Mechanistic description
This hypothesis reconciles conflicting C1q phenotypes by placing receiver-cell state downstream of a common upstream C1q-tagging event. In a competent TREM2 program, microglia clear tagged material efficiently; in TREM2-impaired states, the same substrates persist, amplifying complement and bystander synapse loss.
Evidence for (7)
TREM2 directly interacts with C1q in neurodegeneration-relevant contexts and appears to restrain complement-mediated synapse loss.
Microglial state is a major determinant of neurodegenerative response programs, making it plausible that identical opsonized substrates can lead to different outcomes.
TREM2 drives microglia response to amyloid-β via SYK-dependent and -independent pathways.
TREM2, microglia, and Alzheimer's disease.
Microglia and TREM2.
A Unique Microglia Type Associated with Restricting Development of Alzheimer's Disease.
Anti-human TREM2 induces microglia proliferation and reduces pathology in an Alzheimer's disease model.
Evidence against (2)
TREM2 biology is pleiotropic, and observed effects may reflect broader changes in metabolism, clustering, or plaque handling rather than a specific C1q decision node.
The claim that TREM2 state alone determines adaptive versus toxic handling likely overstates causality because astrocytes, other receptors, and complement regulators also shape outcome.
Bayesian persona consensus
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