Sex-dependent APOE4 regulation of neutrophil-microglia crosstalk in Alzheimer's disease

APOE4 is the strongest genetic risk factor for late-onset Alzheimer’s disease (LOAD). The role of human APOE
variants in AD has been studied extensively in the regulation of microglia and astrocytes but not in neutrophils.
APOE is also expressed in neutrophils and controls their activation. Moreover, neutrophils have been shown to
play a negative role in AD mice via the induction of microgliosis. Thus, a key question is whether APOE variants
derived from neutrophils control immune responses driven by microglia and contribute to disease progression.
Our long-term goal is to define the role of APOE signaling in regulation neutrophil-microglia interactions in
neurodegeneration and determine which phenotypes and functions play a role in AD. We made the
following preliminary observations: 1) Induction of APOE expression in microglia in AD and tau mice is
associated with a phenotype switch from homeostatic (M0) to neurodegenerative microglia (MGnD); 2) APOE4
drives a neurodegenerative signature in neutrophils; 3) Recruited APOE4-neutrophils promote MGnD-microglia
in APP/PS1 and P301S mice. Based on these findings, we hypothesize that APOE4 inflammatory
neutrophils promote MGnD-microglia and accelerate neurodegeneration and cognitive decline in AD. We
will address our hypothesis in the following aims:
Aim 1: Define how APOE variants in neutrophils affects microglia. We propose to 1) Define the role of
APOE variants in neutrophils in the regulation of neutrophil-microglia crosstalk; and 2) Determine whether
replacement of APOE4 neutrophils with APOE2/3 neutrophils will restore microglial neuroprotective functions.
Aim 2: Define the impact of APOE variants in microglia on neutrophil recruitment to the diseased brain.
We will 1) Determine whether APOE variants modulate microglia to induce recruitment of neutrophils to the brain;
and 2) Investigate the spatial distribution of microglia and neutrophils in the brain of AD and tau mouse models.
Aim 3: Define the role of APOE variants in human neutrophils and their impact on human microglia in
AD. We propose to 1) Characterize human neutrophils isolated from APOE e2, e3 and e4 AD carriers and whether
they directly regulate the MGnD signature in iPSC-microglia; and 2) Investigate the neutrophil-microglia spatial
interactions in AD brain of human APOE e2, e3 and e4 AD carriers.
IN SUMMARY, targeting the APOE-neutrophil-microglia axis may provide a novel approach for therapeutic
modulation of innate immunity in AD and dementia.

Grant Number: 5R01AG075509-05
NIH Institute/Center: NIH
Principal Investigator: Oleg Butovsky