Cited by 1,935Neuroinflammation and Neurodegeneration MechanismsAlzheimer's disease research and treatmentsNeurological Disease Mechanisms and Treatments

The DOI matches its Crossref record; 184 of the 184 references it cites were found in a registry or an index; none of the 159 sources its claims cite is checked for support yet.

Microglia in Alzheimer’s disease

Open access
Hansen, David V., Hanson, Jesse E., Sheng, Morgan·2018·Journal of Cell Biology

Abstract

Proliferation and activation of microglia in the brain, concentrated around amyloid plaques, is a prominent feature of Alzheimer’s disease (AD). Human genetics data point to a key role for microglia in the pathogenesis of AD. The majority of risk genes for AD are highly expressed (and many are selectively expressed) by microglia in the brain. There is mounting evidence that microglia protect against the incidence of AD, as impaired microglial activities and altered microglial responses to β-amyloid are associated with increased AD risk. On the other hand, there is also abundant evidence that activated microglia can be harmful to neurons. Microglia can mediate synapse loss by engulfment of synapses, likely via a complement-dependent mechanism; they can also exacerbate tau pathology and secrete inflammatory factors that can injure neurons directly or via activation of neurotoxic astrocytes. Gene expression profiles indicate multiple states of microglial activation in neurodegenerative disease settings, which might explain the disparate roles of microglia in the development and progression of AD pathology.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This review synthesizes human genetic and cell-biological evidence that microglia play a dual role in Alzheimer's disease: protective early (TREM2-dependent clearance and compaction of Aβ) and harmful later (complement-mediated synapse engulfment, inflammatory cytokine release, and tau pathology spread). The authors propose that the detrimental microglial state emerges later in disease, complicating therapeutic strategies that target microglia.

Key findings

  • Human genetics implicate microglia in late-onset AD: over 20 loci associate with AD risk, and most identified risk genes are expressed selectively or preferentially in microglia; apart from APOE, common variants confer only minor effects (∼10–20%) on AD risk.
  • The TREM2 R47H variant (carried by <0.5% of most populations) increases AD risk approximately threefold and appears to be a loss-of-function mutation impairing TREM2-mediated microglial activation, ligand binding (apoE, apoJ/CLU), and Aβ uptake; Trem2 knockout exacerbates plaque accumulation at later ages (8+ months) in β-amyloidosis mouse models.
  • APOE genotype strongly modulates risk: relative to apoE3, a single apoE4 allele confers approximately threefold increased risk and apoE2 approximately twofold reduced risk; apoE4 appears to reduce Aβ clearance and increase plaque deposition.
  • Microglia can be harmful: complement (C1q, C3) and microglia mediate synapse loss in amyloid models, CSF1R-inhibitor microglia depletion protects against synapse loss and rescues behavioral deficits, and microglia are implicated in tau spread; in microglia-depleted brains plaque size increased ∼13% over 1 wk.
  • Transcriptional profiling identifies a disease-associated microglial (DAM) state with reduced homeostatic genes (e.g., Cx3cr1, P2ry12, Tmem119) and induced neurodegeneration genes (e.g., Apoe, Axl, Csf1, Clec7a, Cst7, Igf1, Itgax), with subtle two- to threefold increases in Trem2 and Tyrobp mRNAs; DAM induction depends largely on TREM2.

Methods

  • Narrative review (Hansen, Hanson, and Sheng) synthesizing human genetics (GWAS and rare-variant studies), mouse model studies, and microglial transcriptomic profiling; no primary data are generated.
  • Evidence reviewed includes GWAS-identified AD risk loci (Table 1), TREM2 and other microglial risk genes, complement-pathway and microglia-depletion experiments in amyloid and tau mouse models (Fig. 3), and RNA-sequencing/single-cell studies of microglial activation states.
  • The authors integrate these findings into a proposed two-phase model of microglial function in AD pathogenesis.

