TREM2-Mediated Cholesterol Dysregulation in Microglial Senescence

Proposed by etl-backfill

CYP46A1 neurodegeneration market 87% promoted
Compare across mechanisms →
Composite
67%
Novelty
40%
Feasibility
65%
Impact
75%
Mechanistic
70%
Druggability
59%
Safety
70%
Confidence
72%

Mechanistic description

Mechanistic Overview

TREM2-Mediated Cholesterol Dysregulation in Microglial Senescence starts from the claim that modulating CYP46A1 within the disease context of neurodegeneration can redirect a disease-relevant process. The original description reads: “## Molecular Mechanism and Rationale The proposed mechanism centers on a complex interplay between TREM2-mediated signaling and cholesterol homeostasis regulation, specifically through the modulation of CYP46A1 (cholesterol 24-hydroxylase) expression in microglial cells. Under physiological conditions, TREM2 functions as a pattern recognition receptor that recognizes phospholipids, apoptotic cells, and protein aggregates. Upon ligand binding, TREM2 undergoes conformational changes that facilitate its association with the adaptor protein DNAX-activation protein 12 (DAP12), which contains immunoreceptor tyrosine-based activation motifs (ITAMs). This interaction triggers downstream signaling cascades through spleen tyrosine kinase (SYK) phosphorylation, subsequently activating the PI3K/AKT pathway and promoting nuclear translocation of transcription factors including CREB and NRF2. These transcriptional regulators directly bind to regulatory elements within the CYP46A1 promoter region, enhancing its expression levels and enzymatic activity. CYP46A1 serves as the rate-limiting enzyme for brain cholesterol elimination, catalyzing the conversion of cholesterol to 24S-hydroxycholesterol, which can cross the blood-brain barrier and be eliminated from the central nervous system. Under TREM2 deficiency or dysfunction, this regulatory cascade becomes disrupted, leading to decreased CYP46A1 expression and impaired cholesterol 24-hydroxylation capacity. The resulting cholesterol accumulation occurs preferentially within microglial membrane domains, particularly in lipid rafts that serve as organizing platforms for various signaling complexes. These cholesterol-enriched domains become sites of aberrant inflammatory signaling, with toll-like receptors (TLRs) and other pattern recognition receptors clustering within these regions and promoting sustained NF-κB activation. Simultaneously, accumulated cholesterol triggers endoplasmic reticulum stress responses and mitochondrial dysfunction, leading to increased reactive oxygen species production and cellular stress signaling. This metabolic dysfunction initiates a senescence program characterized by DNA damage responses and cell cycle checkpoint activation. The tumor suppressors p16INK4A and p21CIP1 become upregulated through p53-dependent and p53-independent pathways, leading to permanent cell cycle arrest. Concurrently, the senescence-associated secretory phenotype (SASP) develops through sustained activation of NF-κB, STAT3, and C/EBPβ transcription factors, resulting in increased production of pro-inflammatory cytokines, chemokines, and matrix metalloproteinases that contribute to neuroinflammation and tissue damage. ## Preclinical Evidence Extensive preclinical evidence supports this mechanistic framework across multiple model systems. In the 5xFAD transgenic mouse model of Alzheimer’s disease, microglial-specific TREM2 knockout achieved through CX3CR1-Cre recombination results in a 35-45% reduction in CYP46A1 mRNA expression compared to wild-type controls by 12 months of age. These animals demonstrate accelerated cholesterol accumulation within microglial cells, as measured by filipin staining and mass spectrometry analysis of brain tissue, showing 2.3-fold increases in free cholesterol content within the cortex and hippocampus. Complementary studies using the APP/PS1 mouse model reveal that TREM2 haploinsufficiency leads to enhanced microglial senescence markers, with 60% of cortical microglia expressing SA-β-galactosidase activity by 18 months compared to 25% in wild-type littermates. Flow cytometric analysis of isolated microglia demonstrates increased expression of p16INK4A and p21CIP1 proteins, alongside elevated secretion of SASP factors including IL-6, TNF-α, IL-1β, and MCP-1, with fold-changes ranging from 2.8 to 4.7 compared to controls. In vitro studies using primary microglial cultures from neonatal mice provide mechanistic insights into the temporal sequence of events. TREM2 knockdown via siRNA leads to a progressive decline in CYP46A1 expression over 72-96 hours, with concurrent accumulation of cholesterol in membrane fractions. Cholesterol efflux assays using radioactively labeled cholesterol demonstrate 40-55% reduction in efflux capacity in TREM2-deficient microglia compared to controls. Live-cell imaging studies reveal that cholesterol accumulation precedes senescence marker expression by approximately 48-72 hours, supporting the causal relationship between metabolic dysfunction and cellular senescence. Human genetic studies provide translational evidence for this pathway’s relevance. Analysis of brain tissue from carriers of TREM2 risk variants (R47H, R62H, T96K) demonstrates 25-40% reductions in CYP46A1 protein expression compared to common variant carriers, with corresponding increases in brain cholesterol content