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Recent Advances in Basic Research for CSF1R-Microglial Encephalopathy
Yan-Li Wang1, Fang-Ze Wang2, Runzhi Li1
1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Abstract:
Colony-stimulating factor-1 receptor-microglial encephalopathy is a rare rapidly progressive dementia resulting from colony-stimulating factor-1 receptor (CSF1R) mutations, also named pigmentary orthochromatic leukodystrophy (POLD), hereditary diffuse leukoencephalopathy with spheroids (HDLS), adult-onset leukoencephalopathy with axonal spheroids, and pigmented glia (ALSP) and CSF1R-related leukoencephalopathy. CSF1R is primarily expressed in microglia and mutations normally directly lead to changes in microglial number and function. Many animal models have been constructed to explore pathogenic mechanisms and potential therapeutic strategies, including zebrafish, mice, and rat models which are with CSF1R monogenic mutation, biallelic or tri-allelic deletion, or CSF1R-null. Although there is no cure for patients with CSF1R-microglial encephalopathy, microglial replacement therapy has become a topical research area. This review summarizes CSF1R-related pathogenetic mutation sites and mechanisms, especially the feasibility of the microglia-original immunotherapy.
Insights
Colony-stimulating factor-1 receptor (CSF1R) mutations cause a rare dementia. This review explores CSF1R mutations, animal models, and the potential of microglial replacement therapy for this progressive neurological disease.
Area of Science:
- Neuroscience
- Genetics
- Immunology
Background:
- Colony-stimulating factor-1 receptor (CSF1R) mutations cause rare, rapidly progressive dementias like pigmentary orthochromatic leukodystrophy (POLD), hereditary diffuse leukoencephalopathy with spheroids (HDLS), and adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP).
- CSF1R is crucial for microglial function and number; mutations disrupt these processes, leading to neurodegeneration.
- Current treatments are limited, highlighting the need for novel therapeutic approaches.
Purpose of the Study:
- To review CSF1R mutations, their pathogenetic mechanisms, and associated neurological disorders.
- To summarize existing animal models used to study CSF1R-related encephalopathies.
- To evaluate the feasibility of microglial replacement therapy as a potential treatment strategy.
Main Methods:
- Literature review of studies on CSF1R mutations and related leukoencephalopathies.
- Analysis of various animal models (zebrafish, mice, rats) with different CSF1R genetic alterations.
- Examination of research on microglial function and immunotherapy.
Main Results:
- Identified key CSF1R mutation sites and elucidated their pathogenic mechanisms.
- Detailed the utility of diverse animal models in understanding disease progression.
- Highlighted microglial replacement therapy as a promising, albeit challenging, therapeutic avenue.
Conclusions:
- CSF1R mutations lead to distinct leukoencephalopathies through impaired microglial function.
- Animal models are essential tools for dissecting disease mechanisms and testing interventions.
- Microglia-original immunotherapy presents a novel therapeutic frontier for CSF1R-related encephalopathies.
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