Clearance of cerebral A? in Alzheimer's disease: reassessing the role of microglia and monocytes.
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ABSTRACT: Deficiency in cerebral amyloid ?-protein (A?) clearance is implicated in the pathogenesis of the common late-onset forms of Alzheimer's disease (AD). Accumulation of misfolded A? in the brain is believed to be a net result of imbalance between its production and removal. This in turn may trigger neuroinflammation, progressive synaptic loss, and ultimately cognitive decline. Clearance of cerebral A? is a complex process mediated by various systems and cell types, including vascular transport across the blood-brain barrier, glymphatic drainage, and engulfment and degradation by resident microglia and infiltrating innate immune cells. Recent studies have highlighted a new, unexpected role for peripheral monocytes and macrophages in restricting cerebral A? fibrils, and possibly soluble oligomers. In AD transgenic (ADtg) mice, monocyte ablation or inhibition of their migration into the brain exacerbated A? pathology, while blood enrichment with monocytes and their increased recruitment to plaque lesion sites greatly diminished A? burden. Profound neuroprotective effects in ADtg mice were further achieved through increased cerebral recruitment of myelomonocytes overexpressing A?-degrading enzymes. This review summarizes the literature on cellular and molecular mechanisms of cerebral A? clearance with an emphasis on the role of peripheral monocytes and macrophages in A? removal.
SUBMITTER: Zuroff L
PROVIDER: S-EPMC5425508 | biostudies-literature | 2017 Jun
REPOSITORIES: biostudies-literature
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