Sex-dependent APOE4 neutrophil–microglia interactions drive cognitive impairment in Alzheimer’s disease

  • Neta Rosenzweig
  • , Kilian L. Kleemann
  • , Thomas Rust
  • , Madison Carpenter
  • , Madeline Grucci
  • , Michael Aronchik
  • , Nieske Brouwer
  • , Isabel Valenbreder
  • , Joya Cooper-Hohn
  • , Malvika Iyer
  • , Rajesh K. Krishnan
  • , Kisha N. Sivanathan
  • , Wesley Brandão
  • , Taha Yahya
  • , Ana Durao
  • , Zhuoran Yin
  • , Jean Paul Chadarevian
  • , Michael J. Properzi
  • , Roni Nowarski
  • , Hayk Davtyan
  • Howard L. Weiner, Mathew Blurton-Jones, Hyun Sik Yang, Bart J.L. Eggen, Reisa A. Sperling, Oleg Butovsky*
*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

44 Citations (Scopus)
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Abstract

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.

Original languageEnglish
Pages (from-to)2990–3003
Number of pages37
JournalNature Medicine
Volume30
Early online date3-Jul-2024
DOIs
Publication statusPublished - Oct-2024

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