Cited by 1,044Neuroinflammation and Neurodegeneration MechanismsRedox biology and oxidative stressNeurological Disease Mechanisms and Treatments

The DOI matches its Crossref record; 194 of the 198 references it cites were found in a registry or an index; none of the 222 sources its claims cite is checked for support yet.

ROS Generation in Microglia: Understanding Oxidative Stress and Inflammation in Neurodegenerative Disease

Open access

Abstract

Neurodegenerative disorders, such as Alzheimer’s disease, are a global public health burden with poorly understood aetiology. Neuroinflammation and oxidative stress (OS) are undoubtedly hallmarks of neurodegeneration, contributing to disease progression. Protein aggregation and neuronal damage result in the activation of disease-associated microglia (DAM) via damage-associated molecular patterns (DAMPs). DAM facilitate persistent inflammation and reactive oxygen species (ROS) generation. However, the molecular mechanisms linking DAM activation and OS have not been well-defined; thus targeting these cells for clinical benefit has not been possible. In microglia, ROS are generated primarily by NADPH oxidase 2 (NOX2) and activation of NOX2 in DAM is associated with DAMP signalling, inflammation and amyloid plaque deposition, especially in the cerebrovasculature. Additionally, ROS originating from both NOX and the mitochondria may act as second messengers to propagate immune activation; thus intracellular ROS signalling may underlie excessive inflammation and OS. Targeting key kinases in the inflammatory response could cease inflammation and promote tissue repair. Expression of antioxidant proteins in microglia, such as NADPH dehydrogenase 1 (NQO1), is promoted by transcription factor Nrf2, which functions to control inflammation and limit OS. Lipid droplet accumulating microglia (LDAM) may also represent a double-edged sword in neurodegenerative disease by sequestering peroxidised lipids in non-pathological ageing but becoming dysregulated and pro-inflammatory in disease. We suggest that future studies should focus on targeted manipulation of NOX in the microglia to understand the molecular mechanisms driving inflammatory-related NOX activation. Finally, we discuss recent evidence that therapeutic target identification should be unbiased and founded on relevant pathophysiological assays to facilitate the discovery of translatable antioxidant and anti-inflammatory therapeutics.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This review argues that microglial reactive oxygen species (ROS), generated mainly by NOX2 and NOX4, link neuroinflammation and oxidative stress in neurodegenerative disease, with ROS also acting as second messengers and lipid droplet-accumulating microglia contributing to pathology. It proposes targeting microglial NOX, Nrf2-driven antioxidant pathways, and unbiased disease-relevant drug discovery.

Key findings

  • NOX2 (CYBB) is the most highly expressed NOX isotype transcript in human and mouse brain microglia, with NOX4 second-highest at a much lower level; NOX2 activation in disease-associated microglia is associated with DAMP signalling, inflammation, and amyloid plaque deposition, especially in the cerebrovasculature.
  • ROS from both NOX and mitochondria may act as second messengers to propagate immune activation: H₂O₂ can activate NFκB, and suppressing mitochondrial ROS with mitoTEMPO reduced MAPK/NFκB activation and pro-inflammatory factors (TNFα, IL1β, IL6, iNOS, Cox-2) in LPS-stimulated microglia.
  • Nrf2 controls antioxidant genes such as NQO1 and GSTs in microglia; Nrf2 deficiency promotes inflammatory markers (IL6, Cox2, iNOS) and inhibits anti-inflammatory markers, while sulforaphane enhances Nrf2, limits pro-inflammatory microglial markers, and confers neuroprotection.
  • Lipid droplet-accumulating microglia (LDAM) may be a double-edged sword: ROS/JNK drive lipid droplet formation in flies, antioxidant treatment or SOD1 expression reduces it, and GRN−/− mice show ROS-generating, pro-inflammatory LDAM defective in phagocytosis; ToxSeq identified a ROS-positive microglial signature rescued by acivin in EAE.

Methods

  • Narrative review; no primary data, experimental sample, or statistical analysis are reported.
  • The paper synthesizes literature on microglial NOX/ROS biology, oxidative stress, neuroinflammation, lipid droplet-accumulating microglia, antioxidant regulation, and therapeutic strategies.
  • It discusses evidence from human post-mortem tissue, rodent models, cell lines, single-cell RNA-seq, and drug-screening studies, and proposes future directions including cell-specific NOX manipulation.

Limitations

  • The paper does not state limitations of its own review; it repeatedly notes limitations in the underlying literature, including lack of stringent controls and specific antibodies for NOX expression studies, possible artefactual NOX1 expression in Cx3cr1-EGFP reporter mice, and a human microglial cell line lacking NOX2.
  • It also notes that apocynin specificity for NOX4 has been questioned, mitoTEMPO selectivity is questioned especially at higher concentrations, and a causal relationship between ROS and NFκB activation in microglia remains undetermined.
  • Evident from the text: as a narrative review, no systematic search or formal quality assessment is described, and many conclusions rely on preclinical models or immortalized cells, with calls for validation in primary and iPSC-derived microglia.

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Integrity signals

Registry

Crossref · 10.3390/antiox9080743

Cites

194 of 194 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

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  • Probably not a substantial claim. 24
  • It may state two separate claims as one. 61
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Citations

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  1. 2018, Epidemiology of Alzheimer’s disease and other dementias, Rev. Neurol., 66, 377

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Metadata

Authors
Simpson, D. S. A., & Oliver, P. L.
Affiliations
University of Oxford (GB)
Corresponding author
Oliver, Peter L.
Venue
Antioxidants
Publisher
MDPI AG
Published
2020-08-13
Volume
9
Issue
8
Pages
743
ISSN
2076-3921 (ISSN-L)
OpenAlex
W3048426432
Cited by
1,044
References
198
Citations by year
2026: 156 · 2025: 249 · 2024: 201 · 2023: 183 · 2022: 133 · 2021: 113 · 2020: 9
FWCI
10.90
Type
journal article
Language
en
Open access
Locations
  • Antioxidants (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Medical Research Council (MR/P502005/1)
Topics
  • Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Redox biology and oxidative stress
  • Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
Keywords
reactive oxygen species, microglia, neuroinflammation, oxidative stress, neurodegenerative diseases, Alzheimer's disease, NADPH oxidase 2, NOX2, damage-associated molecular patterns, disease-associated microglia, mitochondrial reactive oxygen species, NQO1, Nrf2, amyloid plaques, antioxidant therapeutics, anti-inflammatory agents

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