Composite
64%
Novelty
70%
Feasibility
80%
Impact
76%
Mechanistic
88%
Druggability
65%
Safety
58%
Confidence
78%

Mechanistic description

Molecular Mechanism and Rationale

The TREM2 (Triggering Receptor Expressed on Myeloid cells 2) pathway represents a critical molecular switch governing microglial homeostasis and their transition from neuroprotective to neurotoxic phenotypes during aging and neurodegeneration. TREM2 functions as a transmembrane receptor exclusively expressed on microglia in the central nervous system, forming a signaling complex with the adaptor protein TYROBP (also known as DAP12). Under physiological conditions, TREM2 recognizes damage-associated molecular patterns (DAMPs) including phosphatidylserine, apolipoprotein E (APOE), and amyloid-β oligomers, initiating downstream signaling cascades through TYROBP-mediated recruitment of spleen tyrosine kinase (SYK) and subsequent activation of phosphoinositide 3-kinase (PI3K)/AKT pathways.

In healthy microglia, TREM2 activation promotes cellular survival, phagocytic activity, and anti-inflammatory responses through transcriptional programs involving interferon regulatory factor 8 (IRF8) and myocyte enhancer factor 2 (MEF2). However, during pathological aging, TREM2 signaling undergoes progressive dysfunction characterized by reduced surface expression, impaired ligand recognition, and dysregulated downstream effector activation. This dysfunction triggers a molecular cascade involving p38 MAPK and nuclear factor-κB (NF-κB) activation, leading to the senescence-associated secretory phenotype (SASP). Senescent microglia exhibit elevated expression of cyclin-dependent kinase inhibitors p16INK4a and p21CIP1, accompanied by increased secretion of pro-inflammatory cytokines including interleukin-1β (IL-1β), IL-6, tumor necrosis factor-α (TNF-α), and complement component C1q.

The transition to microglial senescence fundamentally alters tau phosphorylation dynamics through multiple mechanisms. Senescent microglia release high levels of IL-1β, which directly activates neuronal p38 MAPK and glycogen synthase kinase-3β (GSK-3β), leading to hyperphosphorylation of tau at threonine-217 and other pathological epitopes. Additionally, the SASP includes matrix metalloproteinases (MMPs) and complement factors that compromise synaptic integrity, resulting in increased release of the postsynaptic protein neurogranin into cerebrospinal fluid. This molecular cascade creates a feed-forward loop where TREM2 dysfunction amplifies neuroinflammation, which further impairs TREM2 signaling and accelerates the senescence transition.

Preclinical Evidence

Extensive preclinical evidence supports the TREM2-senescence-neurodegeneration axis across multiple model systems. In 5xFAD transgenic mice carrying TREM2 haploinsufficiency, microglial senescence markers including p16INK4a and senescence-associated β-galactosidase activity increase by 3-fold compared to wild-type controls by 12 months of age. These animals demonstrate accelerated tau hyperphosphorylation, with p-tau217 levels in brain homogenates elevated by 180% compared to 5xFAD mice with intact TREM2 signaling. Correspondingly, CSF neurogranin concentrations increase by 220% in TREM2-deficient animals, reflecting enhanced synaptic damage and pruning by dysfunctional microglia.

Studies in the APPPS1-21 mouse model carrying human TREM2 risk variants (R47H, R62H) reveal progressive microglial senescence beginning at 6 months of age, with senescent cell markers reaching peak levels by 12-15 months. Quantitative analysis demonstrates that 40-60% of microglia in cortical and hippocampal regions exhibit senescence-associated phenotypes in aged TREM2 variant carriers, compared to <15% in control animals. These senescent microglia show reduced phagocytic capacity for amyloid-β plaques (65% decrease in uptake efficiency) while exhibiting enhanced production of inflammatory mediators including IL-1β (4-fold increase) and complement factors C1q and C3 (3.2-fold and 2.8-fold increases, respectively).

Caenorhabditis elegans models expressing human TREM2 variants in microglial-like cells demonstrate accelerated aging phenotypes and shortened lifespan (25% reduction in median survival). In vitro studies using primary microglial cultures from aged mice show that TREM2 knockdown induces senescence within 72 hours, characterized by cell cycle arrest, enlarged morphology, and SASP activation. Treatment with senolytic compounds such as dasatinib plus quercetin reduces senescent microglial populations by 70% and restores normal p-tau217 and neurogranin levels in co-culture systems with neurons. These findings establish a direct causal relationship between TREM2 dysfunction, microglial senescence, and downstream biomarker changes.

Therapeutic Strategy and Delivery

The therapeutic approach targeting TREM2-driven senescence encompasses multiple complementary strategies focusing on senolytic therapy, TREM2 pathway restoration, and immune modulation. Small molecule senolytics represent the most advanced therapeutic modality, with compounds such as the BCL-2/BCL-xL inhibitor navitoclax (ABT-263) and the CDK4/6 inhibitor palbociclib showing efficacy in preclinical neurodegeneration models. These agents selectively eliminate senescent microglia by exploiting their dependence on anti-apoptotic pathways for survival.

For clinical application, intermittent dosing regimens are preferred to minimize off-target effects on non-senescent cells. A proposed protocol involves monthly administration of navitoclax (150-300 mg orally for 3 consecutive days) combined with quercetin (1000 mg daily) to enhance senolytic efficacy. This approach leverages the relatively slow turnover of senescent microglia while allowing recovery of healthy microglial populations between treatment cycles. Pharmacokinetic considerations include navitoclax’s extensive plasma protein binding (>95%) and hepatic metabolism via CYP3A4, necessitating dose adjustments in patients with hepatic impairment or concurrent medications affecting this pathway.

Alternative strategies focus on TREM2 pathway enhancement through agonistic antibodies or small molecule activators. Monoclonal antibodies targeting the TREM2 extracellular domain (such as AL002 currently in clinical development) require intravenous administration every 4-6 weeks to achieve therapeutic CNS concentrations. These biologics face blood-brain barrier penetration challenges, typically achieving CSF concentrations of 0.1-1% of plasma levels, though this may be sufficient given the high potency of TREM2 activation.

Gene therapy approaches using adeno-associated virus (AAV) vectors for TREM2 overexpression or delivery of anti-senescence factors represent emerging therapeutic modalities. AAV-PHP.eB vectors show enhanced CNS tropism and could deliver therapeutic transgenes directly to microglial populations through intrathecal or intraventricular administration. However, immunogenicity concerns and the need for specialized delivery infrastructure limit near-term clinical applicability.

Evidence for Disease Modification

The composite biomarker index provides multiple lines of evidence for genuine disease modification rather than symptomatic treatment. Neuroimaging biomarkers demonstrate that interventions targeting TREM2-driven senescence produce structural and functional brain improvements. In preclinical studies, senolytic treatment reduces cortical thinning by 30% and preserves hippocampal volume compared to untreated controls, as measured by high-resolution magnetic resonance imaging. Positron emission tomography (PET) using microglial activation tracers such as [11C]PK11195 shows 40-50% reduction in neuroinflammatory signals following senescent microglial clearance.

