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Microglia and C9orf72 in neuroinflammation and ALS and frontotemporal dementia
Open accessAbstract
Amyotrophic lateral sclerosis (ALS) is a degenerative disorder that is characterized by loss of motor neurons and shows clinical, pathological, and genetic overlap with frontotemporal dementia (FTD). Activated microglia are a universal feature of ALS/FTD pathology; however, their role in disease pathogenesis remains incompletely understood. The recent discovery that ORF 72 on chromosome 9 (C9orf72), the gene most commonly mutated in ALS/FTD, has an important role in myeloid cells opened the possibility that altered microglial function plays an active role in disease. This Review highlights the contribution of microglia to ALS/FTD pathogenesis, discusses the connection between autoimmunity and ALS/FTD, and explores the possibility that C9orf72 and other ALS/FTD genes may have a "dual effect" on both neuronal and myeloid cell function that could explain a shared propensity for altered systemic immunity and neurodegeneration.
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“The combination of NPTX2 (representing synaptic plasticity [35]), NfL (marker for overall neurodegeneration [60, 61]), and GFAP (depicting astrogliosis [62]) reflects the complexity of pathological mechanisms involved in neurodegenerative disorders and FTD in particular [63–66]”
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BackgroundBVVL/ FL: features caused by SLC52A3 mutations; WDFY4 and TNFSF13B may be novel causative genes
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Self-citationOSMR is a potential driver of inflammation in amyotrophic lateral sclerosis
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Inhibition of SOD1 trimerization is a novel drug target for ALS disease
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Targets and Gene Therapy of ALS (Part 1)
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Spinal interneurons and breathing
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Role of Immunotherapy in Ameliorating Proteopathic Dementia
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Neurodegenerative disorders and the immune system
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Theme 05 - Human Cell Biology and Pathology (including iPSC studies)
(2022) · Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration · doi:10.1080/21678421.2022.2120681
Brain Derived Neurotrophic Factor (BDNF) as a Mediator of Microglia-Induced Neuroinflammation
Charlton, T. (2022) · Carleton University's Institutional Repository (MacOdrum Library, Carleton University) · doi:10.22215/etd/2022-15264
“…genes (SOD1, C9orf72, TDP43) with varying effects in the progression of ALS, however a common factor with these genes is the broad effects on the ability of microglia to regulate the inflammatory response and prevent microglia-associated neurotoxicity (Turner et al., 2004; Lall and Baloh, 2017).”
BackgroundImmune dysregulation and neurodegenerative diseases
Cipollini, V., Troili, F., & Giubilei, F. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-85841-0.00015-8
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Assessment of Rab geranylgeranyltransferase subunit beta in amyotrophic lateral sclerosis
Yang, J., Tian, M., Zhang, L., Xin, C., Huo, J., Liu, Q., Dong, H., Li, R., & Liu, Y. (2024) · Frontiers in Neurology · doi:10.3389/fneur.2024.1447461
“First, microglia and astroglia activation have been reported as prominent features in the spinal cord and motor cortex of ALS patients and transgenic rodent models, and microglia and astroglia have been used as therapeutic targets for ALS (16–20).”
BackgroundMicroglial Signaling in Health and Disease
Oppenheimer, M. R., Singh, S., Antoine, D., Truitt, B., & Roy, S. (2024) · Springer eBooks · doi:10.1007/978-3-031-68237-7_8
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Glial Activation and Autophagic Imbalance in Amyotrophic Lateral Sclerosis
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Disrupted Cellular Clearance and Inflammatory Loops in Frontotemporal Dementia
Halagali, P., Tippavajhala, V. K., Sharma, H., Abalkhail, A., & Almagharbeh, W. T. (2025) · Springer eBooks · doi:10.1007/978-981-95-3945-1_13
Breakthroughs in Stem Cell-Based Treatments for ALS and FTD: Promises and Challenges Ahead
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Al-Juhaishi, M. H. K., Al-Juhaishi, N. M. H., & Al-Juhaishi, A. M. H. (2024) · Neurophysiology · doi:10.1007/s11062-025-09989-3
“C9ORF72 mutations intensify this inflammatory activity [45].”
