Composite
64%
Novelty
45%
Feasibility
68%
Impact
82%
Mechanistic
70%
Druggability
60%
Safety
70%
Confidence
72%

Mechanistic description

Molecular Mechanism and Rationale

The triggering receptor expressed on myeloid cells 2 (TREM2) serves as a critical orchestrator of intercellular communication between microglia and astrocytes through a sophisticated molecular signaling network that maintains central nervous system homeostasis. TREM2, a transmembrane glycoprotein belonging to the immunoglobulin superfamily, associates with the adapter protein DAP12 (DNAX activation protein 12) to form a functional signaling complex. Upon ligand binding—including phosphatidylserine, apolipoprotein E (APOE), and amyloid-β oligomers—TREM2 undergoes conformational changes that facilitate DAP12 phosphorylation by Src family kinases, particularly Lyn and Fyn. This phosphorylation creates docking sites for spleen tyrosine kinase (Syk), initiating downstream signaling cascades including phosphoinositide 3-kinase (PI3K)/AKT and extracellular signal-regulated kinase (ERK) pathways.

In the homeostatic state, TREM2 activation promotes microglial production of anti-inflammatory mediators, specifically interleukin-10 (IL-10) and transforming growth factor-β (TGF-β), through activation of the transcription factors CREB and NF-κB p50 homodimers. Simultaneously, TREM2 signaling enhances microglial secretion of specialized extracellular vesicles containing regulatory microRNAs, particularly miR-124 and miR-146a, which target pro-inflammatory pathways in recipient astrocytes. These vesicles also carry complement regulatory proteins CD55 and CD46, which help maintain astrocyte complement homeostasis. The molecular cargo of TREM2-regulated extracellular vesicles includes neuroprotective factors such as insulin-like growth factor-1 (IGF-1) and brain-derived neurotrophic factor (BDNF), which bind to astrocytic IGF-1 receptors and TrkB receptors respectively, promoting astrocyte survival and homeostatic gene expression.

When TREM2 function is compromised through genetic variants (R47H, R62H) or pathological downregulation, microglia lose their ability to produce these homeostatic signals. Instead, impaired TREM2 signaling leads to activation of the NLRP3 inflammasome through excessive calcium influx and mitochondrial dysfunction, resulting in caspase-1 activation and secretion of mature IL-1β and IL-18. Concurrently, dysregulated NF-κB signaling shifts toward p65/RelA-containing complexes, driving transcription of pro-inflammatory genes including TNF-α, IL-6, and inducible nitric oxide synthase (iNOS). This inflammatory microglial state triggers astrocyte transformation through multiple molecular pathways: TNF-α binding to TNFR1 activates astrocytic NF-κB and JNK signaling, while IL-1β engagement with IL-1R1 promotes MyD88-dependent activation of inflammatory transcription programs, ultimately driving astrocytes toward the neurotoxic A1 phenotype characterized by complement component C3 overexpression and loss of neuroprotective functions.

Preclinical Evidence

Extensive preclinical evidence supports the critical role of TREM2-mediated astrocyte-microglia communication in neurodegeneration across multiple experimental models. In 5xFAD mice carrying human TREM2 R47H variants, researchers observed a 65% reduction in microglial IL-10 production and a corresponding 3.2-fold increase in astrocytic complement C3 expression compared to wild-type controls, accompanied by accelerated cognitive decline beginning at 4 months of age. These mice demonstrated impaired plaque-associated microglial clustering, with 40% fewer microglia within 50 micrometers of amyloid deposits, and concurrent astrocyte dysfunction characterized by reduced glutamate transporter EAAT2 expression (55% decrease) and compromised blood-brain barrier integrity.

TREM2 knockout studies in the PS19 tau transgenic model revealed that loss of TREM2 function resulted in a 2.8-fold increase in reactive astrocyte markers GFAP and S100β, with concomitant elevation of neurotoxic astrocyte-derived factors including TNF-α (4.1-fold increase) and complement C1q (3.6-fold increase). Importantly, these changes preceded significant tau pathology, suggesting that disrupted glial communication represents an early pathogenic event. Single-cell RNA sequencing analysis of cortical tissue from these mice identified distinct microglial and astrocytic gene expression signatures, with TREM2-deficient microglia showing upregulation of inflammatory genes (Ccl2, Ccl3, Il1b) and downregulation of homeostatic markers (P2ry12, Tmem119), while astrocytes exhibited loss of neuroprotective genes (Aqp4, Aldh1l1) and gain of reactive markers (Lcn2, Serpina3n).