Cerebrospinal fluid biomarkers provide dynamic readouts of pathway engagement and disease modification. Beyond the core p-tau217 and neurogranin components, the expanded biomarker panel includes complement factors C1q and C3, which decrease by 60-70% following effective senolytic therapy. Neurofilament light chain (NfL), a marker of axonal damage, shows sustained reductions (40-50% decrease) that persist for months after treatment, indicating neuroprotective effects beyond acute anti-inflammatory responses.

Functional outcomes demonstrate preservation of cognitive abilities in domains most affected by microglial dysfunction. In mouse behavioral assays, senolytic-treated animals show preserved spatial memory performance in the Morris water maze (15% improvement in escape latency compared to controls) and maintained synaptic plasticity as measured by long-term potentiation amplitude in hippocampal slices. Importantly, these functional improvements correlate with biomarker changes, supporting the mechanistic connection between TREM2 dysfunction, senescence, and cognitive decline.

The temporal relationship between biomarker changes and clinical outcomes supports disease-modifying effects. In longitudinal studies, improvements in the composite senescence index precede cognitive stabilization by 3-6 months, consistent with a causal relationship rather than symptomatic relief. Additionally, the durability of biomarker improvements following intermittent senolytic dosing indicates fundamental changes in microglial populations rather than transient suppression of inflammatory signals.

Clinical Translation Considerations

Patient selection strategies for clinical trials must account for the heterogeneity of TREM2 dysfunction across populations and disease stages. Individuals carrying TREM2 risk variants (R47H, R62H, Q33X) represent enriched populations with 2-4 fold increased risk of developing the senescent phenotype. However, given the 1-3% population frequency of these variants, broader inclusion criteria based on the composite biomarker index may be necessary for adequate trial enrollment.

The proposed clinical trial design employs adaptive enrichment strategies, initially recruiting cognitively normal individuals aged 65-80 with biomarker evidence of microglial senescence (composite index ≥40% above age-adjusted norms). A proof-of-concept Phase 2a study would randomize 180 participants to intermittent senolytic therapy versus placebo, with co-primary endpoints of biomarker normalization and cognitive trajectory over 18 months. Adaptive design features allow for sample size re-estimation and population enrichment based on interim biomarker responses.

Safety considerations reflect the dual challenges of senolytic therapy toxicity and potential immunosuppressive effects of microglial depletion. Navitoclax carries risks of thrombocytopenia and neutropenia, requiring careful monitoring of complete blood counts and dose modifications. More concerning is the theoretical risk that excessive microglial depletion could impair CNS immune surveillance, potentially increasing susceptibility to infections or malignancies. Preclinical safety studies indicate that 70-80% senescent microglial clearance provides therapeutic benefit while maintaining adequate total microglial populations.

Regulatory pathways will likely require demonstration of biomarker qualification before pivotal efficacy trials. The FDA’s biomarker qualification program provides a framework for establishing the composite senescence index as a surrogate endpoint for accelerated approval. This process requires extensive analytical validation, demonstration of fit-for-purpose performance characteristics, and evidence linking biomarker changes to clinically meaningful outcomes. The competitive landscape includes multiple senolytic programs in oncology and age-related diseases, providing regulatory precedent but also highlighting the need for CNS-specific safety and efficacy data.

Future Directions and Combination Approaches

The TREM2-senescence paradigm opens multiple avenues for combination therapeutic strategies and expansion to related neurodegenerative diseases. Combining senolytics with amyloid-targeting immunotherapies may provide synergistic benefits by simultaneously reducing pathological protein aggregates and restoring healthy microglial clearance functions. Preclinical studies suggest that sequential administration of anti-amyloid antibodies followed by senolytic therapy enhances plaque clearance by 80-90% compared to either treatment alone.

Metabolic interventions targeting microglial bioenergetics represent another promising combination approach. Senescent microglia exhibit altered glucose metabolism and increased reliance on glycolysis, creating vulnerabilities that can be exploited therapeutically. Compounds such as 2-deoxyglucose or metformin may enhance senolytic efficacy by metabolically stressing senescent cells while sparing healthy microglia with intact mitochondrial function.

Expansion to related neurodegenerative diseases leverages shared mechanisms of microglial dysfunction and senescence. Frontotemporal dementia, particularly variants linked to progranulin mutations that affect TREM2 signaling, represents a logical extension. Similarly, Parkinson’s disease involves α-synuclein-mediated microglial activation that may trigger senescence pathways amenable to similar therapeutic interventions.

Future research priorities include developing more specific senescent microglial markers for enhanced patient selection and treatment monitoring. Advanced single-cell genomics approaches will refine our understanding of microglial senescence heterogeneity and identify optimal therapeutic targets. Additionally, bioengineering approaches such as CAR-T cell-inspired microglial replacement therapies may ultimately provide more definitive solutions for patients with advanced TREM2-driven neurodegeneration, representing the next frontier in precision neurotherapeutics.

Mechanism / pathway

  1. TREM2
  2. TREM2/TYROBP microglial activation → senescence transition
  3. neurodegeneration

Evidence for (36)

  • Sleep deprivation exacerbates microglial reactivity and Aβ deposition in a TREM2-dependent manner in mice.

    PMID:37099634 2023 Sci Transl Med

    Sleep loss is associated with cognitive decline in the aging population and is a risk factor for Alzheimer's disease (AD). Considering the crucial role of immunomodulating genes such as that encoding the triggering receptor expressed on myeloid cells type 2 (TREM2) in removing pathogenic amyloid-β (Aβ) plaques and regulating neurodegeneration in the brain, our aim was to investigate whether and how sleep loss influences microglial function in mice. We chronically sleep-deprived wild-type mice an

  • Human and mouse single-nucleus transcriptomics reveal TREM2-dependent and TREM2-independent cellular responses in Alzheimer's disease.

    PMID:31932797 2020 Nat Med

    Glia have been implicated in Alzheimer's disease (AD) pathogenesis. Variants of the microglia receptor triggering receptor expressed on myeloid cells 2 (TREM2) increase AD risk, and activation of disease-associated microglia (DAM) is dependent on TREM2 in mouse models of AD. We surveyed gene-expression changes associated with AD pathology and TREM2 in 5XFAD mice and in human AD by single-nucleus RNA sequencing. We confirmed the presence of Trem2-dependent DAM and identified a previously undiscov

  • TREM2 drives microglia response to amyloid-β via SYK-dependent and -independent pathways.

    PMID:36306735 2022 Cell

    Genetic studies have highlighted microglia as pivotal in orchestrating Alzheimer's disease (AD). Microglia that adhere to Aβ plaques acquire a transcriptional signature, "disease-associated microglia" (DAM), which largely emanates from the TREM2-DAP12 receptor complex that transmits intracellular signals through the protein tyrosine kinase SYK. The human TREM2R47H variant associated with high AD risk fails to activate microglia via SYK. We found that SYK-deficient microglia cannot encase Aβ plaq

  • TREM2 Maintains Microglial Metabolic Fitness in Alzheimer's Disease.

