Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Institute for Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, Bonn, Germany.
Nat Med. 2024 Oct;30(10):2990-3003. doi: 10.1038/s41591-024-03122-3. Epub 2024 Jul 3.
APOE4 is the strongest genetic risk factor for Alzheimer's disease (AD), with increased odds ratios in female carriers. Targeting amyloid plaques shows modest improvement in male non-APOE4 carriers. Leveraging single-cell transcriptomics across APOE variants in both sexes, multiplex flow cytometry and validation in two independent cohorts of APOE4 female carriers with AD, we identify a new subset of neutrophils interacting with microglia associated with cognitive impairment. This phenotype is defined by increased interleukin (IL)-17 and IL-1 coexpressed gene modules in blood neutrophils and in microglia of cognitively impaired female APOE ε4 carriers, showing increased infiltration to the AD brain. APOE4 female IL-17 neutrophils upregulated the immunosuppressive cytokines IL-10 and TGFβ and immune checkpoints, including LAG3 and PD-1, associated with accelerated immune aging. Deletion of APOE4 in neutrophils reduced this immunosuppressive phenotype and restored the microglial response to neurodegeneration, limiting plaque pathology in AD mice. Mechanistically, IL-17F upregulated in APOE4 neutrophils interacts with microglial IL-17RA to suppress the induction of the neurodegenerative phenotype, and blocking this axis supported cognitive improvement in AD mice. These findings provide a translational basis to target IL-17F in APOE ε4 female carriers with cognitive impairment.
载脂蛋白 E4(APOE4)是阿尔茨海默病(AD)最强的遗传风险因素,女性携带者的优势比增加。针对淀粉样斑块的治疗在非 APOE4 携带者的男性中显示出适度的改善。利用两性 APOE 变体的单细胞转录组学、多重流式细胞术以及在两个独立的 APOE4 女性 AD 携带者队列中的验证,我们鉴定出一种与认知障碍相关的新型中性粒细胞与小胶质细胞相互作用的亚群。这种表型的特征是血液中性粒细胞和认知障碍的 APOE ε4 携带者的小胶质细胞中白细胞介素(IL)-17 和 IL-1 共表达基因模块增加,显示出向 AD 大脑的浸润增加。APOE4 女性 IL-17 中性粒细胞上调了免疫抑制细胞因子 IL-10 和 TGFβ 以及免疫检查点,包括 LAG3 和 PD-1,与加速免疫衰老有关。中性粒细胞中 APOE4 的缺失减少了这种免疫抑制表型,并恢复了小胶质细胞对神经退行性变的反应,限制了 AD 小鼠的斑块病理学。从机制上讲,APOE4 中性粒细胞中上调的白细胞介素 17F 与小胶质细胞白细胞介素 17RA 相互作用,抑制神经退行性表型的诱导,阻断该轴支持 AD 小鼠的认知改善。这些发现为靶向认知障碍的 APOE ε4 女性携带者中的 IL-17F 提供了转化基础。
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