Limitations

  • Stated by the paper: exactly how microglia are involved in the disease mechanism "is not settled"; evidence for microglial-mediated neuronal damage comes "mostly in mouse models"; TREM2 studies in tau models report seemingly conflicting roles (neuroprotective in PS19 vs. neurotoxic in hTau) that the authors attribute partly to analysis at different disease stages; whether the TREM2-dependent transcriptional response is helpful, damaging, or incidental in different disease contexts requires further study.
  • Stated by the paper: studies of microglial gene expression in purified microglia or at the single-cell level from AD brains "have lagged behind" mouse work, and there was "surprisingly limited overlap" in aging-regulated microglial genes between human and mouse, underscoring the need for human microglia profiling at different disease stages and genotypes.
  • Evident from the text: many mechanistic conclusions rest on mouse models that overexpress mutant APP/PS1 or tau transgenes, and the authors note conflicting complement-pathway results (e.g., C3 knockout/inhibition reported both to provide neuroprotection and to increase amyloid burden), so causal direction in humans remains uncertain.

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Integrity signals

Registry

Crossref · 10.1083/jcb.201709069

Cites

184 of 184 references verified0 citation errors · 0 not checkable

Statistics

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Figures

Figure 1. Expression and function of AD risk genes in microglia. (A) These heat maps depict relative expression levels of GWAS-identified AD risk genes among CNS cell types purified from human (Zhang et al., 2016) or mouse (Srinivasan et al., 2016) brain tissues and analyzed by RNA sequencing. Each column within a cell type represents one sample of those cells purified from a different brain. From human dataset GSE73721, samples derived from “normal” cortex are plotted, ranging in age from 8 to 63 yr. From mouse dataset GSE75431, samples from cortex of 13-mo PS2APP β-amyloid model or age-matched nontransgenic littermates are plotted. Z-score represents the number of standard deviations by which a sample’s expression level for a gene differs from the mean expression level for that gene across all samples. For human genes lacking clear mouse orthologues, suitable mouse homologues were selected. (B) This simplified schematic depicts how selected proteins encoded by AD risk genes (red, bold font) participate in pathways for microglial uptake and cellular activation. Lipoproteins containing apoE or apoJ may convey Aβ to microglia for uptake and degradation or may bind to TREM2 and stimulate ITAM-mediated cellular activation leading to chemotaxis, phagocytosis, survival, and transcription.
Figure 1. Expression and function of AD risk genes in microglia. (A) These heat maps depict relative expression levels of GWAS-identified AD risk genes among CNS cell types purified from human (Zhang et al., 2016) or mouse (Srinivasan et al., 2016) brain tissues and analyzed by RNA sequencing. Each column within a cell type represents one sample of those cells purified from a different brain. From human dataset GSE73721, samples derived from “normal” cortex are plotted, ranging in age from 8 to 63 yr. From mouse dataset GSE75431, samples from cortex of 13-mo PS2APP β-amyloid model or age-matched nontransgenic littermates are plotted. Z-score represents the number of standard deviations by which a sample’s expression level for a gene differs from the mean expression level for that gene across all samples. For human genes lacking clear mouse orthologues, suitable mouse homologues were selected. (B) This simplified schematic depicts how selected proteins encoded by AD risk genes (red, bold font) participate in pathways for microglial uptake and cellular activation. Lipoproteins containing apoE or apoJ may convey Aβ to microglia for uptake and degradation or may bind to TREM2 and stimulate ITAM-mediated cellular activation leading to chemotaxis, phagocytosis, survival, and transcription.CC BY-NC-SA · PubMed Central
Figure 2. Depiction of microglial cellular activities related to β-amyloid pathology. The left side illustrates protective microglial activities that limit disease progression. Microglia may clear Aβ peptides via macropinocytosis of soluble Aβ (1; Mandrekar et al., 2009), uptake of lipoprotein-associated Aβ (2), or phagocytosis of fibrillar Aβ aggregates (3). Microglia also help corral larger deposits of Aβ in plaques (4), minimizing damage to the adjacent neuropil. The right side illustrates disease states when microglial containment mechanisms are defective or outstripped. Aβ fibrils on the outskirts of plaque act as substrate for additional Aβ fibrillization and a reservoir of toxic Aβ species that induce neuritic dystrophy (5). Microglia can secrete factors that activate astrocytes (6) and participate in amyloid-dependent synapse loss (7). See also Fig. 3.
Figure 2. Depiction of microglial cellular activities related to β-amyloid pathology. The left side illustrates protective microglial activities that limit disease progression. Microglia may clear Aβ peptides via macropinocytosis of soluble Aβ (1; Mandrekar et al., 2009), uptake of lipoprotein-associated Aβ (2), or phagocytosis of fibrillar Aβ aggregates (3). Microglia also help corral larger deposits of Aβ in plaques (4), minimizing damage to the adjacent neuropil. The right side illustrates disease states when microglial containment mechanisms are defective or outstripped. Aβ fibrils on the outskirts of plaque act as substrate for additional Aβ fibrillization and a reservoir of toxic Aβ species that induce neuritic dystrophy (5). Microglia can secrete factors that activate astrocytes (6) and participate in amyloid-dependent synapse loss (7). See also Fig. 3.CC BY-NC-SA · PubMed Central