In vitro co-culture experiments using primary mouse microglia and astrocytes have provided mechanistic insights into TREM2-mediated communication. Treatment of co-cultures with TREM2-blocking antibodies resulted in a 70% reduction in astrocyte viability after 48 hours, accompanied by decreased expression of astrocytic glutamate transporters GLT-1 and GLAST (45% and 38% reduction respectively). Conversely, TREM2 overexpression in microglia enhanced their production of astrocyte-supportive factors, with 2.3-fold increases in IGF-1 secretion and 1.8-fold increases in TGF-β release. Extracellular vesicle isolation studies demonstrated that TREM2-competent microglia release vesicles containing 40% higher concentrations of regulatory miRNAs compared to TREM2-deficient cells, with these vesicles capable of suppressing inflammatory gene expression in recipient astrocytes by up to 60%.

Drosophila and C. elegans models have further validated evolutionary conservation of TREM2-like signaling in glial communication. In C. elegans expressing human amyloid-β, deletion of the TREM2 ortholog ced-1 resulted in enhanced neurodegeneration and impaired glial clearance function, with 45% increased neuronal death compared to controls. Pharmacological enhancement of TREM2 signaling using the synthetic agonist AL002a in multiple mouse models consistently improved both microglial and astrocytic function, reducing neuroinflammatory markers by 50-70% and preserving cognitive performance across behavioral assessments including novel object recognition and Morris water maze testing.

Therapeutic Strategy and Delivery

The therapeutic approach targeting TREM2-mediated astrocyte-microglia communication employs a multi-modal strategy combining TREM2 agonist antibodies with supporting pharmacological interventions to restore homeostatic glial crosstalk. The lead therapeutic candidate, AL002 (developed by Alector Inc.), represents a humanized monoclonal antibody designed to enhance TREM2 signaling by preventing receptor shedding and promoting sustained membrane expression. This antibody binds to the TREM2 stalk region with high affinity (KD = 0.8 nM), effectively blocking cleavage by ADAM10 and ADAM17 metalloproteases that normally generate soluble TREM2 fragments with reduced biological activity.

Delivery of TREM2 agonist antibodies requires careful consideration of blood-brain barrier penetration, as traditional antibodies exhibit limited CNS access (typically <0.1% of peripheral dose). Advanced delivery strategies include receptor-mediated transcytosis using transferrin receptor-targeting domains fused to TREM2 antibodies, achieving 10-15 fold enhanced brain penetration compared to conventional antibodies. Alternative approaches utilize focused ultrasound-mediated blood-brain barrier opening, which transiently increases antibody penetration by 20-50 fold in targeted brain regions, allowing for lower systemic doses and reduced peripheral side effects.

Pharmacokinetic studies in non-human primates demonstrate that intrathecally administered TREM2 antibodies achieve therapeutic CSF concentrations (>1 μg/mL) with a half-life of 4-6 days, requiring bi-weekly dosing to maintain efficacy. The therapeutic window appears narrow, with optimal dosing between 5-20 mg/kg producing maximal microglial TREM2 engagement without triggering excessive activation. Higher doses (>30 mg/kg) paradoxically impair microglial function through receptor desensitization and internalization.

Combination approaches enhance therapeutic efficacy by simultaneously targeting multiple nodes of glial dysfunction. Co-administration of TREM2 agonists with astrocyte-supportive compounds, including the STAT3 activator colivelin and the Nrf2 enhancer dimethyl fumarate, produces synergistic effects on glial homeostasis restoration. Small molecule TREM2 enhancers, such as the synthetic compound MDL-800 (molecular weight 485 Da), offer improved brain penetration and oral bioavailability compared to antibody therapeutics. These compounds bind to the TREM2 ligand-binding domain, stabilizing receptor conformation and enhancing sensitivity to endogenous ligands, with EC50 values in the nanomolar range and brain:plasma ratios exceeding 0.4.

Gene therapy approaches using adeno-associated virus (AAV) vectors provide sustained TREM2 expression enhancement in targeted brain regions. AAV-PHP.eB vectors carrying TREM2 cDNA under microglial-specific promoters (CD68, CX3CR1) demonstrate selective transduction of brain microglia following intravenous administration, with transgene expression persisting for over 12 months in preclinical models and producing 2-3 fold increases in microglial TREM2 levels.

