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Ewers, Michael; Biechele, Gloria; Suárez-Calvet, Marc; Sacher, Christian; Blume, Tanja; Morenas-Rodriguez, Estrella; Deming, Yuetiva; Piccio, Laura; Cruchaga, Carlos; Kleinberger, Gernot; Shaw, Leslie; Trojanowski, John Q.; Herms, Jochen; Dichgans, Martin; Brendel, Matthias; Haass, Christian ORCID: 0000-0002-4869-1627; Franzmeier, Nicolai (2020): Higher CSF sTREM2 and microglia activation are associated with slower rates of beta-amyloid accumulation. In: EMBO, Vol. 12, No. 9, e12308
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Abstract

Microglia activation is the brain's major immune response to amyloid plaques in Alzheimer's disease (AD). Both cerebrospinal fluid (CSF) levels of soluble TREM2 (sTREM2), a biomarker of microglia activation, and microglia PET are increased in AD; however, whether an increase in these biomarkers is associated with reduced amyloid-beta (Aβ) accumulation remains unclear. To address this question, we pursued a two-pronged translational approach. Firstly, in non-demented and demented individuals, we tested CSF sTREM2 at baseline to predict (i) amyloid PET changes over ∼2 years and (ii) tau PET cross-sectionally assessed in a subset of patients. We found higher CSF sTREM2 associated with attenuated amyloid PET increase and lower tau PET. Secondly, in the AppNL-G-F mouse model of amyloidosis, we studied baseline 18 F-GE180 microglia PET and longitudinal amyloid PET to test the microglia vs. Aβ association, without any confounding co-pathologies often present in AD patients. Higher microglia PET at age 5 months was associated with a slower amyloid PET increase between ages 5-to-10 months. In conclusion, higher microglia activation as determined by CSF sTREM2 or microglia PET shows protective effects on subsequent amyloid accumulation.