex mimics endogenous LGALS3 signaling in APP/PS1 mice.

    “we treated APP/PS1 mice with two different doses of recombinant LGALS3 protein (rLGALS3) or with PBS by injection into the hippocampus and cortex at the age of 4 months.”
  • The paper relies on this without support.

    Gene expression changes measured in whole human brain RNA-seq reflect changes in microglial/astrocyte gene expression rather than only changes in cell composition.

    “we used RNA-seq analysis of whole human brains. We found a significant reduction in the expression levels of MGnD genes, including CLEC7A , AXL , LYZ , CD300LG and HLA -DQB2 , and an induction in expression of the upstream regulator of TGFβ signaling ITGB8 in the brains of male individuals with AD heterozygous for the APOE3 and APOE4 alleles (Fig. 7a and Supplementary Tables 6 and 7).”
  • The paper relies on this without support.

    Mouse models (APP/PS1, P301S) and APOE4-KI/cKO manipulations recapitulate key aspects of human AD and APOE4 biology.

    “These findings in humans are in line with our previous results demonstrating enriched Spi1 expression in APOE4 -KI mice (Fig. 1a,b) and restoration of the MGnD signature following genetic deletion of Spi1 (Fig. 2a,b and Supplementary Table 2).”
  • The paper relies on this without support.

    Publicly available human scRNA-seq and snRNA-seq datasets are representative and comparable for APOE genotype analyses.

    “Analysis of publicly available human brain scRNA-seq data 34 showed increased expression of TGFβ-signaling genes and downstream AD risk factor genes, including INPP5D , in females that are heterozygous for the APOE3 and APOE4 alleles.”
  • The paper relies on this without support.

    Mouse models of AD (APP/PS1, tau, P301S) faithfully represent key aspects of human AD pathology and microglial responses.

    “To test whether enhanced microglia activation and phagocytosis can reduce pathological hallmarks of AD in adult APP/PS1 mice, we used a monoclonal neutralizing antibody to ITGB8 (ADWA11) 43 .”
  • The paper relies on this without support.

    The MGnD signature observed in mouse microglia corresponds to the human MGnD signature.

    “These findings in mice and in humans suggest that APOE4 predisposes to AD pathology in part via the induction of TGFβ-dependent microglia homeostatic regulators 13 that impair microglia-astrocyte cross-talk in response to neurodegeneration.”
  • The paper relies on this without support.

    FCRLS is a microglia-specific marker.

    “FCRLS, a microglia specific marker”
10 of 10

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Metadata

Authors
Yin, Z., Rosenzweig, N., Kleemann, K. L., Zhang, X., Brandão, W., Margeta, M. A., Schroeder, C., Sivanathan, K. N., Silveira, S., Gauthier, C., Mallah, D., Pitts, K. M., Durao, A., Herron, S., Shorey, H., Cheng, Y., Barry, J.-L., Krishnan, R. K., Wakelin, S., Rhee, J., Yung, A., Aronchik, M., Wang, C., Jain, N., Bao, X., Gerrits, E., Brouwer, N., Deik, A., Tenen, D. G., Ikezu, T., Santander, N. G., McKinsey, G. L., Baufeld, C., Sheppard, D., Krasemann, S., Nowarski, R., Eggen, B. J. L., Clish, C., Tanzi, R. E., Madore, C., Arnold, T. D., Holtzman, D. M., & Butovsky, O.
Affiliations
  • Brigham and Women's Hospital (US)
  • Boston University (US)
  • Washington University in St. Louis (US)
  • University Medical Center Groningen (NL)
  • Broad Institute (US)
  • Harvard University (US)
  • University of California, San Francisco (US)
  • Massachusetts General Hospital (US)
Corresponding author
Butovsky, Oleg
Venue
Nature Immunology
Published
2023-09-25
Volume
24
Issue
11
Pages
1839-1853
ISSN
  • 1529-2908 (ISSN-L)
  • 1529-2916
OpenAlex
W4387012769
Cited by
202
References
86
Citations by year
2026: 56 · 2025: 75 · 2024: 61 · 2023: 10
FWCI
16.67
Type
journal article
Language
en
Open access
Locations
  • Nature Immunology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (submittedVersion)
  • HAL (Le Centre pour la Communication Scientifique Directe) (submittedVersion)
  • Oskar-Bordeaux (Universite de Bordeaux) (submittedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
Funders
  • U.S. Department of Health & Human Services | NIH | National Institute on Aging (R01AG051812, R01AG054672, R01AG075509, R21AG076982, R01AG080992)
  • U.S. Department of Health & Human Services | NIH | National Eye Institute (R01EY027921, K12EY016335, K08 EY030160)
  • U.S. Department of Health & Human Services | NIH | National Institute of Neurological Disorders and Stroke (R01NS088137, R21NS101673, RF1NS090934)
  • BrightFocus Foundation (2020A016806)
  • Cure Alzheimer’s Fund
  • U.S. Department of Health & Human Services | NIH | National Institute of General Medical Sciences (R01GM132668)
  • Nancy Davis Foundation for Multiple Sclerosis
  • Alzheimer’s Association (AARF-21-846786)
  • National Multiple Sclerosis Society (FG-2108-38372)
  • U.S. Department of Defense (MS210257)
  • Research to Prevent Blindness
  • Glaucoma Research Foundation
Topics
  • Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
  • Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
Keywords
APOE ε4, Alzheimer's disease, microglia, neurodegeneration, TGF-beta signaling, ITGB8, galectin-3, INPP5D, sex differences, APP/PS1 mice, neuroprotection
MeSH terms
Alzheimer Disease, Animals, Disease Models, Animal, Female, Humans, Mice, Transgenic, Amyloid beta-Peptides, Microglia, Galectin 3, Mice, Apolipoprotein E4

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