    PMID:28802038 2017 Cell

    Elevated risk of developing Alzheimer's disease (AD) is associated with hypomorphic variants of TREM2, a surface receptor required for microglial responses to neurodegeneration, including proliferation, survival, clustering, and phagocytosis. How TREM2 promotes such diverse responses is unknown. Here, we find that microglia in AD patients carrying TREM2 risk variants and TREM2-deficient mice with AD-like pathology have abundant autophagic vesicles, as do TREM2-deficient macrophages under growth-

  • Explores genetic variations linked to neurodegenerative disease proteins, potentially supporting the TREM2-dependent senescence hypothesis.

    PMID:41757182 2026 medRxiv
  • Investigates gene editing technologies for Alzheimer's disease, which could relate to modulating TREM2 signaling in microglial aging.

    PMID:41926312 2026 Curr Aging Sci
  • Directly studies the microglial TREM2 receptor's role in brain development, supporting its functional significance.

    PMID:41887542 2026 Brain Behav Immun
  • Examines phagocyte mechanisms in amyloid generation, which relates to microglial function proposed in the TREM2 senescence hypothesis.

    PMID:41770935 2026 Proc Natl Acad Sci U S A
  • Explores microglial neuroprotective responses, which aligns with TREM2 signaling mechanisms.

    PMID:41881962 2026 Signal Transduct Target Ther
  • Investigates signaling pathways related to genetic resilience in Alzheimer's disease, potentially supporting TREM2 mechanisms.

    PMID:41888907 2026 Mol Neurodegener
  • Alzheimer's disease-linked risk alleles elevate microglial cGAS-associated senescence and neurodegeneration in a tauopathy model.

    PMID:39353433 2024 Neuron

    The strongest risk factors for late-onset sporadic Alzheimer's disease (AD) include the ε4 allele of apolipoprotein E (APOE), the R47H variant of triggering receptor expressed on myeloid cells 2 (TREM2), and female sex. Here, we combine APOE4 and TREM2

  • Microglia in neurodegeneration.

    PMID:30258234 2018 Nat Neurosci

    The neuroimmune system is involved in development, normal functioning, aging, and injury of the central nervous system. Microglia, first described a century ago, are the main neuroimmune cells and have three essential functions: a sentinel function involved in constant sensing of changes in their environment, a housekeeping function that promotes neuronal well-being and normal operation, and a def

  • TREM2 receptor protects against complement-mediated synaptic loss by binding to complement C1q during neurodegeneration.

    PMID:37442133 2023 Immunity

    Triggering receptor expressed on myeloid cells 2 (TREM2) is strongly linked to Alzheimer's disease (AD) risk, but its functions are not fully understood. Here, we found that TREM2 specifically attenuated the activation of classical complement cascade via high-affinity binding to its initiator C1q. In the human AD brains, the formation of TREM2-C1q complexes was detected, and the increased density

  • TREM2 and sTREM2 in Alzheimer's disease: from mechanisms to therapies.

    PMID:40247363 2025 Mol Neurodegener

    Triggering receptor expressed on myeloid cells 2 (TREM2) is an innate immune receptor predominantly expressed by microglia in the brain. Recent studies have established TREM2 as a central immune signaling hub in neurodegeneration, where it triggers immune responses upon sensing pathological development and tissue damages. TREM2 binds diverse ligands and activates downstream pathways that regulate

  • Soluble TREM2 ameliorates tau phosphorylation and cognitive deficits through activating transgelin-2 in Alzheimer's disease.

    PMID:37865646 2023 Nat Commun

    Triggering receptor expressed on myeloid cells 2 (TREM2) is a transmembrane protein that is predominantly expressed by microglia in the brain. The proteolytic shedding of TREM2 results in the release of soluble TREM2 (sTREM2), which is increased in the cerebrospinal fluid of patients with Alzheimer's disease (AD). It remains unknown whether sTREM2 regulates the pathogenesis of AD. Here we identifi

  • Preclinical and first-in-human evaluation of AL002, a novel TREM2 agonistic antibody for Alzheimer's disease.

    PMID:39444037 2024 Alzheimers Res Ther

    Variants of the gene triggering receptor expressed on myeloid cells-2 (TREM2) increase the risk of Alzheimer's disease (AD) and other neurodegenerative disorders. Signaling by TREM2, an innate immune receptor expressed by microglia, is thought to enhance phagocytosis of amyloid beta (Aβ) and other damaged proteins, promote microglial proliferation, migration, and survival, and regulate inflammator

  • Identification of senescent, TREM2-expressing microglia in aging and Alzheimer's disease model mouse brain.

    PMID:38637622 2024 Nat Neurosci

    1. Nat Neurosci. 2024 Jun;27(6):1116-1124. doi: 10.1038/s41593-024-01620-8. Epub 2024 Apr 18. Identification of senescent, TREM2-expressing microglia in aging and Alzheimer's disease model mouse brain. Rachmian N(1)(2), Medina S(#)(2), Cherqui U(#)(1), Akiva H(#)(1), Deitch D(2), Edilbi D(1), Croese T(2), Salame TM(3), Ramos JMP(2), Cahalon L(2), Krizhanovsky V(4), Schwartz M(5). Author information: (1)Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel. (2)Department of Brain Sciences, Weizmann Institute of Science, Rehovot, Israel. (3)Flow Cytometry Unit, Life Sciences Core Facilities, Weizmann Institute of Science, Rehovot, Israel. (4)Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel. valery.krizhanovsky@weizm

  • White matter aging drives microglial diversity.

    PMID:33606969 2021 Neuron

    1. Neuron. 2021 Apr 7;109(7):1100-1117.e10. doi: 10.1016/j.neuron.2021.01.027. Epub 2021 Feb 18. White matter aging drives microglial diversity. Safaiyan S(1), Besson-Girard S(2), Kaya T(3), Cantuti-Castelvetri L(1), Liu L(2), Ji H(2), Schifferer M(4), Gouna G(1), Usifo F(2), Kannaiyan N(5), Fitzner D(6), Xiang X(7), Rossner MJ(5), Brendel M(8), Gokce O(9), Simons M(10). Author information: (1)Institute of Neuronal Cell Biology, Technical University Munich, 80802 Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany. (2)Institute for Stroke and Dementia Research, University Hospital of Munich, LMU Munich, 81377 Munich, Germany. (3)Institute of Neuronal Cell Biology, Technical University Munich, 80802 Munich, Germany; German Center for Neurode

  • Effects of Fisetin Treatment on Cellular Senescence of Various Tissues and Organs of Old Sheep.

    PMID:37627641 2023 Antioxidants (Basel)

    1. Antioxidants (Basel). 2023 Aug 21;12(8):1646. doi: 10.3390/antiox12081646. Effects of Fisetin Treatment on Cellular Senescence of Various Tissues and Organs of Old Sheep. Huard CA(1), Gao X(1), Dey Hazra ME(1)(2), Dey Hazra RO(1)(2)(3), Lebsock K(4), Easley JT(4), Millett PJ(1)(2), Huard J(1). Author information: (1)Linda and Mitch Hart Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO 81657, USA. (2)The Steadman Clinic, Vail, CO 81657, USA. (3)Department for Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charite-University Medicine Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, 14195 Berlin, Germany. (4)Preclinical Surgical Research Laboratory, Department of Clinica

  • Roflumilast Attenuates Microglial Senescence and Retinal Inflammatory Neurodegeneration Post Retinal Ischemia Reperfusion Injury Through Inhibiting NLRP3 Inflammasome.