measured by gas chromatography-mass spectrometry. Single-cell RNA sequencing of post-mortem brain tissue reveals distinct microglial subpopulations characterized by low TREM2/CYP46A1 expression and high senescence gene signatures, with these populations expanding from 8% in cognitively normal individuals to 23% in Alzheimer’s disease patients. Caenorhabditis elegans studies using orthologous genes provide evolutionary conservation evidence, with trem-2 and cyp46a1 mutations resulting in accelerated neuronal degeneration and shortened lifespan, while overexpression of CYP46A1 partially rescues the trem-2 mutant phenotype. ## Therapeutic Strategy and Delivery The therapeutic approach employs targeted gene therapy using adeno-associated virus serotype 9 (AAV9) vectors engineered with microglial-specific promoters to achieve selective CYP46A1 overexpression. The construct utilizes a hybrid promoter combining elements from the CD68 and CX3CR1 genes to ensure microglial specificity while maintaining robust expression levels. The CYP46A1 coding sequence is codon-optimized for enhanced expression and includes a woodchuck hepatitis virus post-transcriptional regulatory element (WPRE) to improve mRNA stability and translation efficiency. Vector delivery occurs through stereotactic injection into multiple brain regions, including the hippocampus, cortex, and white matter tracts, using a total dose of 1×10^12 vector genomes per animal distributed across 8-10 injection sites. Alternative delivery approaches include intraventricular administration or focused ultrasound-mediated blood-brain barrier opening combined with intravenous vector delivery to achieve broader brain distribution with lower invasiveness. Small molecule approaches target CYP46A1 enzymatic activity through allosteric modulation or cofactor enhancement. Lead compounds include synthetic analogs of heme cofactors and small molecules that stabilize the CYP46A1-cytochrome P450 reductase interaction complex. These compounds undergo extensive medicinal chemistry optimization for blood-brain barrier penetration, metabolic stability, and selectivity over other cytochrome P450 enzymes, particularly CYP7A1 and CYP27A1 involved in peripheral cholesterol metabolism. Pharmacokinetic studies in non-human primates demonstrate that optimized small molecules achieve brain-to-plasma ratios of 0.3-0.5, with half-lives of 4-6 hours in brain tissue. Chronic dosing studies establish optimal regimens of twice-daily oral administration to maintain therapeutic brain concentrations while minimizing peripheral exposure and potential hepatotoxicity. Combination therapeutic strategies include concurrent administration of TREM2 agonistic antibodies or small molecule activators to restore upstream signaling capacity while boosting downstream CYP46A1 activity. Nanoparticle delivery systems utilizing lipid nanoparticles or polymeric carriers enable targeted delivery to activated microglia through surface functionalization with microglial-specific ligands or antibodies. ## Evidence for Disease Modification Disease-modifying potential is demonstrated through multiple complementary biomarker approaches that distinguish symptomatic improvement from underlying pathological changes. Cerebrospinal fluid measurements of 24S-hydroxycholesterol serve as a direct pharmacodynamic biomarker, with treated animals showing 2-3 fold increases in CSF levels within 2-4 weeks of treatment initiation. This biomarker correlates strongly with brain CYP46A1 enzymatic activity measured ex vivo and provides real-time assessment of treatment efficacy. Advanced neuroimaging techniques demonstrate structural and functional improvements indicative of disease modification. High-resolution MRI volumetric analysis reveals preservation of hippocampal and cortical volumes in treated 5xFAD mice, with 15-25% larger volumes compared to vehicle-treated controls at 18 months of age. Diffusion tensor imaging demonstrates improved white matter integrity, with increased fractional anisotropy values in major fiber tracts including the corpus callosum and fornix. Positron emission tomography using [11C]PiB for amyloid imaging and [18F]MK-6240 for tau imaging reveals 30-45% reductions in tracer binding in treated animals compared to controls, indicating reduced pathological protein accumulation rather than simply masking existing pathology. Microglial activation imaging using [11C]PK11195 demonstrates normalized microglial activation patterns, with binding values returning to near wild-type levels in treated transgenic animals. Electrophysiological assessments provide functional evidence of disease modification through restoration of synaptic plasticity. Long-term potentiation measurements in hippocampal slices from treated animals show 40-60% improvement in synaptic strength and durability compared to untreated controls, approaching wild-type levels. Gamma oscillation recordings demonstrate restored network synchrony and improved cognitive processing capabilities. Neuropathological analyses confirm disease modification through quantitative assessment of pathological changes. Immunohistochemical staining reveals 25-40% reductions in amyloid plaque density and 35-50% decreases in phosphorylated tau accumulation in treated animals. Microglial morphological analysis demonstrates restoration of ramified, homeostatic morphology with reduced activation