Figure 3. Summary of studies manipulating the complement system or depleting microglia in mouse models of AD. (A) Simplified schematic of the complement pathway illustrating selected proteins. The complement system can be initiated by the classical, lectin, or alternative pathways. Central to complement activation is the cleavage of C3. Effects downstream of C3 cleavage include (1) phagocytosis after recognition of C3b opsonized material by complement receptors, including CR3 (inset); (2) inflammatory signaling by C3a and C5a fragment activation of C3aR and C5aR; and (3) lysis via formation of the C5b-C9 membrane attack complex. In the brain, microglia (yellow) mediate phagocytosis and respond to inflammatory signaling, and are also the cell type that produces C1q. Complement proteins demonstrated to play a role in synapse removal during developmental refinement of retinal ganglion cell projections to the lateral geniculate nucleus using knockout mice are indicated with a heavy border. Proteins that have been studied using knockout mice or inhibitors in the context of AD model mice are highlighted in red. (B) Table indicating the amyloid mouse models that have been tested, manipulations that were tested (complement protein knockout or inhibition or microglia depletion), the resulting impact on synapse or neuronal loss (“protection” indicates rescue of amyloid model deficits, whereas “loss” indicates the manipulation causes deficits), and effects on amyloid load. Blue fonts indicate phenotypes that suggest a beneficial effect of reducing complement activation or microglial cell numbers, and red fonts indicate phenotypes that suggest undesirable effects of reducing complement activation. *Note that in this study, the authors claimed not to deplete microglia but to block microglial proliferation. (C) Similar table as in panel B, except showing models of tauopathy and impacts on tau pathology. *Note that CD59 is an inhibitor of complement pathway activity, so the synapse/neuron loss seen with CD59 knockout is consistent with a beneficial effect of reducing complement activation. Reference (Ref) 1, Fonseca et al., 2004; Ref 2, Hong et al., 2016; Ref 3, Fonseca et al., 2017; Ref 4, Shi et al., 2015; Ref 5, Shi et al., 2017a; Ref 6, Maier et al., 2008; Ref 7, Wyss-Coray et al., 2002; Ref 8, Czirr et al., 2017; Ref 9, Fonseca et al., 2009; Ref 10, Olmos-Alonso et al., 2016; Ref 11, Spangenberg et al., 2016; Ref 12, Britschgi et al., 2012; and Ref 13, Asai et al., 2015. FB (FD, FH, FI), complement factor B (D, H, I); KO, knockout; MASP, MBL-associated serine protease; MBL, mannose-binding lectin.
Figure 3. Summary of studies manipulating the complement system or depleting microglia in mouse models of AD. (A) Simplified schematic of the complement pathway illustrating selected proteins. The complement system can be initiated by the classical, lectin, or alternative pathways. Central to complement activation is the cleavage of C3. Effects downstream of C3 cleavage include (1) phagocytosis after recognition of C3b opsonized material by complement receptors, including CR3 (inset); (2) inflammatory signaling by C3a and C5a fragment activation of C3aR and C5aR; and (3) lysis via formation of the C5b-C9 membrane attack complex. In the brain, microglia (yellow) mediate phagocytosis and respond to inflammatory signaling, and are also the cell type that produces C1q. Complement proteins demonstrated to play a role in synapse removal during developmental refinement of retinal ganglion cell projections to the lateral geniculate nucleus using knockout mice are indicated with a heavy border. Proteins that have been studied using knockout mice or inhibitors in the context of AD model mice are highlighted in red. (B) Table indicating the amyloid mouse models that have been tested, manipulations that were tested (complement protein knockout or inhibition or microglia depletion), the resulting impact on synapse or neuronal loss (“protection” indicates rescue of amyloid model deficits, whereas “loss” indicates the manipulation causes deficits), and effects on amyloid load. Blue fonts indicate phenotypes that suggest a beneficial effect of reducing complement activation or microglial cell numbers, and red fonts indicate phenotypes that suggest undesirable effects of reducing complement activation. *Note that in this study, the authors claimed not to deplete microglia but to block microglial proliferation. (C) Similar table as in panel B, except showing models of tauopathy and impacts on tau pathology. *Note that CD59 is an inhibitor of complement pathway activity, so the synapse/neuron loss seen with CD59 knockout is consistent with a beneficial effect of reducing complement activation. Reference (Ref) 1, Fonseca et al., 2004; Ref 2, Hong et al., 2016; Ref 3, Fonseca et al., 2017; Ref 4, Shi et al., 2015; Ref 5, Shi et al., 2017a; Ref 6, Maier et al., 2008; Ref 7, Wyss-Coray et al., 2002; Ref 8, Czirr et al., 2017; Ref 9, Fonseca et al., 2009; Ref 10, Olmos-Alonso et al., 2016; Ref 11, Spangenberg et al., 2016; Ref 12, Britschgi et al., 2012; and Ref 13, Asai et al., 2015. FB (FD, FH, FI), complement factor B (D, H, I); KO, knockout; MASP, MBL-associated serine protease; MBL, mannose-binding lectin.CC BY-NC-SA · PubMed Central