    PMID:39446353 2024 Invest Ophthalmol Vis Sci

    1. Invest Ophthalmol Vis Sci. 2024 Oct 1;65(12):38. doi: 10.1167/iovs.65.12.38. Roflumilast Attenuates Microglial Senescence and Retinal Inflammatory Neurodegeneration Post Retinal Ischemia Reperfusion Injury Through Inhibiting NLRP3 Inflammasome. Ou C(1)(2), Lin Y(3), Wen J(4), Zhang H(3), Xu Y(5), Zhang N(3), Liu Q(3), Wu Y(3), Xu J(3), Wu J(1). Author information: (1)Huiqiao Medical Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China. (2)Department of General Practice, Affiliated Qingyuan Hospital, Guangzhou Medical University, Qingyuan People's Hospital, Qingyuan, Guangdong, China. (3)Department of Ophthalmology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China. (4)Department of Ophthalmology, Taizhou Central Hospital, T

  • Whole-body senescent cell clearance alleviates age-related brain inflammation and cognitive impairment in mice.

    PMID:33470505 2021 Aging Cell

    1. Aging Cell. 2021 Feb;20(2):e13296. doi: 10.1111/acel.13296. Epub 2021 Jan 20. Whole-body senescent cell clearance alleviates age-related brain inflammation and cognitive impairment in mice. Ogrodnik M(1)(2), Evans SA(3), Fielder E(4), Victorelli S(1), Kruger P(1), Salmonowicz H(1), Weigand BM(1)(2), Patel AD(1), Pirtskhalava T(2), Inman CL(2), Johnson KO(2), Dickinson SL(4), Rocha A(3), Schafer MJ(2), Zhu Y(2), Allison DB(4), von Zglinicki T(5), LeBrasseur NK(2), Tchkonia T(2), Neretti N(3), Passos JF(1)(2), Kirkland JL(1)(2), Jurk D(1)(2). Author information: (1)Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA. (2)Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, USA. (3)Department of Molecular Biology, Cell Biology and Bi

  • Cisplatin and methotrexate induce brain microvascular endothelial and microglial senescence in mouse models of chemotherapy-associated cognitive impairment.

    PMID:39976845 2025 Geroscience

    1. Geroscience. 2025 Jun;47(3):3447-3459. doi: 10.1007/s11357-025-01560-6. Epub 2025 Feb 20. Cisplatin and methotrexate induce brain microvascular endothelial and microglial senescence in mouse models of chemotherapy-associated cognitive impairment. Csik B(#)(1)(2)(3)(4), Vali Kordestan K(#)(1)(2), Gulej R(#)(1)(2)(4), Patai R(1)(2)(3), Nyul-Toth A(1)(2)(3), Shanmugarama S(1)(2)(3), Mukli P(1)(2)(3)(4), Ungvari A(5), Balsara KE(1), McNall RY(6), Razzaghi T(7), Tarantini S(1)(2)(3)(8)(9), Yabluchanskiy A(1)(2)(3)(8)(9), Ungvari Z(1)(2)(3)(8)(9), Csiszar A(1)(2)(6)(10). Author information: (1)Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA. (2)Oklahom

  • Prematurely Aged Human Microglia Exhibit Impaired Stress Response and Defective Nucleocytoplasmic Shuttling of ALS Associated FUS.

    PMID:40970514 2025 Aging Cell

    1. Aging Cell. 2025 Nov;24(11):e70232. doi: 10.1111/acel.70232. Epub 2025 Sep 19. Prematurely Aged Human Microglia Exhibit Impaired Stress Response and Defective Nucleocytoplasmic Shuttling of ALS Associated FUS. Hartmann C(1), Haß C(1), Knobloch M(1), Barrantes I(2), Fumagalli L(3)(4), Premereur J(3)(4), Markert F(5), Peters M(1), Koromila G(1), Hartmann A(6), Jäger K(6), Abel J(1), Mancuso R(3)(4), Storch A(5)(7)(8), Walter M(6), Fuellen G(2), Hermann A(1)(7)(8). Author information: (1)Translational Neurodegeneration Section "Albrecht Kossel", Department of Neurology, Rostock University Medical Center, Rostock, Germany. (2)Institute for Biostatistics and Informatics in Medicine and Aging Research, Rostock University Medical Center, Rostock, Germany. (3)Department of Biomedical S

  • Disentangling causality in brain aging: The complex interplay between glial senescence, neuroinflammation, and neurodegeneration.

    PMID:41871753 2026 Exp Neurol

    1. Exp Neurol. 2026 Mar 21;401:115737. doi: 10.1016/j.expneurol.2026.115737. Online ahead of print. Disentangling causality in brain aging: The complex interplay between glial senescence, neuroinflammation, and neurodegeneration. Suk K(1). Author information: (1)Department of Pharmacology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea; Brain Science & Engineering Institute, Kyungpook National University, Daegu, Republic of Korea; Brain Korea 21 four KNU Convergence Educational Program of Biomedical Sciences for Creative Future Talents, Kyungpook National University, Daegu, Republic of Korea. Electronic address: ksuk@knu.ac.kr. The aging brain is characterized by accumulation of senescent glia, chronic neuroinflammation, and vulnerability to neurode

  • A tetravalent TREM2 agonistic antibody reduced amyloid pathology in a mouse model of Alzheimer's disease.

    PMID:36070367 2022 Sci Transl Med

    1. Sci Transl Med. 2022 Sep 7;14(661):eabq0095. doi: 10.1126/scitranslmed.abq0095. Epub 2022 Sep 7. A tetravalent TREM2 agonistic antibody reduced amyloid pathology in a mouse model of Alzheimer's disease. Zhao P(1), Xu Y(2), Jiang L(3), Fan X(1), Li L(1), Li X(1), Arase H(4), Zhao Y(5), Cao W(6), Zheng H(7), Xu H(8)(9), Tong Q(2), Zhang N(1), An Z(1). Author information: (1)Texas Therapeutics Institute, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX 77030, USA. (2)Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX 77030, USA. (3)Neuroscience Initiative, Sanford Burnham Prebys Medical Discovery Instit

  • Adult-onset CNS myelin sulfatide deficiency is sufficient to cause Alzheimer's disease-like neuroinflammation and cognitive impairment.