markers and normalized phagocytic capacity. Behavioral assessments spanning multiple cognitive domains provide functional endpoints that reflect overall therapeutic benefit. Novel object recognition, Morris water maze, and contextual fear conditioning paradigms demonstrate significant improvements in treated animals, with performance levels approaching or matching wild-type controls in some paradigms. ## Clinical Translation Considerations Clinical translation requires carefully designed patient stratification strategies based on genetic and biomarker profiles. Primary target populations include individuals carrying TREM2 risk variants (R47H, R62H, T96K) who demonstrate evidence of microglial dysfunction through CSF biomarkers or PET imaging. Secondary populations encompass sporadic Alzheimer’s disease patients with low CSF 24S-hydroxycholesterol levels or elevated microglial activation markers, regardless of TREM2 genotype. Phase I/IIa trial design incorporates adaptive elements with interim biomarker analyses to optimize dosing and identify responsive patient subgroups. Primary endpoints focus on safety and biomarker engagement, including CSF 24S-hydroxycholesterol levels, microglial PET imaging, and inflammatory markers. Secondary endpoints encompass cognitive assessments using sensitive instruments such as the Alzheimer’s Disease Composite Score and computerized cognitive batteries designed to detect early changes. Safety considerations encompass potential risks associated with altered cholesterol metabolism, including hepatotoxicity from peripheral CYP46A1 activity and cardiovascular effects from systemic cholesterol changes. Comprehensive safety monitoring includes liver function tests, lipid panels, and cardiovascular assessments throughout the treatment period. Dose-escalation protocols incorporate strict stopping rules based on predefined safety thresholds and biomarker changes. Regulatory strategy leverages breakthrough therapy designation based on the novel mechanism and potential for disease modification in an area of high unmet medical need. The approach emphasizes biomarker-driven development with close collaboration with regulatory agencies to establish acceptable endpoints and trial designs for accelerated approval pathways. Competitive landscape analysis reveals limited direct competition targeting the TREM2-CYP46A1 axis, with most current approaches focusing on amyloid or tau clearance. This provides a strategic advantage for differentiation and potential combination therapy opportunities with existing or emerging treatments targeting complementary pathways. ## Future Directions and Combination Approaches Future research directions encompass expansion into additional neurodegenerative diseases sharing microglial dysfunction and cholesterol dysregulation mechanisms. Frontotemporal dementia, Parkinson’s disease, and amyotrophic lateral sclerosis represent logical extension opportunities given overlapping pathological features and microglial involvement. Preclinical studies in relevant disease models would establish therapeutic potential and optimal treatment parameters for each indication. Combination therapy approaches target multiple aspects of microglial dysfunction and neurodegeneration simultaneously. Pairing CYP46A1 enhancement with TREM2 pathway activators could provide synergistic benefits by addressing both upstream signaling deficits and downstream metabolic dysfunction. Additional combinations might include senolytic agents to eliminate existing senescent microglia while preventing new senescence through cholesterol homeostasis restoration. Immunomodulatory combinations could enhance therapeutic efficacy by addressing both metabolic and inflammatory aspects of microglial dysfunction. Anti-inflammatory agents targeting specific cytokine pathways or broader immunosuppressive approaches might complement metabolic interventions to achieve more comprehensive microglial restoration. Advanced delivery technologies represent another key development area, with next-generation AAV vectors providing improved specificity, reduced immunogenicity, and enhanced brain penetration. Engineered capsids selected through directed evolution or rational design could improve microglial targeting while reducing off-target effects in other brain cell types. Biomarker development continues with focus on non-invasive monitoring approaches including blood-based assays for brain-derived cholesterol metabolites and advanced imaging techniques for real-time assessment of microglial metabolic state. These developments would enable precision medicine approaches with individualized treatment optimization based on patient-specific biomarker profiles and treatment responses. Mechanistic studies continue exploring the broader implications of cholesterol homeostasis in brain function and disease, potentially revealing additional therapeutic targets and combination opportunities. Understanding the relationship between cholesterol metabolism, synaptic function, and cognitive performance could guide development of more comprehensive therapeutic strategies addressing both cellular dysfunction and functional outcomes.” Framed more explicitly, the hypothesis centers CYP46A1 within the broader disease setting of neurodegeneration. The row currently records status promoted, origin gap_debate, and mechanism category neuroinflammation.

