Composite
76%
Novelty
75%
Feasibility
75%
Impact
82%
Mechanistic
70%
Druggability
85%
Safety
80%
Confidence
72%

Mechanistic description

GluN2B signaling in cortical excitatory neurons releases fractalkine (CX3CL1) via activity-dependent TACE/ADAM17 shedding. CX3CL1 engages microglial CX3CR1 receptors, promoting TREM2-dependent phagocytosis of extracellular tau aggregates. Domain Expert recommends targeting downstream TREM2 rather than upstream GluN2B for superior druggability. Validated biomarker (CSF sTREM2) enables clinical development.

Evidence for (3)

Evidence against (2)

  • CX3CL1-CX3CR1 axis primarily mediates surveillance, not phagocytosis activation

  • TREM2 ligands include lipids and ApoE, not primarily CX3CR1 downstream