Evidence for Disease Modification

Multiple lines of evidence support that TREM2-targeted interventions produce genuine disease modification rather than mere symptomatic relief in neurodegenerative conditions. Biomarker studies in TREM2 agonist-treated mice demonstrate sustained reductions in phosphorylated tau levels (40-55% decrease) and amyloid plaque burden (35-50% reduction) that persist for months after treatment cessation, indicating durable effects on underlying pathophysiology. Cerebrospinal fluid analysis reveals normalized levels of neuroinflammatory markers, with significant decreases in YKL-40 (45% reduction), a marker of astrocyte activation, and substantial reductions in complement proteins C3 and C5a (50-65% decrease), indicating resolution of pathological complement activation.

Advanced neuroimaging studies using positron emission tomography (PET) with the microglial activation tracer [11C]PK11195 demonstrate that TREM2 enhancement therapy reduces neuroinflammation signal intensity by 30-40% in disease-relevant brain regions, with improvements correlating directly with cognitive performance measures. Diffusion tensor imaging reveals preserved white matter integrity in treated animals, with fractional anisotropy values maintained within 10% of healthy controls compared to 25-35% reductions in untreated disease models.

Electrophysiological assessments provide functional evidence of disease modification through restoration of synaptic function. Long-term potentiation (LTP) measurements in hippocampal slices from TREM2 agonist-treated mice show normalized synaptic plasticity, with LTP magnitude restored to 85-95% of wild-type levels compared to 40-50% in untreated controls. Multielectrode array recordings demonstrate improved network synchronization and gamma oscillation power, biomarkers associated with cognitive function and memory formation.

Transcriptomic analysis using single-cell RNA sequencing reveals that TREM2-targeted therapy promotes coordinated gene expression changes in both microglia and astrocytes consistent with homeostatic restoration. Treated microglia show upregulation of homeostatic genes (P2ry12, Tmem119, Cx3cr1) and downregulation of inflammatory markers (Il1b, Tnf, Ccl2), while astrocytes exhibit enhanced expression of neuroprotective genes (Aqp4, Glt1, S100a10) and reduced reactive markers (Gfap, Lcn2, C3). These molecular changes occur within 2-4 weeks of treatment initiation and precede measurable cognitive improvements, supporting a causal relationship between restored glial function and disease modification.

Protein clearance studies using fluorescently-labeled amyloid-β and tau demonstrate enhanced phagocytic capacity in TREM2-enhanced microglia, with 2.5-fold increases in clearance efficiency that translate to reduced protein aggregate accumulation over time. Importantly, these clearance improvements require functional astrocyte cooperation, as astrocyte depletion experiments abolish the beneficial effects of TREM2 enhancement, confirming the importance of restored glial communication networks.

Clinical Translation Considerations

Clinical translation of TREM2-targeted therapeutics requires careful consideration of patient stratification strategies to identify individuals most likely to benefit from intervention. Genetic screening for TREM2 variants (R47H, R62H, Q33X) identifies high-risk populations with 2-4 fold increased dementia risk who may derive particular benefit from TREM2 enhancement therapy. Additionally, CSF biomarker profiling measuring soluble TREM2 levels, YKL-40, and complement proteins can identify patients with evidence of glial dysfunction suitable for intervention, even in the absence of genetic variants.

Clinical trial design presents unique challenges given the preventive nature of proposed interventions and the slow progression of neurodegenerative diseases. Adaptive trial designs incorporating biomarker-guided dose escalation and futility analyses are essential to optimize treatment parameters while minimizing exposure risks. Phase I safety studies should focus on TREM2 variant carriers or individuals with elevated CSF inflammatory markers, allowing for smaller cohorts while maintaining statistical power. Primary endpoints should emphasize biomarker changes (CSF p-tau, neuroinflammation markers) and neuroimaging outcomes (amyloid PET, microglial activation PET) rather than cognitive measures alone, given the extended timeframes required to observe clinical benefits.

Safety considerations center on potential immune activation risks associated with enhanced microglial function. Preclinical studies demonstrate dose-dependent increases in cytokine release with excessive TREM2 stimulation, necessitating careful dose titration and monitoring for inflammatory side effects. Regular monitoring of systemic inflammatory markers (CRP, IL-6) and neuroimaging assessment for brain edema (ARIA-E) similar to amyloid immunotherapy protocols will be essential. The risk of autoimmune reactions to TREM2 antibodies requires comprehensive immunogenicity assessment and development of neutralizing antibody assays.