SciDEX scoring currently records confidence 0.72, novelty 0.78, feasibility 0.65, impact 0.75, mechanistic plausibility 0.88, and clinical relevance 0.26.

Molecular and Cellular Rationale

The nominated target genes are CYP46A1 and the pathway label is TREM2/cholesterol homeostasis/microglial senescence. Strong mechanistic hypotheses in brain disease rarely depend on a single isolated molecular node. Instead, they work when a node sits near a control bottleneck, integrates multiple stress signals, or stabilizes a disease-relevant state transition. That is the standard this hypothesis should be held to. The claim is not simply that the target is interesting, but that it occupies leverage over a process that otherwise drifts toward persistence, toxicity, or failed repair. Gene-expression context on the row adds an important constraint: TREM2 is predominantly expressed in microglia across all brain regions, with highest expression in the medial temporal lobe, hippocampus, and temporal cortex—regions most vulnerable to AD pathology. Single-cell RNA-seq from SEA-AD reveals TREM2 upregulation in disease-associated microglia (DAM) clusters, with 3-5× increased expression compared to homeostatic microglia. Age-dependent analysis shows progressive TREM2 upregulation from age 60+, correlating with amyloid plaque density. Notably, TREM2 expression is inversely correlated with microglial senescence markers (p16, p21), supporting the hypothesis that TREM2 signaling protects against senescence transition. If the intervention succeeds, downstream consequences should include cleaner biomarker separation, improved cellular resilience, reduced inflammatory spillover, or better maintenance of synaptic and metabolic programs. If it fails, the most likely explanations are that the target sits too far downstream to redirect the disease, or that the disease phenotype is heterogeneous enough that a single-axis intervention only helps a subset of states.

Evidence Supporting the Hypothesis

  1. Sleep deprivation exacerbates microglial reactivity and Aβ deposition in a TREM2-dependent manner in mice. 1CitationPMID 37099634Open reference.

  2. Human and mouse single-nucleus transcriptomics reveal TREM2-dependent and TREM2-independent cellular responses in Alzheimer’s disease. 2CitationPMID 31932797Open reference.

  3. TREM2 drives microglia response to amyloid-β via SYK-dependent and -independent pathways. 3CitationPMID 36306735Open reference.

  4. TREM2 Maintains Microglial Metabolic Fitness in Alzheimer’s Disease. 4CitationPMID 28802038Open reference.

  5. Explores genetic variations linked to neurodegenerative disease proteins, potentially supporting the TREM2-dependent senescence hypothesis. 5CitationPMID 41757182Open reference.

  6. Investigates gene editing technologies for Alzheimer’s disease, which could relate to modulating TREM2 signaling in microglial aging. 6CitationPMID 41926312Open reference.

Contradictory Evidence, Caveats, and Failure Modes

  1. Microglia-Mediated Neuroinflammation: A Potential Target for the Treatment of Cardiovascular Diseases. 7CitationPMID 35642214Open reference.