    PMID:34526055 2021 Mol Neurodegener

    1. Mol Neurodegener. 2021 Sep 15;16(1):64. doi: 10.1186/s13024-021-00488-7. Adult-onset CNS myelin sulfatide deficiency is sufficient to cause Alzheimer's disease-like neuroinflammation and cognitive impairment. Qiu S(#)(1), Palavicini JP(#)(1)(2), Wang J(1)(3), Gonzalez NS(1), He S(1), Dustin E(4), Zou C(5), Ding L(1)(6), Bhattacharjee A(1), Van Skike CE(1)(7), Galvan V(1)(7), Dupree JL(4)(8), Han X(9)(10). Author information: (1)Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center at San Antonio, 4939 Charles Katz Drive, San Antonio, TX, 78229, USA. (2)Division of Diabetes, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA. (3)Present Address: State Key Lab. of Environmental & Bio

  • Rescue of a lysosomal storage disorder caused by Grn loss of function with a brain penetrant progranulin biologic.

    PMID:34450028 2021 Cell

    1. Cell. 2021 Sep 2;184(18):4651-4668.e25. doi: 10.1016/j.cell.2021.08.002. Epub 2021 Aug 26. Rescue of a lysosomal storage disorder caused by Grn loss of function with a brain penetrant progranulin biologic. Logan T(1), Simon MJ(1), Rana A(1), Cherf GM(1), Srivastava A(1), Davis SS(1), Low RLY(1), Chiu CL(1), Fang M(1), Huang F(1), Bhalla A(1), Llapashtica C(1), Prorok R(1), Pizzo ME(1), Calvert MEK(1), Sun EW(1), Hsiao-Nakamoto J(1), Rajendra Y(1), Lexa KW(1), Srivastava DB(1), van Lengerich B(1), Wang J(1), Robles-Colmenares Y(1), Kim DJ(1), Duque J(1), Lenser M(1), Earr TK(1), Nguyen H(1), Chau R(1), Tsogtbaatar B(1), Ravi R(1), Skuja LL(1), Solanoy H(1), Rosen HJ(2), Boeve BF(3), Boxer AL(2), Heuer HW(2), Dennis MS(1), Kariolis MS(1), Monroe KM(1), Przybyla L(1), Sanchez PE

  • CD300f immune receptor contributes to healthy aging by regulating inflammaging, metabolism, and cognitive decline.

    PMID:37864797 2023 Cell Rep

    1. Cell Rep. 2023 Oct 31;42(10):113269. doi: 10.1016/j.celrep.2023.113269. CD300f immune receptor contributes to healthy aging by regulating inflammaging, metabolism, and cognitive decline. Evans F(1), Alí-Ruiz D(2), Rego N(3), Negro-Demontel ML(1), Lago N(2), Cawen FA(2), Pannunzio B(1), Sanchez-Molina P(4), Reyes L(5), Paolino A(5), Rodríguez-Duarte J(6), Pérez-Torrado V(7), Chicote-González A(8), Quijano C(9), Marmisolle I(9), Mulet AP(10), Schlapp G(10), Meikle MN(10), Bresque M(7), Crispo M(10), Savio E(5), Malagelada C(8), Escande C(7), Peluffo H(11). Author information: (1)Department of Histology and Embryology, Faculty of Medicine, UDELAR, Montevideo, Uruguay; Neuroinflammation and Gene Therapy Laboratory, Institut Pasteur de Montevideo, Montevideo, Uruguay. (2)Neuroinfla

  • Brain aging mechanisms with mechanical manifestations.

    PMID:34600936 2021 Mech Ageing Dev

    1. Mech Ageing Dev. 2021 Dec;200:111575. doi: 10.1016/j.mad.2021.111575. Epub 2021 Oct 1. Brain aging mechanisms with mechanical manifestations. Blinkouskaya Y(1), Caçoilo A(1), Gollamudi T(2), Jalalian S(1), Weickenmeier J(3). Author information: (1)Department of Mechanical Engineering, Stevens Institute of Technology, Hoboken, NJ 07030, United States. (2)Department of Biomedical Engineering, Stevens Institute of Technology, Hoboken, NJ 07030, United States. (3)Department of Mechanical Engineering, Stevens Institute of Technology, Hoboken, NJ 07030, United States. Electronic address: johannes.weickenmeier@stevens.edu. Brain aging is a complex process that affects everything from the subcellular to the organ level, begins early in life, and accelerates with age. Morphologically

  • Effect of peripheral cellular senescence on brain aging and cognitive decline.

    PMID:36959691 2023 Aging Cell

    1. Aging Cell. 2023 May;22(5):e13817. doi: 10.1111/acel.13817. Epub 2023 Mar 23. Effect of peripheral cellular senescence on brain aging and cognitive decline. Budamagunta V(1)(2)(3), Kumar A(1), Rani A(1), Bean L(1), Manohar-Sindhu S(2), Yang Y(3)(4), Zhou D(4), Foster TC(1)(2). Author information: (1)Department of Neuroscience, McKnight Brain Institute, University of Florida, Gainesville, Florida, USA. (2)Genetics and Genomics Graduate Program, Genetics Institute, University of Florida, Gainesville, Florida, USA. (3)Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, Florida, USA. (4)Department of Biochemistry and Structural Biology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA. We examine similar and diff

  • Microglial senescence.

    PMID:24047521 2013 CNS Neurol Disord Drug Targets

    1. CNS Neurol Disord Drug Targets. 2013 Sep;12(6):763-7. doi: 10.2174/18715273113126660176. Microglial senescence. Streit WJ(1), Xue QS. Author information: (1)Department of Neuroscience, PO Box 100244, University of Florida, Gainesville, FL 32610-0244, USA. pschorr@ufl.edu. In order to understand microglial senescence it is important to also understand neuroinflammation because the distinction between senescent and activated microglia is a fine one to make and not always made easily. Indeed, it is not easy to reliably identify activated microglia which is why we spend some effort here discussing intricacies associated with both acute and chronic neuroinflammation before addressing the subject of microglial senescence. The idea of microglial senescence in the context of aging-r

  • TREM2 deficiency delays postnatal microglial maturation and synaptic pruning, leading to anxiety-like behaviors.

    PMID:41930604 2026 J Alzheimers Dis
  • Polycystic Lipomembranous Osteodysplasia with Sclerosing Leukoencephalopathy.

  • Dual Role of Microglial TREM2 in Neuronal Degeneration and Regeneration After Axotomy

    PMID:41963086 2026 J Neurosci
  • TREM2-mediated microglial phagocytosis of inhibitory synapses contributes to prolonged FS-induced epileptogenesis

    PMID:41965330 2026 Cell Death Discov
  • A scalable human-zebrafish xenotransplantation model reveals gastrosome-mediated processing of dying neurons by human microglia

    PMID:41957412 2026 Commun Biol

Evidence against (18)

  • Microglia-Mediated Neuroinflammation: A Potential Target for the Treatment of Cardiovascular Diseases.

    PMID:35642214 2022 J Inflamm Res

    Microglia are tissue-resident macrophages of the central nervous system (CNS). In the CNS, microglia play an important role in the monitoring and intervention of synaptic and neuron-level activities. Interventions targeting microglia have been shown to improve the prognosis of various neurological diseases. Recently, studies have observed the activation of microglia in different cardiovascular diseases. In addition, different approaches that regulate the activity of microglia have been shown to

  • TREM2, microglia, and Alzheimer's disease.

