Higher CSF sTREM2 and microglia activation are associated with slower rates of beta-amyloid accumulation

Michael Ewers1,2, Gloria Biechele3, Marc Suárez-Calvet4,5,6

  • 1Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig Maximilian University (LMU), Munich, Germany.

EMBO Molecular Medicine
|August 14, 2020
PubMed

Insights

Increased microglia activation, measured by CSF sTREM2 or PET scans, appears to protect against amyloid-beta accumulation in Alzheimer's disease (AD). This suggests a beneficial role for these immune responses in AD progression.

Area of Science:

  • Neuroscience
  • Immunology
  • Neurology

Background:

  • Microglia activation is a key brain immune response in Alzheimer's disease (AD), linked to amyloid plaques.
  • Biomarkers like soluble TREM2 (sTREM2) in CSF and microglia PET scans are elevated in AD.
  • The relationship between increased microglia activation and reduced amyloid-beta (Aβ) accumulation is not fully understood.

Purpose of the Study:

  • To investigate whether elevated microglia activation biomarkers predict reduced amyloid-beta accumulation in Alzheimer's disease.
  • To explore the association between cerebrospinal fluid sTREM2 levels and longitudinal changes in amyloid PET.
  • To examine the correlation between microglia PET imaging and amyloid PET progression in a mouse model of amyloidosis.

Main Methods:

  • Human study: Measured CSF sTREM2 to predict longitudinal amyloid PET changes and cross-sectional tau PET in non-demented and demented individuals.
  • Animal study: Utilized the AppNL-GF mouse model to assess baseline 18F-GE180 microglia PET and longitudinal amyloid PET.
  • Controlled for confounding pathologies in the mouse model to isolate the microglia-amyloid relationship.

Main Results:

  • In humans, higher baseline CSF sTREM2 levels correlated with attenuated increases in amyloid PET over two years and lower tau PET.
  • In mice, higher baseline microglia PET at 5 months was associated with a slower rate of amyloid PET increase between 5 and 10 months.
  • These findings demonstrate a consistent protective association between heightened microglia activation and reduced subsequent amyloid accumulation.

Conclusions:

  • Elevated microglia activation, indicated by CSF sTREM2 or microglia PET, demonstrates a protective effect against subsequent amyloid accumulation.
  • This suggests that targeting microglia activation could be a potential therapeutic strategy for Alzheimer's disease.
  • The study provides translational evidence from human and animal models supporting a beneficial role for microglia in mitigating amyloid pathology.