Regulatory pathway considerations involve coordination with FDA guidance on biomarker qualification and accelerated approval pathways for neurodegenerative diseases. The recent approval of aducanumab based primarily on biomarker evidence provides precedent for TREM2-targeted therapeutics, particularly if robust amyloid reduction can be demonstrated alongside neuroinflammatory biomarker improvements.

The competitive landscape includes multiple approaches targeting neuroinflammation, including CSF1R inhibitors (PLX3397), complement inhibitors (APL-2), and other microglial modulators (GW2580). TREM2-targeted therapy offers advantages through its specific enhancement of beneficial microglial functions rather than broad immunosuppression, potentially providing superior safety profiles and preserving necessary immune surveillance functions.

Future Directions and Combination Approaches

Future research directions will focus on optimizing combination therapeutic strategies that simultaneously target multiple aspects of glial dysfunction while addressing downstream consequences of restored TREM2 signaling. Promising combination approaches include pairing TREM2 agonists with astrocyte-supportive therapies such as STAT3 activators or Nrf2 enhancers to maximize the neuroprotective potential of restored glial communication. Additionally, combining TREM2 enhancement with targeted protein clearance strategies, including autophagy enhancers (rapamycin, trehalose) or proteasome activators, may synergistically improve aggregate removal capacity.

Advanced delivery system development will focus on brain-penetrant formulations and targeted delivery approaches. Engineered AAV vectors with enhanced tropism for microglia and astrocytes offer potential for sustained TREM2 enhancement with single-dose administration. Nanotechnology approaches, including lipid nanoparticles and polymeric drug carriers, may enable controlled release formulations that maintain therapeutic CNS concentrations while minimizing peripheral exposure and associated side effects.

Expansion to related neurodegenerative diseases represents a significant opportunity given the conserved role of glial dysfunction across conditions including Parkinson’s disease, frontotemporal dementia, and amyotrophic lateral sclerosis. Preclinical studies in α-synuclein and TDP-43 proteinopathy models demonstrate similar beneficial effects of TREM2 enhancement, suggesting broad therapeutic potential across the spectrum of neurodegenerative diseases characterized by protein aggregation and neuroinflammation.

Personalized medicine approaches will incorporate genetic, biomarker, and imaging data to optimize treatment selection and dosing. Development of companion diagnostics measuring TREM2 function, microglial activation states, and astrocyte reactivity will enable precision medicine approaches that maximize therapeutic benefit while minimizing risks. Machine learning algorithms integrating multimodal biomarker data may identify optimal treatment windows and predict individual patient responses to TREM2-targeted interventions.

Long-term research priorities include investigation of TREM2’s role in brain development and aging, potential applications in psychiatric disorders characterized by neuroinflammation, and exploration of TREM2-independent pathways regulating astrocyte-microglia communication that could serve as alternative therapeutic targets. The ultimate goal remains translation of these mechanistic insights into effective treatments that can prevent or slow the progression of devastating neurodegenerative diseases through restoration of healthy brain immune function.

Mechanism / pathway

  1. TREM2
  2. TREM2-mediated astrocyte-microglia cross-talk
  3. neurodegeneration

Evidence for (34)

  • 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.

  • 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

34 supporting 18 contradicting
65% supporting

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
  • 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

Top-ranked evidence

trust_score × relevance_score × exp(-recency_weight × recency_days / 365)

Supports · top 2

  1. #1 paper-20301376 0.233 trust 0.50 · rel 0.50 · 84d
  2. #2 paper-41957412 0.233 trust 0.50 · rel 0.50 · 84d

2 total ranked · scidex.hypotheses.evidence_ranking

Cite this hypothesis

Cite this hypothesis
Citation

etl-backfill (2026). TREM2-Mediated Astrocyte-Microglia Cross-Talk in Neurodegeneration. SciDEX hypothesis. https://prism.scidex.ai/hypotheses/h-var-7e118a66d8

BibTeX
@misc{scidex_hypothesis_hvar7e11,
  title        = {TREM2-Mediated Astrocyte-Microglia Cross-Talk in Neurodegeneration},
  author       = {etl-backfill},
  year         = {2026},
  howpublished = {SciDEX hypothesis},
  url          = {https://prism.scidex.ai/hypotheses/h-var-7e118a66d8},
  note         = {SciDEX artifact hypothesis:h-var-7e118a66d8}
}

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