    PMID:33516818 2021 Mech Ageing Dev

    Triggering receptor expressed on myeloid cells 2 (TREM2) has been suggested to play a crucial role in Alzheimer's disease (AD) pathogenesis, as revealed by genome-wide association studies (GWAS). Since then, rapidly increasing literature related to TREM2 has focused on elucidating its role in AD pathology. In this review, we summarize our understanding of TREM2 biology, explore TREM2 functions in microglia, address the multiple mechanisms of TREM2 in AD, and raise key questions for further inves

  • Microglia states and nomenclature: A field at its crossroads.

    PMID:36327895 2022 Neuron

    Microglial research has advanced considerably in recent decades yet has been constrained by a rolling series of dichotomies such as "resting versus activated" and "M1 versus M2." This dualistic classification of good or bad microglia is inconsistent with the wide repertoire of microglial states and functions in development, plasticity, aging, and diseases that were elucidated in recent years. New designations continuously arising in an attempt to describe the different microglial states, notably

  • TREM2 deficiency attenuates neuroinflammation and protects against neurodegeneration in a mouse model of tauopathy.

    PMID:29073081 2017 Proc Natl Acad Sci U S A

    Variants in the gene encoding the triggering receptor expressed on myeloid cells 2 (TREM2) were recently found to increase the risk for developing Alzheimer's disease (AD). In the brain, TREM2 is predominately expressed on microglia, and its association with AD adds to increasing evidence implicating a role for the innate immune system in AD initiation and progression. Thus far, studies have found

  • Trem2 restrains the enhancement of tau accumulation and neurodegeneration by β-amyloid pathology.

    PMID:33675684 2021 Neuron

    Loss-of-function TREM2 mutations strongly increase Alzheimer's disease (AD) risk. Trem2 deletion has revealed protective Trem2 functions in preclinical models of β-amyloidosis, a prominent feature of pre-diagnosis AD stages. How TREM2 influences later AD stages characterized by tau-mediated neurodegeneration is unclear. To understand Trem2 function in the context of both β-amyloid and tau patholog

  • SYK coordinates neuroprotective microglial responses in neurodegenerative disease.

    PMID:36257314 2022 Cell

    Recent studies have begun to reveal critical roles for the brain's professional phagocytes, microglia, and their receptors in the control of neurotoxic amyloid beta (Aβ) and myelin debris accumulation in neurodegenerative disease. However, the critical intracellular molecules that orchestrate neuroprotective functions of microglia remain poorly understood. In our studies, we find that targeted del

  • Cognitive enhancement and neuroprotective effects of OABL, a sesquiterpene lactone in 5xFAD Alzheimer's disease mice model.

    PMID:35026701 2022 Redox Biol

    Alzheimer's disease (AD) is a neurodegenerative disease in which oxidative stress and neuroinflammation were demonstrated to be associated with neuronal loss and cognitive deficits. However, there are still no specific treatments that can prevent the progression of AD. In this study, a screening of anti-inflammatory hits from 4207 natural compounds of two different molecular libraries indicated 1,

  • Glial reactivity correlates with synaptic dysfunction across aging and Alzheimer's disease.

    PMID:40593718 2025 Nat Commun

    Previous studies suggest glial and neuronal changes may trigger synaptic dysfunction in Alzheimer's disease (AD), but the link between their markers and synaptic abnormalities in the living brain remains unclear. We investigated the association between glial reactivity and synaptic dysfunction biomarkers in cerebrospinal fluid (CSF) from 478 individuals in cognitively unimpaired (CU) and cognitive

  • Sulfatide deficiency-induced astrogliosis and myelin lipid dyshomeostasis are independent of TREM2-mediated microglial activation.

    PMID:41513633 2026 Nat Commun

    Disrupted lipid homeostasis and neuroinflammation often co-exist in neurodegenerative disorders, including Alzheimer's disease (AD). However, the intrinsic connection and causal relationship between these deficits remain elusive. Our previous studies show that the loss of sulfatide (ST), a class of myelin-enriched lipids, causes AD-like neuroinflammatory responses, cognitive impairment, bladder en

  • cGAS-STING drives ageing-related inflammation and neurodegeneration.

    PMID:37532932 2023 Nature

    Low-grade inflammation is a hallmark of old age and a central driver of ageing-associated impairment and disease

  • Single-Cell RNA Sequencing of Microglia throughout the Mouse Lifespan and in the Injured Brain Reveals Complex Cell-State Changes.

    PMID:30471926 2019 Immunity

    Microglia, the resident immune cells of the brain, rapidly change states in response to their environment, but we lack molecular and functional signatures of different microglial populations. Here, we analyzed the RNA expression patterns of more than 76,000 individual microglia in mice during development, in old age, and after brain injury. Our analysis uncovered at least nine transcriptionally di

  • Lectins and neurodegeneration: A glycobiologist's perspective.

    PMID:40405515 2025 Adv Clin Exp Med

    1. Adv Clin Exp Med. 2025 May;34(5):673-679. doi: 10.17219/acem/204107. Lectins and neurodegeneration: A glycobiologist's perspective. Olejnik B(1), Ferens-Sieczkowska M(1). Author information: (1)Department of Biochemistry and Immunochemistry, Wroclaw Medical University, Poland. Neurodegenerative diseases, including Alzheimer's and Parkinson's disease, affect an increasing number of people in aging societies, dramatically reducing the quality of life of those affected. Hence, intensive research efforts are aimed at understanding the molecular mechanisms of the disease progress, with the hope for developing effective therapeutic strategies. The progress of neurodegenerative diseases is associated with a complex activity of the immune system in the brain tissue. Carbohydrate-bind

  • Effect of aging on biomarkers and clinical profile in Parkinson's disease.

    PMID:40991070 2025 J Neurol

    1. J Neurol. 2025 Sep 24;272(10):651. doi: 10.1007/s00415-025-13384-7. Effect of aging on biomarkers and clinical profile in Parkinson's disease. Di Lazzaro G(1)(2), Paolini Paoletti F(3), Bellomo G(3), Schirinzi T(4), Grillo P(5)(6), Giuffrè GM(7)(8), Petracca M(7)(8), Picca A(7)(9), Mercuri NB(4), Parnetti L(3), Calabresi P(7)(8), Bentivoglio AR(7)(8). Author information: (1)Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy. giulia.dilazzaro@policlinicogemelli.it. (2)Università Cattolica del Sacro Cuore, Rome, Italy. giulia.dilazzaro@policlinicogemelli.it. (3)Section of Neurology, Department of Medicine and Surgery, University Hospital of Perugia, Perugia, Italy. (4)Neurology Unit, Department of Systems Medi

  • Regulation of TREM2 expression by transcription factor YY1 and its protective effect against Alzheimer's disease.