Verification

Claims the paper makes

86 Not checked yet · 27 Own interpretation · 6 No basis given · 4 Sources not found

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  • It may state two separate claims as one. 47
47 of 47
  • The paper relies on this without support.

    Soluble oligomeric Aβ is the form that exerts the most toxic effects on neurons.

    “A halo of soluble, oligomeric Aβ (the form currently thought to exert the most toxic effects on neurons) likely exists around amyloid plaques.”
  • The authors state this as an assumption.

    The relationship between INPP5D SNP rs35349669 genotype and INPP5D expression level observed in whole blood holds true in microglia.

    “If this relationship between genotype and expression level holds true in microglia, then it might explain the elevated AD risk, because higher SHIP1 level would dampen microglial activation and phagocytosis.”
  • The paper relies on this without support.

    Microglia express the C3a and C5a receptors that trigger inflammation in response to complement activation.

    “and they express the C3a and C5a receptors that trigger inflammation in response to complement activation.”
  • The paper relies on this without support.

    Findings in amyloidosis and tauopathy mouse models are informative about the mechanisms of microglial function in human AD.

    “most published studies in amyloidosis mouse models suggest that depleting microglia and blocking complement pathway activation may have beneficial effects in AD, at least in terms of synapse and neuron loss”
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Citations

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Research works printed but not linked: 1

  1. Bales, 1997, Lack of apolipoprotein E dramatically reduces amyloid beta-peptide deposition, Nat. Genet., 17, 263, 10.1038/ng1197-263 · DOI · Paper page

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Metadata

Authors
Hansen, D. V., Hanson, J. E., & Sheng, M.
Affiliations
Genentech (US)
Corresponding author
  • Hansen, David V.
  • Sheng, Morgan
Venue
Journal of Cell Biology
Published
2017-12-01
Volume
217
Issue
2
Pages
459-472
ISSN
  • 0021-9525 (ISSN-L)
  • 1540-8140
OpenAlex
W2774947569
Cited by
1,935
References
184
Citations by year
2026: 208 · 2025: 296 · 2024: 296 · 2023: 305 · 2022: 271 · 2021: 241 · 2020: 173 · 2019: 110 · 2018: 33 · 2017: 2
FWCI
8.39
Type
journal article
Language
en
Open access
Locations
  • The Journal of Cell Biology (publishedVersion, cc-by-nc-sa)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
  • PubMed Central (publishedVersion, cc-by-nc-sa)
  • PubMed (publishedVersion)
Funders
Genentech
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
microglia, Alzheimer's disease, microglial activation, amyloid plaques, amyloid-beta, risk genes, synaptic loss, tau pathology, neuroinflammation, astrocyte activation, microglial activation states, neurodegeneration
MeSH terms
Alzheimer Disease, Animals, Brain, Humans, Microglia

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