  2. TREM2, microglia, and Alzheimer’s disease. 8CitationPMID 33516818Open reference.

  3. Microglia states and nomenclature: A field at its crossroads. 9CitationPMID 36327895Open reference.

  4. TREM2 deficiency attenuates neuroinflammation and protects against neurodegeneration in a mouse model of tauopathy. 10CitationPMID 29073081Open reference.

  5. Trem2 restrains the enhancement of tau accumulation and neurodegeneration by β-amyloid pathology. 2CitationPMID 31932797Open reference0.

Clinical and Translational Relevance

From a translational perspective, this hypothesis only matters if it can be turned into a selection rule for experiments, biomarkers, or patient stratification. The row currently records market price 0.8906, debate count 3, citations 50, predictions 2, and falsifiability flag 1. Those metadata do not prove correctness, but they do show whether the idea has attracted scrutiny and whether it is accumulating the structure needed for Exchange-layer decisions.

  1. Trial context: RECRUITING.

  2. Trial context: COMPLETED.

  3. Trial context: RECRUITING. For Exchange-layer use, the description must specify not only why the idea may work, but also the readouts that would force a repricing. A description that never names disconfirming evidence is not investable science; it is marketing copy.

Experimental Predictions and Validation Strategy

First, the hypothesis should be decomposed into a perturbation experiment that directly manipulates CYP46A1 in a model matched to neurodegeneration. The key readout should include pathway markers, cell-state markers, and at least one phenotype that maps onto “TREM2-Mediated Cholesterol Dysregulation in Microglial Senescence”. Second, the study design should include a rescue arm. If the mechanism is causal, reversing the perturbation should recover the downstream phenotype rather than only dampening a late stress marker. Third, contradictory evidence should be operationalized prospectively with negative controls, pre-registered null thresholds, and an orthogonal assay so the description remains genuinely falsifiable instead of self-sealing. Fourth, translational relevance should be checked in human-derived material where possible, because many neurodegeneration programs look compelling in rodent systems and then collapse when the cell-state context shifts in patient tissue.

Decision-Oriented Summary

In summary, the operational claim is that targeting CYP46A1 within the disease frame of neurodegeneration can produce a measurable change in mechanism rather than only a cosmetic change in a terminal biomarker. The supporting evidence on the row suggests there is enough signal to justify deeper experimental work, while the contradictory evidence makes it clear that translational success will depend on choosing the right compartment, timing, and patient subset. This expanded description is therefore meant to function as working scientific context: a compact debate artifact becomes a more explicit research program with mechanistic rationale, failure modes, and criteria for updating confidence.

References

  1. PMID:37099634 PMID 37099634
  2. PMID:31932797 PMID 31932797
  3. PMID:36306735 PMID 36306735
  4. PMID:28802038 PMID 28802038
  5. PMID:41757182 PMID 41757182
  6. PMID:41926312 PMID 41926312
  7. PMID:35642214 PMID 35642214
  8. PMID:33516818 PMID 33516818
  9. PMID:36327895 PMID 36327895
  10. PMID:29073081 PMID 29073081
  11. PMID:33675684 PMID 33675684

Mechanism / pathway

  1. CYP46A1
  2. TREM2/cholesterol homeostasis/microglial senescence
  3. neurodegeneration

Evidence for (32)

  • 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

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

32 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

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 3

  1. #1 paper-010e9cad39a2 0.236 trust 0.50 · rel 0.50 · 70d
  2. #2 paper-6e0b549de457 0.236 trust 0.50 · rel 0.50 · 70d
  3. #3 paper-2c2e3ee8ef93 0.236 trust 0.50 · rel 0.50 · 70d

4 total ranked · scidex.hypotheses.evidence_ranking

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-Mediated Cholesterol Dysregulation in Microglial Senescence. SciDEX hypothesis. https://prism.scidex.ai/hypotheses/h-var-e0e82ff2e2

BibTeX 
@misc{scidex_hypothesis_hvare0e8,
  title        = {TREM2-Mediated Cholesterol Dysregulation in Microglial Senescence},
  author       = {etl-backfill},
  year         = {2026},
  howpublished = {SciDEX hypothesis},
  url          = {https://prism.scidex.ai/hypotheses/h-var-e0e82ff2e2},
  note         = {SciDEX artifact hypothesis:h-var-e0e82ff2e2}
}

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