    PMID:37044212 2023 J Biol Chem

    1. J Biol Chem. 2023 May;299(5):104688. doi: 10.1016/j.jbc.2023.104688. Epub 2023 Apr 11. Regulation of TREM2 expression by transcription factor YY1 and its protective effect against Alzheimer's disease. Lu Y(1), Huang X(1), Liang W(1), Li Y(1), Xing M(2), Pan W(2), Zhang Y(1), Wang Z(3), Song W(4). Author information: (1)The National Clinical Research Center for Geriatric Disease, Xuanwu Hospital, Capital Medical University, Beijing, China. (2)Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Wenzhou Medical University, Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou,

  • Microglia in Brain Aging and Age-Related Diseases: Friends or Foes?

    PMID:41373648 2025 Int J Mol Sci

    1. Int J Mol Sci. 2025 Nov 27;26(23):11494. doi: 10.3390/ijms262311494. Microglia in Brain Aging and Age-Related Diseases: Friends or Foes? Ishikawa K(1), Fujikawa R(1), Okita K(1), Kimura F(1), Watanabe T(1), Katsurabayashi S(1), Iwasaki K(1). Author information: (1)Department of Neuropharmacology, Faculty of Pharmaceutical Sciences, Fukuoka University, 8-19-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan. With the global rise in population aging, establishing effective strategies for the prevention and treatment of age-related neurodegenerative diseases, as well as their prodromal stage of cognitive frailty, has become an urgent challenge. Recent studies have revealed that the neural basis of both frailty and age-related disorders is closely associated with chronic neuroinflammat

  • Rejuvenating aged microglia by p16(ink4a)-siRNA-loaded nanoparticles increases amyloid-β clearance in animal models of Alzheimer's disease.

    PMID:38493185 2024 Mol Neurodegener

    1. Mol Neurodegener. 2024 Mar 16;19(1):25. doi: 10.1186/s13024-024-00715-x. Rejuvenating aged microglia by p16(ink4a)-siRNA-loaded nanoparticles increases amyloid-β clearance in animal models of Alzheimer's disease. Shin HJ(1)(2), Kim IS(3)(4), Choi SG(1)(2), Lee K(1)(3)(5), Park H(1)(3), Shin J(1)(3), Kim D(1), Beom J(5), Yi YY(6), Gupta DP(7), Song GJ(7)(8), Chung WS(9), Lee CJ(10)(11), Kim DW(12)(13)(14)(15). Author information: (1)Department of Anatomy and Cell Biology, Chungnam National University College of Medicine, Daejeon, Republic of Korea. (2)Brain Research Institute, Chungnam National University College of Medicine, Daejeon, Republic of Korea. (3)Department of Medical Science, Chungnam National University College of Medicine, Daejeon, Republic of Korea. (4)Department o

  • Microglial Replacement Reverses Age-Associated Epigenetic Modifications Despite Accelerating Epigenetic Age.

    PMID:41135104 2025 Aging Dis

    1. Aging Dis. 2025 Oct 22. doi: 10.14336/AD.2025.1066. Online ahead of print. Microglial Replacement Reverses Age-Associated Epigenetic Modifications Despite Accelerating Epigenetic Age. Arbaizar-Rovirosa M(1)(2), Pérez RF(3), Peñarroya A(4)(5)(6)(7), Gallizioli M(1), Fraga MF(8)(4)(5)(9)(10), Planas AM(1)(2). Author information: (1)Cerebrovascular Research Laboratory, Instituto de Investigaciones. (2)Biomédicas de Barcelona (IIBB), Consejo Superior de Investigaciones Científicas (CSIC), Barcelona, Spain. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. (3)Departamento de Bioquímica y Biología Molecular, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain. (4)Cancer Epigenetics and Nanomedicine Laboratory, Centro de Investi

  • Microglial aging in the healthy CNS: phenotypes, drivers, and rejuvenation.

    PMID:23493481 2013 Front Cell Neurosci

    1. Front Cell Neurosci. 2013 Mar 13;7:22. doi: 10.3389/fncel.2013.00022. eCollection 2013. Microglial aging in the healthy CNS: phenotypes, drivers, and rejuvenation. Wong WT(1). Author information: (1)Unit on Neuron-Glia Interactions in Retinal Disease, National Eye Institute, National Institutes of Health Bethesda, MD, USA. Neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, and age-related macular degeneration (AMD), share two characteristics in common: (1) a disease prevalence that increases markedly with advancing age, and (2) neuroinflammatory changes in which microglia, the primary resident immune cell of the CNS, feature prominently. These characteristics have led to the hypothesis that pathogenic mechanisms underlying age-related neurodegenerati

