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Higher CSF sTREM2 attenuates ApoE4-related risk for cognitive decline and neurodegeneration.

ABSTRACT: BACKGROUND:The Apolipoprotein E ?4 allele (i.e. ApoE4) is the strongest genetic risk factor for sporadic Alzheimer's disease (AD). TREM2 (i.e. Triggering receptor expressed on myeloid cells 2) is a microglial transmembrane protein brain that plays a central role in microglia activation in response to AD brain pathologies. Whether higher TREM2-related microglia activity modulates the risk to develop clinical AD is an open question. Thus, the aim of the current study was to assess whether higher sTREM2 attenuates the effects of ApoE4-effects on future cognitive decline and neurodegeneration. METHODS:We included 708 subjects ranging from cognitively normal (CN, n?=?221) to mild cognitive impairment (MCI, n?=?414) and AD dementia (n?=?73) from the Alzheimer's disease Neuroimaging Initiative. We used linear regression to test the interaction between ApoE4-carriage by CSF-assessed sTREM2 levels as a predictor of longitudinally assessed cognitive decline and MRI-assessed changes in hippocampal volume changes (mean follow-up of 4?years, range of 1.7-7?years). RESULTS:Across the entire sample, we found that higher CSF sTREM2 at baseline was associated with attenuated effects of ApoE4-carriage (i.e. sTREM2 x ApoE4 interaction) on longitudinal global cognitive (p?=?0.001, Cohen's f2?=?0.137) and memory decline (p?=?0.006, Cohen's f2?=?0.104) as well as longitudinally assessed hippocampal atrophy (p?=?0.046, Cohen's f2?=?0.089), independent of CSF markers of primary AD pathology (i.e. A?1-42, p-tau181). While overall effects of sTREM2 were small, exploratory subanalyses stratified by diagnostic groups showed that beneficial effects of sTREM2 were pronounced in the MCI group. CONCLUSION:Our results suggest that a higher CSF sTREM2 levels are associated with attenuated ApoE4-related risk for future cognitive decline and AD-typical neurodegeneration. These findings provide further evidence that TREM2 may be protective against the development of AD.

SUBMITTER: Franzmeier N

PROVIDER: S-EPMC7545547 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Higher CSF sTREM2 attenuates ApoE4-related risk for cognitive decline and neurodegeneration.

Franzmeier Nicolai N Suárez-Calvet M M Frontzkowski Lukas L Moore Annah A Hohman Timothy J TJ Morenas-Rodriguez Estrella E Nuscher Brigitte B Shaw Leslie L Trojanowski John Q JQ Dichgans Martin M Kleinberger Gernot G Haass Christian C Ewers Michael M

Molecular neurodegeneration 20201008 1

<h4>Background</h4>The Apolipoprotein E ε4 allele (i.e. ApoE4) is the strongest genetic risk factor for sporadic Alzheimer's disease (AD). TREM2 (i.e. Triggering receptor expressed on myeloid cells 2) is a microglial transmembrane protein brain that plays a central role in microglia activation in response to AD brain pathologies. Whether higher TREM2-related microglia activity modulates the risk to develop clinical AD is an open question. Thus, the aim of the current study was to assess whether ...[more]

PMID: 33032659

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Project description:BackgroundTREM2 is a transmembrane receptor that is predominantly expressed by microglia in the central nervous system. Rare variants in the TREM2 gene increase the risk for late-onset Alzheimer's disease (AD). Soluble TREM2 (sTREM2) resulting from shedding of the TREM2 ectodomain can be detected in the cerebrospinal fluid (CSF) and is a surrogate measure of TREM2-mediated microglia function. CSF sTREM2 has been previously reported to increase at different clinical stages of AD, however, alterations in relation to Amyloid ?-peptide (A?) deposition or additional pathological processes in the amyloid cascade (such as tau pathology or neurodegeneration) remain unclear. In the current cross-sectional study, we employed the biomarker-based classification framework recently proposed by the NIA-AA consensus guidelines, in combination with clinical staging, in order to examine the CSF sTREM2 alterations at early asymptomatic and symptomatic stages of AD.MethodsA cross-sectional study of 1027 participants of the Alzheimer's Disease Imaging Initiative (ADNI) cohort, including 43 subjects carrying TREM2 rare genetic variants, was conducted to measure CSF sTREM2 using a previously validated enzyme-linked immunosorbent assay (ELISA). ADNI participants were classified following the A/T/N framework, which we implemented based on the CSF levels of A?1-42 (A), phosphorylated tau (T) and total tau as a marker of neurodegeneration (N), at different clinical stages defined by the clinical dementia rating (CDR) score.ResultsCSF sTREM2 differed between TREM2 variants, whereas the p.R47H variant had higher CSF sTREM2, p.L211P had lower CSF sTREM2 than non-carriers. We found that CSF sTREM2 increased in early symptomatic stages of late-onset AD but, unexpectedly, we observed decreased CSF sTREM2 levels at the earliest asymptomatic phase when only abnormal A? pathology (A+) but no tau pathology or neurodegeneration (TN-), is present.ConclusionsA? pathology (A) and tau pathology/neurodegeneration (TN) have differing associations with CSF sTREM2. While tau-related neurodegeneration is associated with an increase in CSF sTREM2, A? pathology in the absence of downstream tau-related neurodegeneration is associated with a decrease in CSF sTREM2.

Dataset Information

Higher CSF sTREM2 attenuates ApoE4-related risk for cognitive decline and neurodegeneration.

Publications

Higher CSF sTREM2 attenuates ApoE4-related risk for cognitive decline and neurodegeneration.

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