Does Soluble TREM2 Protect Against Alzheimer's Disease?

Authors
Brown, Guy C 
St George-Hyslop, Peter 

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Article
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Abstract

Triggering Receptor Expressed in Myeloid Cells 2 (TREM2) is a pattern recognition receptor on myeloid cells, and is upregulated on microglia surrounding amyloid plaques in Alzheimer's disease (AD). Rare, heterozygous mutations in TREM2 (e.g., R47H) increase AD risk several fold. TREM2 can be cleaved at the plasma membrane by metalloproteases to release the ectodomain as soluble TREM2 (sTREM2). Wild-type sTREM2 binds oligomeric amyloid beta (Aβ) and acts as an extracellular chaperone, blocking and reversing Aβ oligomerization and fibrillization, and preventing Aβ-induced neuronal loss in vitro. Whereas, R47H sTREM2 increases Aβ fibrillization and neurotoxicity. AD brains expressing R47H TREM2 have more fibrous plaques with more neuritic pathology around these plaques, consistent with R47H sTREM2 promoting Aβ fibrillization relative to WT sTREM2. Brain expression or injection of wild-type sTREM2 reduces pathology in amyloid models of AD in mice, indicating that wild-type sTREM2 is protective against amyloid pathology. Levels of sTREM2 in cerebrospinal fluid (CSF) fall prior to AD, rise in early AD, and fall again in late AD. People with higher sTREM2 levels in CSF progress more slowly into and through AD than do people with lower sTREM2 levels, suggesting that sTREM2 protects against AD. However, some of these experiments can be interpreted as full-length TREM2 protecting rather than sTREM2, and to distinguish between these two possibilities, we need more experiments testing whether sTREM2 itself protects in AD and AD models, and at what stage of disease. If sTREM2 is protective, then treatments could be designed to elevate sTREM2 in AD.

Publication Date
2021
Online Publication Date
2022-01-28
Acceptance Date
2021-12-31
Keywords
Alzheimer's disease, TREM2, amyloid beta, microglia, neurodegeneration, neuroinflammation, neuroprotection, sTREM2
Journal Title
Front Aging Neurosci
Journal ISSN
1663-4365
1663-4365
Volume Title
Publisher
Frontiers Media
Sponsorship
Wellcome Trust (084645/Z/08/Z)
Medical Research Council (MR/L010593/1)
European Commission Horizon 2020 (H2020) Research Infrastructures (RI) (115976)
Wellcome Trust (203249/Z/16/Z)
EU IMI2