Nanotherapeutics targeting neuroinflammation
Chaulagain, B., Tagoe, B., Gothwal, A., Mahanta, A. K., Muolokwu, C. E., Lamsal, B., & Singh, J. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-33623-2.00013-1
Huang, Y., Mavinkurve, A., Sabikunnahar, B., Stevens, B., & Lemke, G. (2026) · Nature Communications · doi:10.1038/s41467-026-76728-5
Neurodegeneration as a dysregulation of neuroimmune crosstalk
Bennett, F. C., Hong, S. Y., Jiang, N. J., & Marazzi, I. (2026) · Cell · doi:10.1016/j.cell.2026.07.015 · Cited by 3
“153 These immune phenotypes often precede or parallel neurodegenerative symptoms, suggesting that disruptions in cellular homeostasis extend across compartments of the neuroimmune system and that immune dysfunction is not merely a consequence but, in some contexts, a concause of disease.”
Chromosome 9 Open Reading Frame 72 as a Multifunctional Regulator of Cellular Homeostasis
Chan, S. C., Yang, S., Wu, P., Chen, S.-F., Cheng, P., & Tung, C.-W. (2026) · Journal of physiological investigation. · doi:10.4103/ejpi.ejpi-d-26-00014
Tang, L., & Fan, D. (2026) · Translational Neurodegeneration · doi:10.1186/s40035-026-00572-2
“Activating the TREM2 pathway holds particular promise for ALS patients harboring specific genetic variants, such as those in C9orf72 [41, 183] or TREM2 [184] itself, as it may enhance the microglial clearance of pathological protein aggregates and suppress detrimental neuroinflammatory responses…”
Steinbeck, J., Viggiano, N., & Speelman, D. (2026) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/dem/aciag003
Minding the gates: dual cell-autonomous and non-cell-autonomous mechanisms of TBK1 in ALS/FTD
Smeyers, J., & Mordes, D. A. (2026) · Frontiers in Neuroscience · doi:10.3389/fnins.2026.1941293
“…regulates endosomal trafficking and the autophagy pathway in neurons, yet loss of this protein is insufficient to induce motor neuron degeneration, which likely involves modifier gain-of-function effects from the hexanucleotide repeat expansion (Lall and Baloh, 2017; Smeyers et al., 2021).”
Metadata
- Authors
- Lall, D., & Baloh, R. H.
- Affiliations
- Regenerative Medicine Institute (MX)
- Cedars-Sinai Medical Center (US)
- Corresponding author
- Baloh, Robert H.
- ORCID
- Baloh, Robert H.
- Venue
- Journal of Clinical Investigation
- Published
- 2017-07-24
- Volume
- 127
- Issue
- 9
- Pages
- 3250-3258
- ISSN
- 0021-9738 (ISSN-L)
- 1558-8238
- PMC
- PMC5669558
- OpenAlex
- W2736657964
- Cited by
- 175
- References
- 150
- Citations by year
- 2026: 14 · 2025: 16 · 2024: 11 · 2023: 22 · 2022: 27 · 2021: 16 · 2020: 20 · 2019: 28 · 2018: 16 · 2017: 5
- FWCI
- 2.50
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Investigation (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Target ALS
- Cedars-Sinai Medical Center
- National Institutes of Health
- National Institute of Neurological Disorders and Stroke (R01NS097545, R01NS069669)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Amyotrophic Lateral Sclerosis Research
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Health Sciences › Medicine › Clinical Neurology › Multiple Sclerosis Research Studies
- Keywords
- microglia, C9orf72, amyotrophic lateral sclerosis, frontotemporal dementia, neuroinflammation, autoimmunity, myeloid cells, neurodegeneration, pathogenesis, systemic immunity
- MeSH terms
- Superoxide Dismutase-1, C9orf72 Protein, Amyotrophic Lateral Sclerosis, Animals, DNA-Binding Proteins, Humans, Inflammation, Motor Neurons, Mutation, Phenotype, Proteins, Autoimmunity, Microglia, Disease Progression, Genetic Predisposition to Disease, Myeloid Cells, Mice, Frontotemporal Dementia
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