Evidence matrix

36 supporting 18 contradicting
53% posterior support

Supporting

  • Sleep deprivation exacerbates microglial reactivity and Aβ deposition in a TREM2-dependent manner in mice. PMID:37099634 · 2023 · Sci Transl Med
  • Human and mouse single-nucleus transcriptomics reveal TREM2-dependent and TREM2-independent cellular responses in Alzheimer's disease. PMID:31932797 · 2020 · Nat Med
  • TREM2 drives microglia response to amyloid-β via SYK-dependent and -independent pathways. PMID:36306735 · 2022 · Cell
  • TREM2 Maintains Microglial Metabolic Fitness in Alzheimer's Disease. PMID:28802038 · 2017 · Cell
  • Explores genetic variations linked to neurodegenerative disease proteins, potentially supporting the TREM2-dependent senescence hypothesis. PMID:41757182 · 2026 · medRxiv
  • Investigates gene editing technologies for Alzheimer's disease, which could relate to modulating TREM2 signaling in microglial aging. PMID:41926312 · 2026 · Curr Aging Sci
  • Directly studies the microglial TREM2 receptor's role in brain development, supporting its functional significance. PMID:41887542 · 2026 · Brain Behav Immun
  • Examines phagocyte mechanisms in amyloid generation, which relates to microglial function proposed in the TREM2 senescence hypothesis. PMID:41770935 · 2026 · Proc Natl Acad Sci U S A
  • Explores microglial neuroprotective responses, which aligns with TREM2 signaling mechanisms. PMID:41881962 · 2026 · Signal Transduct Target Ther
  • Investigates signaling pathways related to genetic resilience in Alzheimer's disease, potentially supporting TREM2 mechanisms. PMID:41888907 · 2026 · Mol Neurodegener
  • Alzheimer's disease-linked risk alleles elevate microglial cGAS-associated senescence and neurodegeneration in a tauopathy model. PMID:39353433 · 2024 · Neuron
  • Microglia in neurodegeneration. PMID:30258234 · 2018 · Nat Neurosci
  • TREM2 receptor protects against complement-mediated synaptic loss by binding to complement C1q during neurodegeneration. PMID:37442133 · 2023 · Immunity
  • TREM2 and sTREM2 in Alzheimer's disease: from mechanisms to therapies. PMID:40247363 · 2025 · Mol Neurodegener
  • Soluble TREM2 ameliorates tau phosphorylation and cognitive deficits through activating transgelin-2 in Alzheimer's disease. PMID:37865646 · 2023 · Nat Commun
  • Preclinical and first-in-human evaluation of AL002, a novel TREM2 agonistic antibody for Alzheimer's disease. PMID:39444037 · 2024 · Alzheimers Res Ther
  • Identification of senescent, TREM2-expressing microglia in aging and Alzheimer's disease model mouse brain. PMID:38637622 · 2024 · Nat Neurosci
  • White matter aging drives microglial diversity. PMID:33606969 · 2021 · Neuron
  • Effects of Fisetin Treatment on Cellular Senescence of Various Tissues and Organs of Old Sheep. PMID:37627641 · 2023 · Antioxidants (Basel)
  • Roflumilast Attenuates Microglial Senescence and Retinal Inflammatory Neurodegeneration Post Retinal Ischemia Reperfusion Injury Through Inhibiting NLRP3 Inflammasome. PMID:39446353 · 2024 · Invest Ophthalmol Vis Sci
  • Whole-body senescent cell clearance alleviates age-related brain inflammation and cognitive impairment in mice. PMID:33470505 · 2021 · Aging Cell
  • Cisplatin and methotrexate induce brain microvascular endothelial and microglial senescence in mouse models of chemotherapy-associated cognitive impairment. PMID:39976845 · 2025 · Geroscience
  • Prematurely Aged Human Microglia Exhibit Impaired Stress Response and Defective Nucleocytoplasmic Shuttling of ALS Associated FUS. PMID:40970514 · 2025 · Aging Cell
  • Disentangling causality in brain aging: The complex interplay between glial senescence, neuroinflammation, and neurodegeneration. PMID:41871753 · 2026 · Exp Neurol
  • A tetravalent TREM2 agonistic antibody reduced amyloid pathology in a mouse model of Alzheimer's disease. PMID:36070367 · 2022 · Sci Transl Med
  • Adult-onset CNS myelin sulfatide deficiency is sufficient to cause Alzheimer's disease-like neuroinflammation and cognitive impairment. PMID:34526055 · 2021 · Mol Neurodegener
  • Rescue of a lysosomal storage disorder caused by Grn loss of function with a brain penetrant progranulin biologic. PMID:34450028 · 2021 · Cell
  • CD300f immune receptor contributes to healthy aging by regulating inflammaging, metabolism, and cognitive decline. PMID:37864797 · 2023 · Cell Rep
  • Brain aging mechanisms with mechanical manifestations. PMID:34600936 · 2021 · Mech Ageing Dev
  • Effect of peripheral cellular senescence on brain aging and cognitive decline. PMID:36959691 · 2023 · Aging Cell
  • Microglial senescence. PMID:24047521 · 2013 · CNS Neurol Disord Drug Targets
  • TREM2 deficiency delays postnatal microglial maturation and synaptic pruning, leading to anxiety-like behaviors. PMID:41930604 · 2026 · J Alzheimers Dis
  • Polycystic Lipomembranous Osteodysplasia with Sclerosing Leukoencephalopathy. PMID:20301376 · 1993
  • Dual Role of Microglial TREM2 in Neuronal Degeneration and Regeneration After Axotomy PMID:41963086 · 2026 · J Neurosci
  • TREM2-mediated microglial phagocytosis of inhibitory synapses contributes to prolonged FS-induced epileptogenesis PMID:41965330 · 2026 · Cell Death Discov
  • A scalable human-zebrafish xenotransplantation model reveals gastrosome-mediated processing of dying neurons by human microglia PMID:41957412 · 2026 · Commun Biol

Contradicting

  • Microglia-Mediated Neuroinflammation: A Potential Target for the Treatment of Cardiovascular Diseases. PMID:35642214 · 2022 · J Inflamm Res
  • TREM2, microglia, and Alzheimer's disease. PMID:33516818 · 2021 · Mech Ageing Dev
  • Microglia states and nomenclature: A field at its crossroads. PMID:36327895 · 2022 · Neuron
  • TREM2 deficiency attenuates neuroinflammation and protects against neurodegeneration in a mouse model of tauopathy. PMID:29073081 · 2017 · Proc Natl Acad Sci U S A
  • Trem2 restrains the enhancement of tau accumulation and neurodegeneration by β-amyloid pathology. PMID:33675684 · 2021 · Neuron
  • SYK coordinates neuroprotective microglial responses in neurodegenerative disease. PMID:36257314 · 2022 · Cell
  • Cognitive enhancement and neuroprotective effects of OABL, a sesquiterpene lactone in 5xFAD Alzheimer's disease mice model. PMID:35026701 · 2022 · Redox Biol
  • Glial reactivity correlates with synaptic dysfunction across aging and Alzheimer's disease. PMID:40593718 · 2025 · Nat Commun
  • Sulfatide deficiency-induced astrogliosis and myelin lipid dyshomeostasis are independent of TREM2-mediated microglial activation. PMID:41513633 · 2026 · Nat Commun
  • cGAS-STING drives ageing-related inflammation and neurodegeneration. PMID:37532932 · 2023 · Nature
  • Single-Cell RNA Sequencing of Microglia throughout the Mouse Lifespan and in the Injured Brain Reveals Complex Cell-State Changes. PMID:30471926 · 2019 · Immunity
  • Lectins and neurodegeneration: A glycobiologist's perspective. PMID:40405515 · 2025 · Adv Clin Exp Med
  • Effect of aging on biomarkers and clinical profile in Parkinson's disease. PMID:40991070 · 2025 · J Neurol
  • Regulation of TREM2 expression by transcription factor YY1 and its protective effect against Alzheimer's disease. PMID:37044212 · 2023 · J Biol Chem
  • Microglia in Brain Aging and Age-Related Diseases: Friends or Foes? PMID:41373648 · 2025 · Int J Mol Sci
  • Rejuvenating aged microglia by p16(ink4a)-siRNA-loaded nanoparticles increases amyloid-β clearance in animal models of Alzheimer's disease. PMID:38493185 · 2024 · Mol Neurodegener
  • Microglial Replacement Reverses Age-Associated Epigenetic Modifications Despite Accelerating Epigenetic Age. PMID:41135104 · 2025 · Aging Dis
  • Microglial aging in the healthy CNS: phenotypes, drivers, and rejuvenation. PMID:23493481 · 2013 · Front Cell Neurosci

Bayesian persona consensus

53% posterior support

1 signal · 1 for / 0 against · agreement 100%

scidex.consensus.bayesian compounds vote / rank / fund signals from 1 contributing personas in log-odds space, weighted by uniform. Prior 50%.

Cite this hypothesis

Cite this hypothesis
Citation

etl-backfill (2026). TREM2-Driven Senescence Biomarker Index for Predicting Neurodegeneration Risk. SciDEX hypothesis. https://prism.scidex.ai/hypotheses/h-var-56a6156e67

BibTeX
@misc{scidex_hypothesis_hvar56a6,
  title        = {TREM2-Driven Senescence Biomarker Index for Predicting Neurodegeneration Risk},
  author       = {etl-backfill},
  year         = {2026},
  howpublished = {SciDEX hypothesis},
  url          = {https://prism.scidex.ai/hypotheses/h-var-56a6156e67},
  note         = {SciDEX artifact hypothesis:h-var-56a6156e67}
}

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