Cited by 55Alzheimer's disease research and treatmentsNeuroinflammation and Neurodegeneration MechanismsDementia and Cognitive Impairment Research

Aducanumab anti-amyloid immunotherapy induces sustained microglial and immune alterations

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Cadiz, Mika P., Gibson, Katelin A., Todd, Kennedi T., Nascari, David G., Massa, Nashali, Lilley, Meredith T., Olney, Kimberly C., Al-Amin, Md Mamun +3 more·2024·Journal of Experimental Medicine

Abstract

Aducanumab, an anti-amyloid immunotherapy for Alzheimer's disease, efficiently reduces Aβ, though its plaque clearance mechanisms, long-term effects, and effects of discontinuation are not fully understood. We assessed the effect of aducanumab treatment and withdrawal on Aβ, neuritic dystrophy, astrocytes, and microglia in the APP/PS1 amyloid mouse model. We found that reductions in amyloid and neuritic dystrophy during acute treatment were accompanied by microglial and astrocytic activation, and microglial recruitment to plaques and adoption of an aducanumab-specific pro-phagocytic and pro-degradation transcriptomic signature, indicating a role for microglia in aducanumab-mediated Aβ clearance. Reductions in Aβ and dystrophy were sustained 15 but not 30 wk after discontinuation, and reaccumulation of plaques coincided with loss of the microglial aducanumab signature and failure of microglia to reactivate. This suggests that despite the initial benefit from treatment, microglia are unable to respond later to restrain plaque reaccumulation, making further studies on the effect of amyloid-directed immunotherapy withdrawal crucial for assessing long-term safety and efficacy.

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Authors
Cadiz, M. P., Gibson, K. A., Todd, K. T., Nascari, D. G., Massa, N., Lilley, M. T., Olney, K. C., Al-Amin, M. M., Jiang, H., Holtzman, D. M., & Fryer, J. D.
Affiliations
  • Mayo Clinic (US)
  • Indiana University Indianapolis (US)
  • Washington University in St. Louis (US)
Corresponding author
Fryer, John D.
Venue
Journal of Experimental Medicine
Published
2024-01-16
Volume
221
Issue
2
ISSN
  • 0022-1007 (ISSN-L)
  • 1540-9538
OpenAlex
W4390909157
Cited by
55
References
51
Citations by year
2026: 25 · 2025: 19 · 2024: 11
FWCI
9.77
Type
journal article
Language
en
Open access
Locations
  • The Journal of Experimental Medicine (publishedVersion, cc-by-nc-sa)
  • PubMed Central (publishedVersion, cc-by-nc-sa)
  • PubMed (publishedVersion)
  • IUScholarWorks (Indiana University) (submittedVersion, cc-by-nc-sa)
  • Digital Commons@Becker (Washington University School of Medicine) (submittedVersion, cc-by-nc-sa)
Funders
  • Mayo Clinic Foundation
  • Ben Dov Family Luminescence Foundation
  • Florida Department of Health (6AZ06)
  • Rotary Coins for Alzheimer’s Research Trust
  • CureAlz Foundation
  • Goodman Family Foundation
  • National Institutes of Health (NS084974, AG062556, AG062110, NS094137, AG057997, AG062077, NS110435, AG047327, AG049992, AG062677)
Topics
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
  • Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Keywords
aducanumab, anti-amyloid immunotherapy, Alzheimer's disease, amyloid-beta, microglia, astrocytes, neuritic dystrophy, APP/PS1 mice, plaque clearance, microglial recruitment, treatment withdrawal
MeSH terms
Animals, Immunotherapy, Phagocytes, Microglia, Mice, Plaque, Amyloid, Antibodies, Monoclonal, Humanized

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